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Beth McCoy, JDDeputy Under Secretary for Field OperationsVeterans Benefits Administration
FY 14-15: Agency Priority Goal
Eliminate the Disability Claims Backlog
Priority Goal
Goal Overview
VA will provide timely, accurate decisions on Veterans’ disability compensation and eliminate the claims backlog in Fiscal Year (FY) 2015. Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner. In FY 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency. However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this Agency Priority Goal. To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy. As of the end of June 2015, over 94 percent of VBA’s inventory is in an electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS). All claims are either received electronically or are converted to electronic format for processing.
Strategies
Veterans Benefits Administration (VBA) is positioned to achieve the 2015 goal of completing all rating-related disability compensation and pension claims within 125 days with 98% accuracy. VBA’s Transformation Plan integrates people, process, and technology initiatives that incorporate VA’s strategic plan, goals, and objectives. Ideas for initiatives that help improve business processes were solicited from employees and other internal and external stakeholders including Veterans Service Organizations (VSO), state and county service officers, and industry partners, as well as Veterans themselves. Implementation of VBA’s Transformation Plan drives standardization among all employees at the 56 regional offices, establishes a methodology for governing implementation, and ensures that the improvements are sustainable for the future. VBA’s Transformation Plan includes effective communication and change management, detailed implementation planning, establishment of national standards, and effective and measurable training. Utilizing the new organizational model and mandatory overtime, VBA was able to achieve its two highest output months in FY 2013, completing over 128,000 claims in August 2013 and over 129,000 claims in September 2013.
VBA’s integrated approach includes technology solutions that drive automation, improve the quality of work, reduce variance, and speed efforts to complete claims electronically. These innovative technologies include VBMS and the Veterans Relationship Management (VRM), integrating business processes to take into account electronic filing of claims, national workload distribution, as well as the receipt of complete and certified medical, dental, and personnel records from the military services. VBA established the Veterans Claims Intake Program (VCIP) in 2012 to streamline the process for receiving records and data into VBMS. VCIP converts claims and other paper records into a digital format that is usable within VBMS. At the end of September 2013, 60 percent of current claims were in the electronic environment and over 250 million images had been converted from paper and uploaded into VBMS.
Because VBA’s organizational transformation is sweeping and multi-faceted, this major change cannot be a “once-and-done,” “flip-of-the-switch” proposition. Transformation is a deliberate and multi-year process. VBA is pursuing transformation according to a carefully developed timeline and an implementation plan that rolls out changes in people, processes, and technology in a progressive, intentional sequence that enables efficiency gains while minimizing risks to performance.
On April 19, 2013, VBA implemented a special initiative to quickly decide the oldest claims in the inventory. This initiative was created to accelerate the delivery of benefits to Veterans who have waited the longest for a decision, and is a key part of VA’s overall strategy to eliminate the claims backlog in 2015. In June, VA completed the first phase of the initiative, which focused on all claims pending over two years. Over 99 percent of these two-year claims (over 67,000) have been processed for Veterans, eliminating those claims from the backlog. Since that milestone, VBA claims processors focused on completing the claims of Veterans who have been waiting one year or longer for a decision. VA had processed approximately 95 percent of the 513,000 one-year claims as of the end of FY 2013. In FY 2014 and 2015 VBA employees will continue to process oldest claims as a priority.
In addition, VBA implemented mandatory overtime starting in May 2013 for VBA’s claims processing staff. VBA also redistributed, or brokered, work among regional offices to maximize the capacity of the entire VBA workforce to ensure that the next oldest claim was completed on the basis of a national workload.
On October 1, 2012, VBA initiated issue-based reviews of rating claims using the existing Systematic Technical Accuracy Reviews (STAR) process. The primary goal was to identify, down to the specific diagnostic code, all existing benefit entitlement errors, and correct actions at the issue level. These new procedures were also developed to more accurately identify issue-specific deficiencies in rating procedures, and to identify targeted training opportunities. Each claimed condition is evaluated independently using the STAR rating-decision checklist. Dual reporting of claim-based and issue-based accuracy statistics continued through FY 2013.
Since inception, the accuracy of issue-based reviews has averaged six percentage points greater than claim-based reviews. This was primarily due to the evaluation methodology for assessing claim-based accuracy, where one error in a multi-issue claim resulted in a 0% accuracy assessment. For the three months concluding September 30, 2013, issue-based accuracy was 96.7% compared to 90.6% for claim-based reviews. Beginning in October 2013, issue-based accuracy will be reported, as it represents a more appropriate way to measure accuracy. Three-month and twelve-month cumulative accuracy reports for the nation and each regional office will be available.
