The Office of Inspector General (OIG) conducted a review to evaluate VA’s implementation of the Referral Coordination Initiative (RCI), a program designed to improve veterans’ timely access to care, empower patients to make informed care decisions, reduce providers’ administrative burden and increase their time on patient care, and enhance access to community care for veterans eligible under the MISSION Act of 2018. In 2019, the Veterans Health Administration began implementing the RCI at 139 VA medical facilities, with expected completion across all facilities and all specialty services by June 30, 2021.The OIG team conducted 75 interviews with leaders at VA and other offices and performed site visits at four facilities. VHA staff generally agreed the RCI had the potential to achieve its stated goals. However, facilities struggled with implementation for several reasons, including insufficient staffing and resources, unreliable data (such as a lack of accurate wait times for community care), and a lack of required training. The RCI describes two implementation models, centralized and decentralized, but facility staff were sometimes confused which model to apply and noted slow responses to questions. The Office of Integrated Veteran Care predecessor, the program office responsible for overseeing the RCI, also lacked the ability to monitor progress due to insufficient data. Because of these deficiencies, no VA facility had fully implemented the RCI almost a full year after VA’s own June 2021 deadline.The under secretary for health concurred with the OIG’s seven recommendations to improve RCI implementation by better assigning responsibilities and roles, improving training, establishing local procedures for sharing community care data for informing patients, sharing best practices among all facilities, ensuring accurate tracking of RCI consults, and developing ways to measure how well facilities meet the initiative’s requirements.
Report Date | Agency Reviewed / Investigated | Report Title | Type | Location | |
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Department of Veterans Affairs | Additional Actions Needed to Fully Implement and Assess Impact of the Patient Referral Coordination Initiative | Review | Agency-Wide | View Report | |
Office of Personnel Management | Audit of Blue Cross Blue Shield Association’s Service Benefit Plan’s Specialty Drug Pharmacy Program as Administered by Prime Therapeutics, LLC for Contract Years 2018 through 2021 | Audit | Agency-Wide | View Report | |
National Science Foundation | Performance Audit of Incurred Costs – Cary Institute of Ecosystem Studies | Audit |
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View Report | |
Department of Homeland Security | Major Management and Performance Challenges Facing the Department of Homeland Security | Top Management Challenges | Agency-Wide | View Report | |
Commodity Futures Trading Commission | CPF Audit Opinion and Financial Statements FY 2022 | Audit | Agency-Wide | View Report | |
U.S. Agency for International Development | Financial Audit of the Disabilities Integration of Services and Therapies Network for Capacity and Treatment Project in Vietnam, Managed by Sustainable Health Development Center, for the Fiscal Year Endeding December 31, 2021 | Other |
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View Report | |
Federal Trade Commission | Semiannual Report to Congress – FY 2022 – (Second Half) | Semiannual Report | Agency-Wide | View Report | |
U.S. Agency for International Development | Independent Audit Report on IFES's and IRI's Direct Costs Incurred and Billed Through the Consortium for Elections and Political Process Strengthening Under USAID/Iraq Cooperative Agreement 72026718LA00002, October 1, 2020, to September 30, 2021 | Other |
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View Report | |
Department of the Treasury | FINANCIAL MANAGEMENT: Audit of the United States Mint's Schedules of Custodial Deep Storage Gold and Silver Reserves as of September 30, 2022 and 2021 | Audit | Agency-Wide | View Report | |
Department of Health & Human Services | CMS Can Use OIG Audit Reports To Improve Its Oversight of Hospital Compliance | Audit | Agency-Wide | View Report | |