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GAO: VA Dialysis Pilot Plagued By Delays And Poor Communication

Due to significant delays, the Department of Veterans Affairs has abandoned its original timeline for a pilot program intended to establish independent dialysis centers.

Final evaluation of the program may not be completed for another 12 months, according to a report by the Government Accountability Office.

In recent years, the number of veterans with end-stage renal disease has exceeded the capacity of the VA’s own dialysis facilities, forcing the agency to refer veterans to non-VA facilities. In FY 2013, “VA referred about 14,000 veterans to non-VA dialysis providers at a cost of about $425 million.” (RELATED: VA Expects To Have More Medical-Care Funding Than It Can Spend For The Fifth Year In A Row)

In an effort to achieve cost savings and cope with the growing demand, VA instituted a four-location pilot program in 2010 to assess the feasibility of establishing dialysis treatment facilities throughout its network.

Initially, “VA planned to conclude the Dialysis Pilot 5 years after the pilot locations opened and assumed all four pilot locations would begin operations at generally the same time”—around April 2010. However, the first two locations did not open until June 2011, and the fourth location was only opened in July 2013. (RELATED: VA Employees Destroyed Veterans’ Medical Records to Delete Backlogged Exam Requests)

Rather than pushing its completion target back to 2018, the VA decided to abandon its timeline entirely, opting instead to consider the program successful if the pilot locations could achieve cost savings and offer a replicable model for expanding the program to other facilities.

VA officials told the GAO that “they believe the pilot locations have already achieved [both] milestones,” but that “VA has not formally communicated these achievements in writing.” The GAO warns that this failure could impede independent evaluations of the program, and shows that the VA “lacks accountability for ensuring the success of the Dialysis Pilot.” (RELATED: VA Lied to Congress About Veteran Deaths and Wait Times)

However, the VA contends that its sluggish approach is necessary to allow for completion of internal and independent evaluations. Due to delays and “operational challenges,” complete data is unavailable for two of the pilot locations, leading the VA to recommend that “another full 12 months of data from the Philadelphia and Cleveland pilot locations be analyzed,” before any final conclusions are made about the program.

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