Launched in January 2013, VBA’s Statistical (STAT) Reviews are robust performance analysis mechanisms that use operational data and graphical visual displays to monitor progress and drive performance improvement. These reviews involve rigorous performance evaluations with VBA senior leadership and regional office directors to analyze and measure results. VBA leaders discuss challenges, successes, best practices, and action plans using targeted data-driven performance measures focused on accountability for improved performance.
VBA continued its strong collaboration with the Veterans Health Administration (VHA). VHA supported the oldest claims initiative by expediting the scheduling of examinations. VHA also used all available resources by temporarily assigning clinicians to conduct examinations, maximizing the use of disability contract examiners, and employing innovative solutions such as the Acceptable Clinical Evidence (ACE) process. ACE facilitates the completion of Disability Benefits Questionnaires (DBQs) using existing medical evidence of record when the clinician determines that the evidence is sufficient to complete the requested evaluation, reducing the need to conduct an in-person VA examination. VHA provides clinicians at VBA regional offices to expedite claims processing by clarifying medical opinions and answering claims processors’ questions.
Through these prioritization initiatives, VBA has made notable progress in reducing both the backlog and the pending inventory and is on track to eliminate the backlog in 2015. As of September 30, 2013, the number of disability claims in the VBA inventory had been reduced from the peak of 884,000 to 722,000, the lowest number of claims since October 2010. In addition, the number of claims in the backlog was reduced by more than 31 percent from 611,000 to 418,000 claims.
Progress Update
During the fourth quarter of FY 2015, VBA made progress on the execution of its claims transformation plan to change the way benefits and services are delivered to Veterans, their families, and Survivors for generations to come.
From the peak in March 2013 through September 30, 2015, the claims backlog (defined as claims that have been pending over 125 days) was reduced from 611,073 to 71,352 claims, an 88.3-percent decrease.
The total inventory of claims dropped 58.9 percent from the peak of 883,930 in July 2012 to 363,034 on September 30, 2015. During this quarter, the percentage of claims in the backlog decreased from 32.6 end of June 19.7 percent at the end of September 2015. There are specific factors of VA’s claims process and the specific nature of some claims that contribute to extend some claims taking longer than 125 days to process. VA must ensure that VA meets its legal obligations to assist Veterans in the development of their claims and provide their full entitlement to benefits. VA will always consider additional evidence or new medical conditions added throughout the claims process; however, late evidence or new contentions stop the momentum made in processing the claim, as it usually require a new round of evidence-gathering, medical examinations, and analysis. Additionally, some complex disability claims may require more extensive evidence gathering, or face difficulties securing necessary evidence. Where possible, VA mitigates the impact of extended processing by providing Veterans with an interim rating decision on as many claimed disabilities as possible, while keeping the claim open to develop for the needed evidence to decide all claims. VBA projects that 15 percent of rating claims fall into the category where they cannot be completed in 125 days.
During this quarter, VBA’s three-month claim-based accuracy decreased from 89.8 percent at the end of June 2015 to 89.0 percent at the end of September 2015. Issue-based accuracy increased slightly from 95.9 percent at the end of June 2015 to 96.0 percent at the end of September 2015. Quality continues to be a strong focus area for VBA. Consistent with Government Accountability Office (GAO) best practices for quality assurance programs, VBA uses a 95-percent confidence level with a five-percent margin for error in accuracy reporting. This means that the accuracy of VBA disability rating claims has not substantially changed in the past quarter. VBA continues to monitor errors and trends to provide feedback and training for VA employees.
As we have made major progress in reducing the claims backlog, we have also dramatically increased the accuracy of our claim decisions. VA’s aspirational 98 percent accuracy goal for disability claims was initially reflected in the 2005 President’s Budget as a method to drive VBA’s decision quality as high as possible – and VA has done that with monumental progress over the past 4 years. In fact, VA is now correct 98 percent of the time in seven of the eight categories measured within a Veteran’s disability claim, with the eighth factor coming in at 97.7 percent.
