In October 2023, under the direction of the Deputy Undersecretary for Health for VHA, the VA began Access Sprint. Access Sprint’s mission is to create workgroups at the facility, VISN and Central Office levels to identify and create pathways for veterans to have access to VA healthcare. VA wants to change veteran’s perception of VA Healthcare, wants veterans to choose to come to the VA and to do that VA must be able to provide access to healthcare within VA.

What makes this unique from other initiatives that have come down from VA Central Office is that Access Sprint is intended to take facility level and VISN level successes and best practices and disseminate those throughout the enterprise. The solutions and innovations are meant to improve the objectives of timeliness of care, efficiency in providing care, capacity for care, and to enhance the employee experience. Each VISN and medical center was to have Access Sprint teams forming workgroups to achieve the Access Sprint objectives.

Access Sprint was divided into 3 phases:

• Phase 1 was for Primary Care which also included Women’s Health, Geri-PACT and Clinical Resource Hubs. Primary Care was chosen for Phase 1 because this is usually where patients coming to VA for the first time have their first encounters or services. All VA medical centers and outpatient clinics and CBOC offer Primary Care.

• Phase 2 was for Specialty care which included Neurology, Gastroenterology, Oncology, and Cardiology.

• Phase 3 for Mental Health.  Each facility and VISN had deadlines to report their finding, innovations and best practices to VA Central Office who then had a workgroup to compile, collate and disseminate the innovations to the field. The push for this initiative is to allow VA to capture more veteran patients providing them the care they have earned.

VA is reporting the following data for Access Sprint:

New Patient Appointments increased 11% or 10,000 appointments for Primary care: 10% or 9,000 appointments for Specialty Care and 12% or 6,000 appointments for Mental Health.

New Patients waiting >20 or >28 days decreased 19% in Primary care and 9% for Mental Health. There was no decrease in Specialty care waiting time.

New Patients waiting for Community Care decreased 20% in Primary Care and Specialty care and 5% in Mental Health.

Overall Outcomes across VA it is reported that there was an increase of 11% in New Patient appointments, 12% decrease in New Patients waiting more than 20 or 28 days for an appointment and a decrease of 14% for New Patients waiting for Community care.

The solutions across the enterprise that were most implemented included reviewing existing appointments, scheduling to maximize provider clinic grids and optimize panel sizes, and expansion of clinic hours by adding night and weekend clinics. Expanding clinic hours alone during the Primary Care phase increased new patient appointments by 20%.  In the specialty care phase, there was an overall 10% increase in specialty care appointments and a 20% decrease in patients waiting for those appointments in the community. The facilities reported the most gains in appointments and the highest decreases in wait times by utilizing residents, maximizing the clinic grids in scheduling, and using telehealth for appointments where face to face visits were not necessary. In the Mental Health phase, the focus was on timely access to mental health services and providing lifesaving support. Veteran suicide rates significantly outpace non-veteran suicide rates when corrected for other factors. VA’s goal is to reduce veteran suicide to 0%.  Overall VA noted a 12% increase in new patient appointments and 9% decrease in new patients waiting for VA appointments and a 5% decrease in new patients waiting for community care appointments. Again, the most implemented solutions were to maximize provider clinic grids.  Other widely implemented solutions from the field included offering of same day mental health care in primary care clinics and increasing the use of group psychotherapy.

NAVAPD applauds VA’s efforts to decrease wait times and increase availability of appointments. VA has enrolled over 401,000 veterans in the past year for VA healthcare. This represents a 30% increase in the number of enrollees as compared to the previous year and a 50% increase in enrollees compared to 2020.  The number of new enrollees increased in all 50 states.

The states with the most new enrollees over the past year include Texas (41,287 Veterans), California (33,468) Florida (32,712), Virginia (20,537), North Carolina (17,562), Pennsylvania (16,167), Georgia (15,747), Ohio (12,717), Washington (11,873), Illinois (10,167), Colorado (10,028), Arizona (9,789), Tennessee (9,584), and Michigan (9,294). This increase in new enrollees is largely due to the signing of the PACT Act.

NAVAPD supports VA’s push to enroll every veteran into VA Healthcare because we are aware of the data and studies that show that veteran’s receiving healthcare from VA have better health outcomes than those not receiving VA Healthcare. Many of NAVAPD’s physician and dentist members are veterans themselves so they are aware of the challenges and unique needs of the veteran population, and they are inimitably positioned to provide those services.  However, the VA physician workforce only increased 3% this past year.

NAVAPD is very concerned that with a large increase in eligible veterans (and VA’s push to continue to enroll veterans at the rate they did this past year) and only a small increase in physicians and dentists, and the Access Sprint initiative to decrease wait times, that the existing workforce will experience burnout, which can demoralize and lead to apathy or the potential for harm.

NAVAPD would like to know your experience with Access Sprint. We would like to know if it is working without being unduly burdensome and what positive outcomes have resulted. Please use the Contact Us feature to tell us about your experience.  Please encourage your colleagues to join us using the Join Now button.