The benefits and health arms within the Department of Veterans Affairs are exceeding hiring goals amid efforts to recruit more personnel to support growing demands in care and benefits delivery to veterans.
The Veterans Health Administration (VHA) met its fiscal year 2023 goal of increasing total employees within the health care system by 3%, with the total workforce resembling the highest growth rate in more than 20 years, Undersecretary for Health Shereef Elnahal told reporters Tuesday.
"That is a function, of course, of hiring new people into the system — we call external hires — but it's also a function of retention, which is at higher rates than we've seen in the last several years. The combination of those two things have led us to reach the 3% growth mark in only six months, when we had originally set that target for the entire fiscal year,” Elnahal said.
Similarly, the Veterans Benefits Administration has seen the highest growth rate in a decade with a 13% growth rate in the past year and a half.
"We've been aggressively expanding our workforce through hiring fairs and through other avenues," said newly confirmed Undersecretary for Benefits Joshua Jacobs at a press conference Thursday. "This growth is what's allowing us to deliver more benefits to more veterans than ever before."
The agency has enacted a broader push for hiring talent as government strives to recruit in a competitive market. The VA Careers Act, which Sen. Jon Tester introduced at the beginning of the year, would enable VA to have an entirely market-based payment system for select job categories, so VHA can better compete with the private sector.
Now to assist with this increase in onboarding, VHA has integrated new tools and processes, including a Candidate Care Model and a "hire right, hire fast" mindset, Elnahal told GovCIO Media & Research.
"VISN 22 recently presented their onboarding tool, which is a power AI engine that takes from our baseline systems — USA Staffing, USA Jobs, etc. — and aggregates that information in a way that presents situational awareness for all parties," Elnahal added. "They're continuing to iterate on that. Of course, it's not a perfect system, but it's one that's at least allowing for an understanding about where packages are. ... It's a lot of process work, but it's also some technology.”
VA is Innovating the Veteran Experience
In addition to VHA’s hiring progress, the agency has made strides in what Elnahal calls “North Star metrics,” including improving scheduling, access to care and satisfaction scores.
VHA saw about 1.5 million appointments in its direct care system in the first quarter of this fiscal year and just under one million in the second quarter, a 9.2% growth quarter over quarter.
"[There is] significantly more demand just between those two periods of time. And despite that, we are seeing more than half of our facilities meet our improvement targets for access to care,” Elnahal said.
VHA set a goal for a 3% improvement over baseline wait times across primary care, mental health and specialty care. For primary care, just over half of VA’s facilities are meeting this target for direct care wait times. For mental health, not including telehealth visits scheduled outside VA’s system, the agency has approximately 40% of facilities meeting the 3% target.
On the benefits side, Jacobs said the agency has processed about 14% more claims than this time last year. Amid PACT Act implementation, the agency has completed over 241,000 of the 500,000 claims it has received since.
VBA is working with the Veterans Experience Office to deploy new surveys measuring satisfaction and trust for veterans who have filed recent claims. The agency aims to take any measured pain points and "turn them into action" for driving improvements, Jacobs said.
Experience Principles Are Driving Technology Spend
The agency is looking at technology improvements to further support the overall experience for both the veteran and employee, especially with increased use of automation.
VBA is currently testing an automated decision support tool at eight regional sites.
"The promise of the automated decision support technology is that we can help our employees deliver more benefits to more veterans more equitably and accurately and consistently than ever before," Jacobs said. "When we take care of our employees, they can take care of veterans."
In response to feedback in the veteran community, VHA is also turning to new solutions to make internal improvements with scheduling.
“VSOs have been very clear with us, as have veterans directly, that we need to do better with our internal processes and scheduling community care,” Elnahal said.
VHA is targeting a commercial-off-the-shelf scheduling system that will aid in community care scheduling. VA is currently conducting a pilot with an outside scheduling system that sees directly into community provider grids. That platform is currently live in Orlando, Florida, and Columbia, South Carolina.
“The results in Columbia have been much more impressive because a lot of work was done by network and facility leadership to compel community providers to allow that system to see directly into scheduling grids, especially for high volume providers that see our veterans there. As a result, they've seen tremendous improvements in efficiency of scheduling community care,” Elnahal said. “The question is, how scalable is it? Can that provider serve the entire country?”
An agency request for proposals outlines requirements for systems that have the technological capability of looking into a community providers grid and scheduling veterans directly through that mechanism.
“The Columbia experience has been really good, but the Orlando has been a mixed experience because they’ve had a harder time asking the community providers to allow us to get into there. I think there's a lot that goes into those decisions from the community providers standpoint. So we're continuing to assess this and see what we can scale and what we can't,” Elnahal said.