Right to Care: Recommendations to Improve VA Systems

In 2014, Congress established the Commission on Care, charging the group to examine veteran’s access to Department of Veterans Affairs (VA) healthcare and to provide recommendations on how best to organize the Veterans Health Administration (VHA), locate health resources, and deliver healthcare to veterans during the next 20 years.

Our Executive Director Michael Blecker was one of the 15 commissioners appointed to the Commission on Care, and was tasked by the president and Congress to evaluate the VA healthcare system and provide recommendations on how to improve the VA system of care.

Commissioner Blecker was one of the very few commissioners who represented veterans who use and depend on the VA for healthcare services. In order to amplify the veteran narrative within the Commission on Care, Swords to Plowshares investigated access to VA and non-VA systems-of-care, and measured perceptions of the quality of services among the Swords to Plowshares veteran community.

We used a human-centered design for our user research and conducted one-on-one, in-depth interviews with 22 veteran clients and staff who have accessed VA care locally and throughout the country.

Our findings from these interviews and our research lead Swords to Plowshares to submit a number of recommendations to the Commission on Care:

  • Ensure VA providers can coordinate care
  • Ensure case management, continuity and consistency in providers, especially for those with critical needs
  • Increase access to mental healthcare
  • Communicate to veterans about VA Choice program, VA capacity, and preserve VA’s role as coordinator of care
  • Validation and real talk: customizing communications and offering a multi-faceted approach that is accessible and informs all veterans about their health care choice and outcomes
  • Hire more veterans and increase access to patient advocates and peer mentors
  • Increase cultural competency trainings for VA providers
  • Move toward veteran-focused, and veteran-centric care

The commission’s final report included 18 recommendations aimed at strengthening the administration, and 17 of them outline solid and bold plans for improvement. However, the most significant recommendation did not heed to our Executive Director’s recommendations and redesigns the care-delivery system to include private health care providers. This recommendation for “choice” was not based on data that show cost savings, improved quality of care, or improved access to care.

To view the Swords to Plowshares findings presented to the Commission on Care, please visit the following link: http://bit.ly/RightToCare


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