A recently contracted external analysis found that VA’s 98 percent claim-level accuracy goal is not considered to be achievable in VA’s current human-operated system. Claim-level accuracy measures the claim with the “pass or fail” method. Every issue within each of the eight error categories must be 100-percent accurate to “pass”. Because Veterans are claiming more disabilities than ever before – with separating Servicemembers in our Benefits Delivery at Discharge Program averaging 16 medical conditions per claim – attaining 98 percent accuracy at the claim-level is virtually impossible.
Each quarter, VBMS releases new features and functionalities, allowing the system to evolve to meet the needs of the organization and claim processers. As major software releases are implemented, VBMS progresses toward the future end-state of a complete, end-to-end electronic claims processing system. This quarter, VBMS focused on enhancements within the work queue, the new deferral process, and auto assignment configuration rules in support of National Work Queue rollout in FY 2016. At the end of this quarter, 94.1 percent of the claims inventory for rating end products was in digital format for electronic processing. Paper claims received by VBA are immediately sent for scanning and digitally uploaded to VBMS. As of the end of the FY 2015, more than 1.77 billion images have been scanned through the Veterans Claims Intake Program with 99-percent image accuracy. Scanning provides a front-end catalyst that facilitates shared access to the claims folder and eliminates transfer time delays throughout the claims process.
Due to VBA’s extensive outreach efforts, more Veterans are using an electronic intake method – the joint Department of Defense (DoD)/VA web portal eBenefits – to submit claims electronically. In FY 2013, 2.4 percent of Veterans’ claims (20,035) were received electronically; in FY 2015, 12.5 percent (154,398) of claims were received electronically. As of September 30, 2015, there are 5.1 million registered eBenefits users with access to benefits information and the capability to submit claims and upload evidence online through electronic claims submission that will feed directly into VBMS. Registered eBenefits users with a free premium-level account can also track the status of their claims and access a variety of other benefit information including pension, education, health care, home loan eligibility, and vocational rehabilitation and employment. Additionally, the Stakeholder Enterprise Portal (SEP), an electronic web portal that mirrors eBenefits, allows VA partners and Veterans Service Organizations (VSOs) to electronically file
claims for benefits and services on behalf of Veterans for whom they have power of attorney.
VBA continues to work closely with Congressional and VSO partners to promote VBA’s FDC Program, which reduces the longest phase of the claims-processing timeline by allowing Veterans to certify that they have submitted their claims with all available supporting information and non-Federal private medical evidence. Many Veterans are submitting their claims as FDCs, and more continue to do so thanks in large part to strong support and endorsement by our VSO partners. From July 1, 2015, through September 30, 2015, approximately 62.6 percent of claims received were submitted as FDCs. Veterans filing their initial disability compensation claim as an FDC through August 5, 2015 may be eligible for up to one year of retroactive benefits.
None of the progress VBA has made would be possible without the tremendous support VA receives from its partners including Congress, VSO partners, and county and state Departments of Veterans Affairs. VBA’s progress is also the result of unprecedented effort and dedication by the 21,000+ VBA employees (of which over 50 percent are Veterans themselves), and the support provided by our partners in VA’s Office of Information and Technology and the Veterans Health Administration.
As a direct result of the claims transformation initiatives VBA has implemented over the last three years, VBA is deciding more disability compensation rating claims for Veterans at higher accuracy levels than ever before in the history of VBA. But there is still more work to do. The groundwork laid thus far will help VBA continue to transform the way benefits are delivered to Veterans, their family members, and Survivors for generations to come. As VBA moves into advanced generations of VBMS, it is improving access, driving automation, enabling greater exchange of information, and increasing transparency to Veterans, our workforce, and other stakeholders.
Valuable tools, such as automated disability benefits questionnaires and an embedded rules engine, inject much-needed efficiency and effectiveness into VBA’s system. This helps VBA meet today’s demand while also preparing it to meet the demands of the future. VBMS uses an iterative and agile development model in which software development is broken down into smaller components to design, test, and release new functionality. Progressive software releases will continue building out these automated capabilities, allowing employees to focus on more difficult claims by automating more routine processes. With the transition to a paperless claims process, VBA is in a better position to adopt a national workload management strategy within VBMS that is “boundary-free” and improves overall production capacity to serve Veterans in the same way they served: side by side without regard to state affiliation. With VBMS, VBA can more efficiently manage the claims workload, prioritizing and distributing the claims electronically across its network of regional offices (ROs) to improve resource utilization and improve and normalize processing timeliness.
