VA Long-Term Care

More Accurate Measure of Home-Based Primary Care Workload Is Needed Gao ID: GAO-04-913 September 8, 2004

The Department of Veterans Affairs (VA) provides a variety of long-term care services that includes nursing home care and noninstitutional care provided in community-based settings or in the homes of veterans. One important noninstitutional service is home-based primary care, which uses a multidisciplinary team approach involving VA health care providers and others such as social workers to treat veterans who are homebound. As part of GAO's work for the Committee on Veterans' Affairs, House of Representatives, to assess how VA meets veterans' long-term care needs, GAO reviewed how VA measures workload for home-based primary care and five other noninstitutional services.

The amount of home-based primary care veterans receive is not accurately reflected in VA's workload measurement for that service. VA measures home-based primary care workload using the number of days a veteran is enrolled in the program rather than the number of visits the veteran received. For example, if a veteran was enrolled in VA's home-based primary care program for 1 week, and received two visits from VA providers that week, VA would calculate the workload using 7 days, rather than two visits. As a result, using enrolled days as the workload unit of measure overstates the amount of home-based primary care actually received by veterans. In fiscal year 2003, VA reported an average daily workload for home-based primary care of 8,370 using enrolled days; in contrast, GAO determined that using the number of visits results in a workload of 944. In addition, VA's measurement of home-based primary care using enrolled days is inconsistent with the way it measures workload for the other noninstitutional long-term care services GAO reviewed. VA measures workload for these other services using the number of visits a veteran received. As a result, VA's workload total for home-based primary care overstates that service's use compared to other noninstitutional services VA provides.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

Director: Team: Phone:


The Justia Government Accountability Office site republishes public reports retrieved from the U.S. GAO These reports should not be considered official, and do not necessarily reflect the views of Justia.