Monday, March 5, 2007

Health Plans Can Learn From VHA Turnaround

In 1990, ABC News "Primetime" won an investigative reporters and editors award for a hidden camera account of patient neglect, abuse, and unsanitary conditions at a Veterans Health Administration hospital in Ohio. That same year, JCAHO found that VHA hospitals were at least 20 percent more likely than others to fall below quality standards.

Article 99, starring Kiefer Sutherland, appeared two years later. It was a movie drama about a group of Kansas City VHA hospital doctors forced to contend with bureaucratic red tape, inefficiency, and a paperwork abundance that left patients in the lurch.

Despite the negative publicity, the bloated, politicized VHA system remained impervious to gripes about substandard care and service at its 172 hospitals, 194 outpatient clinics, and 128 nursing homes.

Often, veterans continued to wait an entire day to be seen, arriving at 9 a.m. with a book and a sandwich. Prescription refills were not usually permitted without a personal appearance. A hospital stay was sometimes required to pick up crutches. One vet reported it took him more than five years to obtain a hearing aid. At the lowest point, decomposed remains of several patients were found near a Salem, Va., VHA hospital a year after their last disappearance. They had wandered into the woods. It is no wonder that 90 percent of eligible veterans chose private alternatives over the VHA.

"Care was lousy across the board," says Rick Weidman, executive director for policy and government affairs for the Vietnam Veterans of America. "Older vets felt no matter how bad it was, that was their lot," says the one-time Vietnam War army medic.

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