VBA will continue to drive and incentivize claims filing through eBenefits and SEP, especially the filing of electronic FDCs. VBA is continuing its comprehensive communications and training efforts to increase Veterans’ and stakeholders’ awareness of the ability to file claims online. As VBA continues to refine these technologies, it is also improving its customer relationship management program by increasing integration across VA systems by providing a single view of Veterans’ information, benefits utilization, and interactions across VA. With data from many separate systems available in a single place, VA will have a comprehensive view of each Veteran from his or her service commencement date onward.
FY 2015 Actions & Milestones:
- Completed over 1.38 million claims in FY 2015 compared to 1.32 million in FY 2014.
- Increased percentage of FDC disability compensation receipts from 38.5 percent in FY 2014 to 55.7 percent in FY 2015.
- Increased the annual percent of disability compensation claims received virtually or electronically from 6.9 percent in FY 2014 to 12.5 percent in FY 2015.
- Reduced average days pending for Veterans’ disability claims from 150 days at the end of FY 2014 to 93.1 days at the end of FY 2015.
Next Steps
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Performance Indicators
Reduce the percentage of disability claims pending for more than 125 days
Improve national issue-based rating accuracy for disability claims
Improve national “claim-based” rating accuracy for disability claims.
Contributing Programs & Other Factors
Contributing programs within the agency: Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), National Cemetery Administration (NCA), Board of Veterans Appeals (BVA), Office of Public and Intergovernmental Affairs (OPIA), Office of Information and Technology (OI&T), and Office of Human Resources and Administration (OHRA).
Contributing partners outside the agency: Department of Defense (DOD), Department of Labor (DOL), Social Security Administration (SSA), Department of Education (DOE), and Veterans Service Organizations (VSOs).
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Strategic Goals
Strategic Goal:
Empower Veterans to Improve Their Well-being
Statement:
Empower Veterans to Improve Their Well-being
Strategic Objectives
Statement:
Improve Veteran Wellness and Economic Security
Description:
Summary:
Numerous programs provide a broad spectrum of benefits and support services that assist Veterans and eligible beneficiaries. To enable Veterans and eligible beneficiaries to choose the best benefits and services for their needs, VA will improve coordination between our programs, leverage supportive interactions between programs, and reduce overlap across programs. Success will be measured by the differences made in the lives of the Veterans we serve, including decreasing Veteran unemployment, decreasing home foreclosures, decreasing homelessness, reducing processing times for disability compensation claims, increasing preventive care and healthy lifestyle changes, and increasing access to and utilization of virtual care modalities.
Strategies:
VA will eliminate Veteran homelessness by the end of FY 2015. VA, in collaboration with its Federal partners, will continue to provide rehabilitation services for homeless and at-risk Veterans, including employment assistance, access to permanent and transitional housing, and other supportive services. As the number of homeless Veterans continues to decline, the focus will shift from rescue to prevention.
VA will improve Veteran career readiness to reduce Veteran unemployment. We will synchronize and align Veteran employment programs managed by VA, and improve coordination across the various Federal Veteran employment initiatives. We will increase support to our Veterans with disabilities and those who are GI Bill eligible through programs offering educational and vocational counseling. VA will increase support to Veteran entrepreneurs through public-private partnerships to provide capacity building and by providing access to Federal contracting opportunities.
VA will provide Veterans and eligible beneficiaries with personalized, proactive, patient-driven health care to optimize health and well-being, while providing state-of-the-art disease management. VA’s Patient Aligned Care Teams (PACT) will ensure patient engagement in self-care, preventive services, primary care, and mental health services. PACT is a partnership between the Veteran and the health care team with an emphasis on prevention, health promotion, and self-management. PACTs use a team-based approach, with various members of the team stepping in at different points in time to provide needed care. We will expand and refine, in coordination with DoD, research into the long-term consequences of TBI and PTSD. VA will increasingly seek to understand underlying health, injury and disorder mechanisms to create evidence-based diagnosis, treatment, and rehabilitation methods for Veterans and eligible beneficiaries with support from their families.
Statement:
Increase Customer Satisfaction through Improvements in Benefits and Services Delivery Policies, Procedures, and Interfaces
Description:
Summary:
VA is a customer service organization. Complicated application processes, long processing timelines or difficulties getting information and appointments all impact the client’s experience and satisfaction. Veterans and eligible beneficiaries deserve a support system that is responsive to their needs. VA must keep pace with Veterans’ expectations and transform its customer services – soliciting regular customer feedback, streamlining processes, and delivering consistent service across customer-preferred channels.
