VA, DoD Leaders Questioned About Handling Influx of New Veterans in System

by U.S. Medicine

September 6, 2012

By Sandra Basu

WASHINGTON — How exactly does the VA plan to address its claims backlog problem with a wave of new veterans entering to the system? Can DoD and VA handle the needs of the influx of returning troops transitioning out of the military?

These were among the questions on which members of two House committees pressed VA Secretary Eric Shinseki and Defense Secretary Leon Panetta at a recent 2.5-hour congressional hearing.

The two sometimes were blunt in their responses. “This system is going to be overwhelmed. Let’s not kid anybody,” Panetta said at one point. “We are looking at a system that is already overwhelmed.”

Based on historical data, the problem will not resolve itself anytime soon. Shinseki predicted that VA’s requirements will “continue to grow for about a decade or … more” after the last U.S. troops leave Afghanistan.

“Over the next five years, there is the potential for one million serving men and women to either leave military service or demobilize from active duty,” he explained in written testimony. “The newest of our nation’s veterans are relying on VA at unprecedented levels. Most recent data indicate that, of the approximately 1.4 million veterans who returned from deployments to Iraq and Afghanistan, roughly 67% are using some VA benefit or service.”

Further complicating the picture is the prospect of sequestration, which calls for $500 billion in cuts from defense spending unless a debt-reduction plan is agreed upon by Congress. If sequestration is enacted, it could mean cutting 100,000 military personnel from the DoD budget, and VA’s healthcare system likely would have to take up the slack. These cuts would be on top of $487 billion DoD cuts that are already scheduled to take effect.

Defense Secretary Leon E. Panetta and Veterans Affairs Secretary Eric K. Shinseki testify at a joint hearing of the House Armed Services and Veterans Affairs committees. DOD photo

“Whatever impacts [DoD] will have some effect here,” Shinseki told the committee.

Claims Backlog

VA officials have been touting the Transformation Campaign Plan as a way to improve the claims process, which has been bogged down with 558,000 backlogged claims, as of mid-July. In FY 2012, VA’s backlog reduction target is 60%. Overall, VA’s goal is to be able to process all claims within 125 days with 98% accuracy by 2015.

House members at the hearing seemed skeptical that the VA would be able to meet these goals, particularly with new beneficiaries entering the system.

VA, DoD Leaders Questioned About Handling Influx of New Veterans in System

“How can you do this, if roughly almost 700,000 new servicemembers are coming in? … How are you going to cut the backlog in half and increase the accuracy by almost 30% to 40%?” asked Rep. Cliff Stearns (R-FL).

A key element of the VA’s strategy is the new Veterans Benefit Management System that will automate the previously paperbound claims process, Shinseki said. According to the VA, the new system has cut the average time to process claims to 119 days in pilot programs. The system already is deployed to four regional office locations, and 12 more offices are slated tol use the system in FY 2012. By 2013, the system will be in all 56 VA regional offices.

“We get paper from DoD, and we are a paperbound process. So, in order to go paperless in VA, it will take coordination with both departments. We are piloting that automation tool today,” Shinseki said.

“Congressman, what you pointed out is a hell of a challenge,” Panetta added. “We are not kidding anybody. What you pointed out is exactly the concern, because we are going to be adding more and more to that list. I think the key for us, if we can develop the systems to deal with what we are dealing with now and make that work; it will be much easier as individuals come on board. If we don’t deal with it and make it more efficient now, then it will become even a worse problem in the future.”

Shinseki acknowledged to lawmakers that VA, “created the backlog in large measure” through decisions it has made to expand benefits to veterans..

“We made an Agent Orange decision that added a quarter of a million claims to the existing inventory,” he said. “We made a decision on combat-related PTSD that added half a million claims to the inventory. Some would say, ‘Why would you do that?’ But it was the right decision to do for veterans who have waited for many, many years.”

Integrated Electronic Health Record

Members of Congress also expressed frustration about the length of time it is taking the agencies to build an integrated electronic health record. The target date for the iEHR to replace the DoD’s and VA’s separate electronic health record systems is 2017.

Earlier this year, it was announced that, in 2014, initial capabilities of iEHR will be rolled out at San Antonio, TX and Hampton Roads, VA, in two test sites.

Progress still is not fast enough, the lawmakers said.

“Another five years is unacceptable,” said Rep. Bill Johnson (R-OH). “It’s unacceptable to me. And, gentlemen, it should be unacceptable to you.”

Rep. Jeff Miller (R-FL) also said he could not understand why it was taking so long.

“In 1961, John F. Kennedy said we’d put a man on the moon,” he said. “Eight years later, America was there. … We are not starting from ground zero with an electronic health record. Why is it taking so long?”

Panetta and Shinseki agreed that the need for a joint record is critical.

“We are working on a major initiative to do that,” Panetta said. “For too long, efforts to achieve a real seamless transition between our healthcare systems have been hamstrung by separate legacy health-record systems.”

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