VA Health Care: Actions Needed to Improve Information Reported on Mobile Medical Units
Fast Facts
The Department of Veterans Affairs uses mobile medical units to provide primary and specialty care to veterans with limited access to health care, such as those in rural areas. The units can help reduce veterans' travel burdens and address provider shortages.
Each year, VA reports to Congress about the units, but the reports contain inaccuracies and lack context. For example, some units reported as active were not in use, and VA didn't explain why about half of the active units didn't have appointment data in 2023. Without better reports, Congress won't know if the units improve veterans' access to care.
Our recommendations address this issue.
A Department of Veterans Affairs Mobile Medical Unit
Highlights
What GAO Found
The Department of Veterans Affairs (VA) operates mobile medical units to provide medical services to veterans. These units can deliver primary and specialty care to veterans in communities with veteran populations too small to support local facilities, such as VA clinics, or in areas with limited access to specialty care.
Example of a Department of Veterans Affairs Mobile Medical Unit
GAO found that VA's annual reports to Congress about the operations and performance of mobile medical units did not have quality information. Specifically, VA reported some information that was inaccurate or lacked context on why some operational requirements were not being met. For example, in its 2023 report, VA reported there were 52 active units. However, 25 of them reported appointment data. GAO also found:
- VA inaccurately included nine of the 20 mobile medical units in GAO's review in its total number of active units. Per VA's definition, these nine units were not active, meaning they were not open and treating patients away from parent facilities. VA officials said they do not assess the reliability of information they report on the units because such information is taken from existing databases.
- VA did not provide context for why 20 of 25 mobile medical units reporting appointment data did not meet VA's operational requirement to conduct 845 appointments. For example, one unit in GAO's review conducted 17 appointments; however, the unit was not yet fully operational. VA is not required to include such context, but without it, VA's report suggests that unit was underperforming.
Without quality information, VA and Congress cannot rely on VA's reports for a complete picture of overall operations and performance of mobile medical units. As a result, they may miss opportunities to use these units effectively to help ensure access to care for rural veterans, especially those living in areas with limited access.
Why GAO Did This Study
Mobile medical units are vehicles equipped to deliver clinical services in self-contained environments away from parent facilities. Congress included a provision in the Veterans Access, Choice, and Accountability Act of 2014 for VA to develop operational requirements for these units and annually report on performance against those requirements.
GAO was asked to review VA's mobile medical units. This report's objectives include examining the information VA reports to Congress on the units' operations and performance.
GAO reviewed VA's annual reports to Congress for 2018 through 2023, VA policies, and data for fiscal year 2022. GAO also interviewed officials from the Veterans Health Administration's Office of Emergency Management and from five regional networks and the 12 VA medical centers in those regional networks about their 20 units. Regional networks were selected for variation in geographic location and number of units, and to include a mixture of rural and urban VA medical centers. GAO also interviewed representatives from two veterans service organizations.
Recommendations
GAO is making two recommendations to VA: (1) assess the reliability of data it reports on mobile medical units and ensure their reliability, and (2) include contextual information about unit operations in its reports to Congress. VA concurred or concurred in principle with GAO's recommendations and identified steps it plans to take to address them.
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Veterans Affairs | The Department of Veterans Affairs Under Secretary for Health should assess the reliability of the data it reports to Congress on the operations and performance of its MMUs and ensure the reliability of the data it reports. (Recommendation 1) |
As of May 2024, VHA reported on actions it has taken to develop a data management strategy. VHA was instructed to develop a Concept of Operations for VHA Mobile Assets, that will evaluate the existing MMU data capture methodology. We will continue to monitor the department's progress toward implementing this recommendation
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| Department of Veterans Affairs | The Department of Veterans Affairs Under Secretary for Health should include contextual information on MMU operations and performance to supplement the information it provides in its reports to Congress. Such information should include the types of services MMUs provide, as well as other information on operational conditions and any limitations, as appropriate. (Recommendation 2) |
As of July 2024, VHA reported it plans to identify limitations in MMU reporting and data capture and include contextual information on the uses of MMUs in upcoming reports to Congress. We will continue to monitor the department's progress toward implementing this recommendation.
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