We live in a connected world. The rapid pace of technological advancement is reshaping Veterans’ expectations regarding how services, benefits, and support should be delivered. Today’s client expects instant access to information and self-service options via the Internet, and increasingly through mobile devices like tablets and smartphones (and the next generation “smart” devices that are yet to be deployed).
To provide a personalized experience, we must listen, learn, and understand the needs and expectations of those we serve. We must have the knowledge, information and insight to understand why some choose not to fully engage with VA.
Strategies:
VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog. We will then implement a robust plan, and revisit procedures to ensure claims are addressed in no more than 125 days with at least 98 percent accuracy. The plan includes redesigning policies and procedures, continuing to enhance training for claims processors, and utilizing the most advanced IT. We will also increase the use of video teleconference hearings to address claims appeals.
VA will continue to expand implementation of PACT to improve partnerships with Veterans and eligible beneficiaries, increase team-based care coordination and management, and expand access to care. VA will improve patient-facing and clinician-facing e-health systems by expanding the development and use of health-related virtual modalities. These modalities include telehealth[1], E-Consult[2], secure messaging, MyHealtheVet, and mobile applications.
VA will enhance client satisfaction by capturing client data once, sharing it enterprise-wide, and using this client data for a lifetime, which will promote more efficient use of data across business lines. We will identify sources of consistent, reliable, and authoritative Veteran data. We will establish architecture, business rules, roles and responsibilities, and governance to enable VA lines of business to use the authoritative common client data to improve delivery of benefits and services to Veterans. VA will gain access to additional external data, knowledge, and experiences so we can broaden our understanding of our client’s needs and expectations. We will enable secure, privacy-protected electronic exchange of personal, health, and economic data on Veterans from induction oath through the final survivor benefit.
VA will rethink its operations as a Department, defining the fundamental crosscutting capabilities and interdependencies required to perform them. We will identify and address any internal organizational, policy, procedural, perceptual, and cultural boundaries that constrain our ability to coordinate, integrate, and deliver benefits and services.
VA will streamline its virtual presence (Web sites, portals and call centers), reducing duplication and enhancing personalization to enable clients to get the information they need, on their schedule.
VA will increase access to burial benefits in national cemeteries through its plans to construct five new national cemeteries and by recognizing and addressing the unique needs of Veterans and eligible beneficiaries who reside in densely populated urban areas as well as sparsely populated rural locations. We will ensure that the service and appearance of our national cemeteries meets the highest standards commensurate with these national shrines.
[1] Telehealth uses information and telecommunication technologies to provide health care services in situations in which the patient and practitioner are separated by geographical distance. Telehealth in VA increases access to high quality health care services using Clinical Video Telehealth (CVT), Home Telehealth (HT) and Store and Forward Telehealth (SFT).
[2] E-Consult is an approach to provide clinical support from provider to provider. Through a formal consult request, processed and documented in the Computerized Patient Record System, a provider requests a specialist to address a clinical problem or to answer a clinical question for a specific patient. Utilizing information provided in the consult request and/or review of the patient’s electronic medical record, the consultant provides a documented response that addresses the request without a face-to-face visit.
Agency Priority Goals
Statement:
|
Improve client and stakeholder awareness of, and access to, Veterans benefits and health care services. By September 30, 2015, VA will increase the use of virtual service options by increasing the percent of claims received electronically, by increasing the number of accredited Veterans service officers registered on the Stakeholder Enterprise Portal, by increasing the number of registered eBenefits users, and by increasing the percent of patients who access VA health care using a virtual format such as video telehealth or online services.
Indicators:
|
Description:
VA’s focus in Fiscal Year (FY) 2015 is to deliver seamless and integrated services while increasing the efficiency and effectiveness of virtual access. To achieve the best possible outcomes for Veterans, Servicemembers, and eligible beneficiaries, VA will improve access to, and encourage the use of, its virtual benefits and services. VA and Department of Defense (DoD) have established a jointly supported portal known as eBenefits, which allows Veterans, Servicemembers, and other eligible beneficiaries to access and submit information when, where, and how they want.
