Evaluating Access to Care for Veterans

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Evaluating Access to Care for Veterans

Posted on 04.08.24

Preparing a report for Congress

The MISSION Act (the John S. McCain III, Daniel K. Akaka and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018) required the Department of Veterans Affairs (VA) to establish access standards for furnishing Veterans with hospital care, medical services and extended care services. The act, which became law, also required VA to submit a report to Congress detailing the access standards and, within three years of establishing the standards, to review them and report the findings and any modifications to the standards to Congress.

VA needed outside support to evaluate existing access standards against those of relevant federal agencies, state agencies, private health plan and health system entities and other non-government agencies through industry research, conversations with industry health care leaders and the consultation process required by the MISSION Act.


VA hired Aptive HTG as a trusted partner to assist with meeting the MISSION Act requirements. Aptive HTG has a team of experienced program management professionals, data analysts and evaluation and performance improvement experts with vast knowledge of VA and expertise in developing reports for Congress.

Providing Program and Project Management

Aptive HTG applied a proven project management and staffing approach — refined through years of supporting clients — that provides project management rigor, enterprise-wide relationships and unmatched expertise. Our approach and project management plan are built from the Project Management Institute Project Management Body of Knowledge and tailored to VA through leading practices to optimize management, planning and implementation.

Evaluating Access Standards

Aptive conducted an evaluation of existing VA access standards. Building off the assessment created in 2018, we consulted with pertinent federal- and state-level entities, including the Department of Defense (DoD), Department of Health and Human Services, Centers for Medicare & Medicaid Services and Indian Health Service, as well as other non-governmental entities and private-sector organizations, to identify best practices and acceptable standards to consider in updating the VA access standards. This included a review of access standards for Medicare Advantage, state Medicaid programs, state insurance departments, DoD’s Tricare program, and leading commercial health plans and health systems to compare against the established VA access standards.

After collecting best practices of both government and commercial health plans and comparing them with the VA access standards, we evaluated performance of the VA standards, including assessing their use since implementation in 2019, and compared their impact to other community care eligibility factors.

Together with key VA stakeholders, we identified the top factors for measuring the effectiveness of each of the average drive-time and appointment wait-time standards. We compared these factors with other federal- and state-level agency data to assess VA performance against industry standards.

Last, Aptive interpreted data findings from the statistical analyses by addressing the key factors to measure the access standards’ effectiveness.

Within 25 business days of contract award, we delivered the draft of the Summary of Assessment and Findings, which detailed access standards in the government and private sectors based on our consultations and research.

Supporting Administrative and Facilitation Functions

Aptive HTG also provided project management and facilitation services for program meetings, conferences, workshops, symposia, governance body meetings, joint work stream meetings, brainstorming sessions and other meetings to support interim access standard updates, report planning and execution, and any actions as an outcome of the Congressional Mandated Report. Our skilled facilitators ensured meetings stayed on topic and achieved the planned objectives, making valuable use of participants’ limited time. We handled planning and preparation; logistics management; facilitation and execution; documentation (including meeting agendas, notes, outcomes and action items); and work product finalization.


Retaining Aptive support in implementing report recommendations

Aptive HTG submitted a report to Congress on the review process for the existing VA access standards, any proposed changes and reasons for the changes.

We achieved a 100% score on staffing the program on day one of the contract. Our deliverables, which included white papers, slide decks and other products to share information regarding the access standards and rationale for recommended standards for discussion, met or exceeded client expectations. The project was so successful that the client exercised the option period to support implementing our team’s recommendations.

Results at a Glance

  • A perfect score for program staffing
  • Deliverables that exceeded client expectations
  • Extended option period to implement report recommendations