The landscape of veteran healthcare is evolving, with increased emphasis on delivering care through community providers. This shift is largely due to initiatives like the VA MISSION Act of 2018, which established the Veterans Community Care Program. This program marks a significant change for the Department of Veterans Affairs (VA), aiming to broaden access to healthcare for eligible veterans outside of traditional VA facilities. But What Is A Program Statement For Community Care in this context, and what are the key aspects veterans should be aware of?
Recent findings from the Government Accountability Office (GAO) shed light on critical areas within the Veterans Community Care Program. Over the past decade, as Congress expanded community care options, GAO has been monitoring and evaluating the program’s effectiveness. Their reports highlight both progress and persistent challenges, particularly in scheduling efficiency and contractor oversight. Understanding these findings is crucial for veterans seeking to utilize community care services.
Scheduling and Wait Times: Ensuring Timely Access to Care
A fundamental aspect of effective healthcare is timely access. The VA recognizes wait times as a crucial metric for both care within Veterans Health Administration (VHA) facilities and in the community. GAO investigations have consistently focused on this area.
One key recommendation from a June 2018 GAO report urged the VA to establish a comprehensive community care scheduling process. This included setting timeframes for referral processing, appointment scheduling, and the actual occurrence of appointments. While the VA has made progress by implementing timeframes for referral processing and appointment scheduling, the establishment of standard timeframes for when appointments must occur remains incomplete. This gap highlights an ongoing need for improvement in ensuring veterans receive timely care in the community.
Further scrutiny in a January 2025 GAO report focused on VHA’s Referral Coordination Initiative. This initiative was designed to streamline scheduling and enhance the veteran experience. However, GAO found inconsistencies in its implementation, pointing to a need for stronger program direction and clearer guidance. GAO recommended that VHA solidify program direction through documented strategic goals, consistent implementation standards, defined roles and responsibilities, and robust oversight and accountability measures within national policy. The VA has agreed with this recommendation in principle, indicating ongoing efforts to address these scheduling challenges.
Contract Oversight and Network Adequacy: Managing Community Care Providers
The VHA’s Office of Integrated External Networks plays a vital role in managing the community care program. This office is responsible for developing, leading, and overseeing contracts and provider networks that serve veterans in the community. Effective oversight is essential to ensure that these networks are adequate and provide high-quality care.
GAO reports have identified areas where VA’s contract oversight needs strengthening. A November 2022 report highlighted the need for improved data and oversight of community care network providers, leading to two recommendations, both of which the VA has implemented.
However, an August 2024 GAO report revealed persistent weaknesses in VA’s contract oversight mechanisms. The office responsible for this critical function lacked a complete and clear set of guidelines for oversight procedures, among other concerns. To address these shortcomings, GAO issued three recommendations. The VA has concurred with these recommendations and outlined planned actions for improvement, which GAO will continue to monitor.
Conclusion: Moving Towards Improved Community Care for Veterans
The Veterans Community Care Program is a critical avenue for providing healthcare to millions of veterans. As the number of veterans receiving community care has grown significantly, ongoing evaluation and improvement are paramount. GAO’s findings and recommendations provide a roadmap for the VA to enhance the program’s effectiveness. Addressing the remaining challenges in scheduling timeliness and contract oversight is crucial to ensuring veterans receive the high-quality, timely care they deserve through community care programs. Understanding the program statement for community care means recognizing both its potential and the ongoing efforts needed to optimize its implementation and impact for veterans.
This analysis is based on information from seven GAO reports issued between 2018 and 2025, including: GAO-18-281, GAO-20-643, GAO-23-105290, GAO-23-105617, GAO-24-106410, GAO-24-106390, and GAO-25-106678. For detailed information, refer to these reports available at the GAO website.