The development and proliferation of virtual access to care supports an organizational approach that is personalized, proactive, and patient-driven. VA virtual health services use technology and health informatics to provide Veterans with better access and more effective care management. Advances in virtual care expand where health care services can be accessed, reduce the need for travel to medical facilities, and transform VA’s delivery of health care and its effect on patients’ health outcomes.
Statement:
|
Improve accuracy and reduce the time it takes to complete disability compensation benefit claims. Eliminate the disability claims backlog and process all claims in 125 days in FY 2015.
Indicators:
* VA is in the midst of reviewing its claims processing accuracy metrics and goals to ensure VA continues to drive decisions of the highest quality. VA plans to engage its VSO partners and other stakeholders as more information becomes available. |
Description:
VA will provide timely, accurate decisions on Veterans’ disability compensation and eliminate the claims backlog in Fiscal Year (FY) 2015. Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner. In FY 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency. However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this Agency Priority Goal. To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy. As of the end of June 2015, over 94 percent of VBA’s inventory is in an electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS). All claims are either received electronically or are converted to electronic format for processing.
Statement:
In partnership, the Department of Housing and Urban Development (HUD) and VA aim to reduce the number of Veterans living on the streets, experiencing homelessness to zero (as measured by the FY 2016 PIT Count).
Indicators:
- Reduction in homeless Veterans living on the streets, experiencing homelessness to zero (as measured by the FY 2016 PIT Count).
- The “Number of Homeless Veterans” on a single night is determined by the PIT Count, which is conducted annually the last week of January each year “The PIT Count reflects the results of the work performed and the fiscal obligation/budget made in the prior fiscal year.”
- Reduction in total homeless Veterans temporarily living in shelters or transitional housing to 12,500 (as measured by the FY 2016 PIT Count).
Description:
VA has taken decisive action toward its goal of ending homelessness among Veterans. The End Veteran Homelessness initiative is intended to prevent Veterans and their families from entering homelessness and to assist those who are homeless in exiting as safely and quickly as possible. VA’s “no wrong door” philosophy will ensure that homeless and at risk for homeless Veterans have timely access to appropriate housing and services. Any door a Veteran comes to - at a medical center, a regional office, or a community organization - will lead to the tools to offer Veteran assistance. Ending homelessness among Veterans will advance the mission of VA by ensuring that all Veterans and their families achieve housing stability.
On a single night in January 2014 during the Point in Time (PIT) Count [1], there were 49,933 homeless Veterans in the US. Effectively ending homelessness among Veterans requires rapid access to permanent housing, health care, employment, benefits, and other supportive services. VA works closely with community partners to meet current and new demands for any Veteran who is experiencing or is at imminent risk of homelessness. Housing First and Rapid Re-housing are two of the many evidence-based approaches VA uses to end homelessness. The Housing First model follows the philosophy of providing permanent housing as quickly as possible to Veterans/individuals experiencing homelessness and then wrapping health care and other supportive services as needed around the Veteran to sustain housing and improve their quality of life. Rapid Re-housing is a set of strategies to help families quickly move out of homelessness and into permanent housing. It typically involves: housing search and landlord mediation assistance, short-term or flexible rental assistance, and transitional case management services. Rapid Re-housing provides crisis intervention services to quickly place an individual or family who is currently homeless into a permanent, sustainable housing situation.
[1] The annual PIT estimates are a snapshot of homelessness. They are submitted to HUD each year by communities and account for homeless Veterans in emergency shelters or transitional housing on the night of the PIT count (i.e., sheltered) as well as homeless Veterans who are in places not meant for human habitation such as the streets, abandoned buildings, cars, or encampments (i.e., unsheltered). Communities typically conduct their PIT count during the last week in January when a large share of the homeless population is expected to seek shelter rather than stay outside. Because counting people in shelters is more precise than conducting street counts, the timing of the PIT count is intended to improve the accuracy of the estimates. (Source: Veteran Homelessness: A Supplemental Report to the FY 2010 Annual Homeless Assessment Report to Congress).
Strategic Objectives
Strategic Objective:
Statement:
Increase Customer Satisfaction through Improvements in Benefits and Services Delivery Policies, Procedures, and Interfaces
Description:
Summary:
VA is a customer service organization. Complicated application processes, long processing timelines or difficulties getting information and appointments all impact the client’s experience and satisfaction. Veterans and eligible beneficiaries deserve a support system that is responsive to their needs. VA must keep pace with Veterans’ expectations and transform its customer services – soliciting regular customer feedback, streamlining processes, and delivering consistent service across customer-preferred channels.
