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Years After Scandal, the VA Is Still Reporting Misleading Medical Appointment Wait Times for Veterans

The department is not "clearly and accurately presenting" how long patients wait for appointments, IG says.

Despite widespread attention and funding to address the Veterans Affairs Department's failures to present accurate data on how long patients wait for medical appointments, a new audit found the agency is still in some instances relying on misleading information in its public reports. 

Deceptive practices to hide true wait times led to a national scandal in 2014 and multiple legislative overhauls aimed at creating more transparency and allowing veterans to receive medical care more quickly. VA has launched two public websites to show patients and stakeholders what delays they might face in scheduling an appointment, but an audit from the department’s inspector general released on Thursday found they are reporting the data inconsistently and in a manner that obscures true wait times. 

The issues stem from when VA starts the clock on how long veterans must wait for care. Consistent with federal statute and regulation, a website stood up in 2014 uses the “request date” as the starting point, or when a clinician or patient requests an appointment take place. Another site launched in 2017, Access to Care, however, has relied on the “create date” for new patients, meaning the date that a scheduler actually books an appointment. 

As an example, the IG said in one case a veteran saw a doctor on June 28, 2021. The doctor suggested the patient see a cardiologist, putting that same day as the “request date” so the patient would be scheduled as soon as possible. A VA scheduler did not actually book an appointment—set for early September of that year—until nearly a month later. That led to the wait time being logged as only 43 days, instead of the actual total of 66. 

Last year, the then-acting undersecretary for health at VA acknowledged to the IG that the department never tackled the issue of how to measure wait times. The IG absolved any individuals of wrongdoing, but wanted to issue an alert so VA management could address its problems. 

“Calculating wait times is complex, and it has been challenging for [the Veterans Health Administration] to consistently implement a suitable methodology that transparently and accurately reflects the amount of time patients wait for an appointment,” the IG said. “As a result, VHA has sometimes presented wait times with different methodologies, using inconsistent start dates that affect the overall calculations without clearly and accurately presenting that information to the public.”

Mark Ballesteros, a VA spokesman, said VA is consistently “striving to do more” as it looks to boost transparency. Part of that process, he added, is standardizing how appointments are scheduled to ensure “all veterans receive uniform, timely access to care, regardless of the location or type of care.”

The Veterans Health Administration “appreciates the OIG’s review and is working to develop a more clear and consistent system to measure access and wait times and build upon our public reporting transparency,” Ballesteros said. 

VA has been aware of the issue and has discussed making changes to the process since 2019, the IG said, but has yet to make any adjustments. In addition to potentially providing misleading information to Congress and veterans, the inconsistencies could create problems with eligibility for private sector care on the government’s dime. Veterans can tap into those offerings in part based on their wait times for appointments, but VA is using a different calculation for them.  

“The inconsistent use of start dates for calculating wait times can be misleading and may result in inaccurate reporting,” the IG said. 

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