WASHINGTON — Does the Department of Veterans Affairs need a BRAC round?

A board to move and close unneeded hospitals — such as the military system to shutter old bases — is one of the recommendations in a landmark independent review of the VA released Friday.

The long-awaited report mandated by Congress found an agency plagued by problems of leadership and bureaucracy while also struggling to provide uniform, high-quality health care. It determined that radical changes might be needed for the agency’s Health Administration to emerge from its ongoing crisis.

Lawmakers ordered up the review last summer at the height of the VA’s scandal over manipulation of patient wait times at hospitals and clinics across the country. The report, dated Sept. 1, was written by the federally funded group CMS Alliance to Modernize Healthcare and posted Friday morning to the VA website.

Teams conducting the review “consistently found that VHA’s health care facilities deliver strikingly different patient experiences, apply inconsistent business processes, and differ widely on key measures of performance and efficiency.”

The review also said the health care system is “plagued by many problems: growing bureaucracy, leadership and staffing challenges, and an unsustainable trajectory of capital costs.”

Such findings track with myriad audits and media reports over the past 18 months that have documented widespread VA dysfunction. The wait-time manipulation, which led to the resignation of then-VA secretary Eric Shinseki, began the turmoil in 2014 and snowballed into the biggest scandal in the agency’s history.

The review makes some bold recommendations for turning the VA around.

Congress should create a governance board to guide the new VA strategy. The board could also reshape the agency’s geographic footprint, moving or closing hospitals to better serve veteran health care needs, similar to the Base Realignment and Closure process, it said.

Lawmakers and the VA must also decide the agency’s place in the modern era of health care. The 16 members of the review panel wrote a letter to VA Secretary Bob McDonald — included in the review package — suggesting that the agency consider scaling back care to “focus on specific areas of service-related conditions.”

Chairmen of the Senate and House veterans affairs committees issued a joint statement Friday saying the review proves that fears last year of deeper dysfunction in veterans’ hospitals were justified.

“The VA can no longer deny that its problems, as outlined in this report, are deep-seated and systemic. From delays in care and scandal cover-ups, to rampant unaccountability and a lack of leadership, the VA is an organization challenged at every level,” Sen. Johnny Isakson, R-Ga., and Rep. Jeff Miller, R-Fla., said.

The House committee will hold a hearing on the findings Oct. 7 titled “a call for system-wide change.”

In a response Friday, the VA said it welcomes the findings and that it has already undertaken what it calls a “radical transformation” under McDonald’s leadership.

The initiative, started a year ago, has been branded MyVA and is aimed at streamlining what the review called one of the country’s largest and most complex organizations to focus on service to vets. The health care system is comprised of 167 medical centers in 50 states and employs about 300,000 people.

The VA said the review findings are consistent with what it has found during its internal overhaul.

“VA will especially work closely with Congress on those final report recommendations that specify specific congressional action needed to implement,” the agency statement said.

The review drew fire from the conservative group Concerned Veterans for America, which called it “bulletproof” evidence that the VA needs a major restructuring.

“This report is yet another indictment of the VHA’s current inability to deliver timely, quality health care to our nation’s veterans, and calls for nothing less than a ‘system-wide reworking’ of the VHA,” CEO Pete Hegseth said in a statement.

The group has called for partially privatizing the Health Administration to solve its dysfunction.

tritten.travis@stripes.com
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