We live in a connected world. The rapid pace of technological advancement is reshaping Veterans’ expectations regarding how services, benefits, and support should be delivered. Today’s client expects instant access to information and self-service options via the Internet, and increasingly through mobile devices like tablets and smartphones (and the next generation “smart” devices that are yet to be deployed).
To provide a personalized experience, we must listen, learn, and understand the needs and expectations of those we serve. We must have the knowledge, information and insight to understand why some choose not to fully engage with VA.
Strategies:
VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog. We will then implement a robust plan, and revisit procedures to ensure claims are addressed in no more than 125 days with at least 98 percent accuracy. The plan includes redesigning policies and procedures, continuing to enhance training for claims processors, and utilizing the most advanced IT. We will also increase the use of video teleconference hearings to address claims appeals.
VA will continue to expand implementation of PACT to improve partnerships with Veterans and eligible beneficiaries, increase team-based care coordination and management, and expand access to care. VA will improve patient-facing and clinician-facing e-health systems by expanding the development and use of health-related virtual modalities. These modalities include telehealth[1], E-Consult[2], secure messaging, MyHealtheVet, and mobile applications.
VA will enhance client satisfaction by capturing client data once, sharing it enterprise-wide, and using this client data for a lifetime, which will promote more efficient use of data across business lines. We will identify sources of consistent, reliable, and authoritative Veteran data. We will establish architecture, business rules, roles and responsibilities, and governance to enable VA lines of business to use the authoritative common client data to improve delivery of benefits and services to Veterans. VA will gain access to additional external data, knowledge, and experiences so we can broaden our understanding of our client’s needs and expectations. We will enable secure, privacy-protected electronic exchange of personal, health, and economic data on Veterans from induction oath through the final survivor benefit.
VA will rethink its operations as a Department, defining the fundamental crosscutting capabilities and interdependencies required to perform them. We will identify and address any internal organizational, policy, procedural, perceptual, and cultural boundaries that constrain our ability to coordinate, integrate, and deliver benefits and services.
VA will streamline its virtual presence (Web sites, portals and call centers), reducing duplication and enhancing personalization to enable clients to get the information they need, on their schedule.
VA will increase access to burial benefits in national cemeteries through its plans to construct five new national cemeteries and by recognizing and addressing the unique needs of Veterans and eligible beneficiaries who reside in densely populated urban areas as well as sparsely populated rural locations. We will ensure that the service and appearance of our national cemeteries meets the highest standards commensurate with these national shrines.
[1] Telehealth uses information and telecommunication technologies to provide health care services in situations in which the patient and practitioner are separated by geographical distance. Telehealth in VA increases access to high quality health care services using Clinical Video Telehealth (CVT), Home Telehealth (HT) and Store and Forward Telehealth (SFT).
[2] E-Consult is an approach to provide clinical support from provider to provider. Through a formal consult request, processed and documented in the Computerized Patient Record System, a provider requests a specialist to address a clinical problem or to answer a clinical question for a specific patient. Utilizing information provided in the consult request and/or review of the patient’s electronic medical record, the consultant provides a documented response that addresses the request without a face-to-face visit.
Agency Priority Goals
Statement: Improve Veterans Experience with VA: Fulfilling our country’s commitment to Veterans, VA will deliver effective and easy customer experiences in which Veterans feel valued. By September 30, 2017, reach 90% agreement with the statement “I trust VA to fulfill our country’s commitment to Veterans.” Because this is a new measure, VA will establish the baseline in FY16 and add the measure to surveys covering all of VA’s primary services and product lines.
