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The VA has released recommendations for better health care. Here are four questions we still have.

Doctor Looking at a Veteran's VA Records

By Concerned Veterans for America

You might have seen news outlets covering recommendations for streamlining veterans’ care from the Department of Veterans Affairs.

Those recommendations represent a giant step in the Asset and Infrastructure Review process that will allow the VA to cut through waste and bureaucracy and adapt to veterans’ evolving needs.

But misinformed concerns about these recommendations have been widespread, specifically from lawmakers and news outlets who are focusing solely on the potential closures of VA facilities.

Those concerns are missing the point. The VA’s assessment is about creating flexibility to deliver care that adapts to veterans’ needs.  After all, the VA should be as dynamic as the veterans it serves, rather than static and unchanging.

CVA Deputy Director Russ Duerstine said this about the recommendations:

“Today’s veteran population is vastly different from what it was even five years ago, let alone decades ago. A rigid system that cannot adapt to the changing and unique needs of the veterans it serves leads to waste, complications, and ultimately, an absence of care. We welcome these recommendations and urge all stakeholders to consider and debate them thoughtfully as they go forward. This process is long overdue, and while some may decry some of these recommendations, everyone should keep in mind the end goal: make sure our veterans can get the care they need, when and where they need it. The current system is outdated and broken. Making improvements does not mean cutting care or resources; rather, it means making sure resources are best serving the veteran.”

As lawmakers and news outlets focus on the report’s assessment of facilities, our takeaways raise more immediate questions that need to be answered before anyone has a conversation about closures, renovations, or new facilities.

Here are four questions we had from the VA’s AIR Commission recommendations.


1. Is the VA using the best information to make its assessments?

This is one of the biggest flags we saw. The VA’s report notes that the data from which it is basing its recommendations is based on outdated information.

Specifically, the market assessments are from before the COVID-19 pandemic began, so they don’t account for dramatic changes in how health care is delivered, including the rapid rise of telehealth options.

The assessments were also made before the VA MISSION Act expanded community care.  Veterans just aren’t utilizing VA care the same way they were when market assessments were gathered.

While the VA’s recommendations are likely on the right track, they are missing key information. That information will be crucial to have when the AIR Commission finalizes a report on the future of VA care.


2. Is there enough time to comply with the VA MISSION Act?

Let’s rewind just a bit to the VA MISSION Act and the AIR Commission process.

The VA MISSION Act established the Asset and Infrastructure Review Commission to review all things VA care — buildings and facilities, offerings, needed updates and renovations, communities’ capacity for care, and veteran population, geography, and demographics.

All that information, which includes the VA’s own recommendations, will be used to put forth a final report to the president with a path forward on streamlining VA care.

But setting up the commission is behind schedule. Nominees for the commission were submitted nine months past the May 31, 2021, deadline and remain unconfirmed by the Senate. So the whole process has been pushed back.  

The VA MISSION Act states that a final report from the AIR Commission is due January 31, 2023. Given how far behind schedule the commission is, the prospect of completing the report on time does not look good.


3. Should Congress step in?

Congress has a role to play as the AIR Commission process continues.

First, as mentioned above, confirming commission members is way behind. The Senate needs to confirm commissioners as soon as possible.

Once members are confirmed, Congress needs to consider extending the deadline for a final report. Getting that done by January 31, 2023, is just not feasible.

Second, the VA’s recommendations for streamlining care present innovative solutions for some of VA’s biggest problems, but Congress would have to take further steps if the AIR Commission includes those recommendations in the final report.

Proposals worth considering include entering more private-public partnerships, finding solutions for excess land VA no longer needs, and joint facility sharing between the VA and the Department of Defense.

Each of these ideas would give the VA flexibility to work in partnership with others to provide veterans the best possible care.


4. Is there a communication breakdown between the VA, Congress, and the AIR Commission?

The simple answer is yes.

When the VA’s initial recommendations came out in March, many stakeholders, specifically lawmakers, launched into defensive mode, decrying what they thought were attempts to shut down VA facilities that are currently serving veterans.

But the recommendations are just that: recommendations. And the focus of these recommendations and the commission in general isn’t to shut down facilities that have a consistent flow of veteran patients.

The point is to find ways to streamline care so veterans have what they need when and where they need it – that means identifying underused and unused facilities, looking into buildings that need repair and renovation, and reviewing states and communities that don’t have enough VA resources.

The VA and lawmakers should be in constant communication to understand the process, importance, and goals of the AIR Commission.


Want to learn more about the AIR Commission and how it could improve veterans’ health care? Check out our hub of AIR Commission resources.