Description: VA offers a remarkable array of services and benefits to Veterans and eligible dependents. But the experience is disjointed and inconsistent. There are hundreds of phone numbers and thousands of websites, each operating independently under different standards. Similarly, there are a wide array of VA and non-VA resources at the Federal, state, local, corporate, non-profit and tribal level that are not coherently organized or coordinated into a single source or reference point for the Veteran. Veterans deserve better and so do VA staff, who care deeply about delivering the best possible outcome for Veterans. The Veterans Experience team is leading a powerful new effort to improve customer experiences across VA, nationwide. Our goal: Fostering the delivery of effective and easy customer experiences in which Veterans feel valued. We are achieving this goal the same way the world’s most successful companies do: by listening to our customers – Veterans, their families and supporters – when they describe how they want things to work. Equally important, we are listening to our employees about obstacles to excellence on-the-job. Employee empowerment is an essential part of the equation. This is user-centered design. It puts Veterans and the employees who serve them front and center. VA and the Veterans Experience team face a number of challenges and barriers: The APG will track our ability to overcome these barriers by implementing the strategies described in the next section. To build trust among our customers, VA must consistently deliver customer experiences marked by effectiveness, ease, and engagement.[1] To ensure comparability across VA’s disparate service and product lines, the same measures of Trust and Customer Experience will be applied. Trust VA earns trust among Veterans by knowing them and showing that we care; by understanding and anticipating their needs; by providing fair benefits and timely services; by being there when they need us; and by keeping our promises. With every interaction, VA has the opportunity to deepen a trusting relationship with Veterans, or to diminish that trust. Our Agency Priority Goal states: By September 30, 2017, VA will reach 90% agreement with the statement “I trust VA to fulfill our country’s commitment to Veterans.” Timeline: Q1 FY16: Trust and Experience measures incorporated into existing customer experience surveys Q2 FY16: Baseline data collection begins Q3 FY16: Baseline measurement established; quarterly targets specified Q4 FY 2016: Publish quarterly update Q1 FY 2017: 70 percent of VA customers surveyed ‘agree’ or ‘strongly agree’ with Trust statement Customer Experience Q2 FY 2017: 75 percent of VA customers surveyed ‘agree’ or ‘strongly agree’ with Trust statement Customer Experience Q3 FY 2017: 80 percent of VA customers surveyed ‘agree’ or ‘strongly agree’ with Trust statement Customer Experience Q4 FY17: 90% of VA customers surveyed ‘agree’ or ‘strongly agree’ with Trust statement Customer Experience Trust in VA is built one interaction at a time. The experience must be effective; it must be easy; and, ideally, it must be engaging and reflective of a valued, personal relationship with our customer. Trust is broken when VA does not consistently meet expectations in these three categories. VA will use customers’ ratings of their individual experiences as indicators of performance toward the overall Veterans Experience APG. The measures will include level of agreement with questions such as: These measures are also new, and will be implemented along the timeline for the Trust measure indicated above. They will be added to new and existing VA customer experience surveys where responses will be correlated with operational data to highlight performance improvement opportunities that will improve Veterans experiences. [1] Adopted from the Forrester Research customer experience framework.
Statement: Indicators:
Improve client and stakeholder awareness of, and access to, Veterans benefits and health care services. By September 30, 2015, VA will increase the use of virtual service options by increasing the percent of claims received electronically, by increasing the number of accredited Veterans service officers registered on the Stakeholder Enterprise Portal, by increasing the number of registered eBenefits users, and by increasing the percent of patients who access VA health care using a virtual format such as video telehealth or online services.
Description: VA’s focus in Fiscal Year (FY) 2015 is to deliver seamless and integrated services while increasing the efficiency and effectiveness of virtual access. To achieve the best possible outcomes for Veterans, Servicemembers, and eligible beneficiaries, VA will improve access to, and encourage the use of, its virtual benefits and services. VA and Department of Defense (DoD) have established a jointly supported portal known as eBenefits, which allows Veterans, Servicemembers, and other eligible beneficiaries to access and submit information when, where, and how they want. The development and proliferation of virtual access to care supports an organizational approach that is personalized, proactive, and patient-driven. VA virtual health services use technology and health informatics to provide Veterans with better access and more effective care management. Advances in virtual care expand where health care services can be accessed, reduce the need for travel to medical facilities, and transform VA’s delivery of health care and its effect on patients’ health outcomes.
Statement: Indicators: * VA is in the midst of reviewing its claims processing accuracy metrics and goals to ensure VA continues to drive decisions of the highest quality. VA plans to engage its VSO partners and other stakeholders as more information becomes available.
Improve accuracy and reduce the time it takes to complete disability compensation benefit claims. Eliminate the disability claims backlog and process all claims in 125 days in FY 2015.
Description: VA will provide timely, accurate decisions on Veterans’ disability compensation and eliminate the claims backlog in Fiscal Year (FY) 2015. Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner. In FY 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency. However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this Agency Priority Goal. To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy. As of the end of June 2015, over 94 percent of VBA’s inventory is in an electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS). All claims are either received electronically or are converted to electronic format for processing.
