VHA Progressed in the Follow-Up of Canceled Appointments during the Pandemic but Could Use Additional Oversight Metrics

The OIG reviewed the Veterans Health Administration’s (VHA) progress in monitoring their follow-up of canceled appointments during the COVID-19 pandemic.In 2020, the OIG reported that VHA had not followed up on about 32 percent of canceled appointments. VHA then implemented the Cancelled Appointments and Consult Management Initiative and created a cancellation report to track follow-up conducted for appointments originally scheduled to occur after July 21, 2020. The report allowed tracking by types of care, by month, and cumulatively, but VHA did not use all the reporting features. VHA required facilities to meet a minimum 80 percent follow-up rate or develop corrective action plans.VHA had evidence of follow-up activity for about 87 percent of appointments originally scheduled to occur from January through July 2021. However, when the OIG team evaluated follow-up by types of care, the assessment revealed that more than one-third of specific types of care fell below 80 percent, and every facility had at least one type of care below 80 percent. The team also assessed data by month and identified seven facilities that dropped below 80 percent during June and July 2021 (not evident in cumulative reporting). Since the cancellation report’s implementation, VHA officials have not reevaluated the tracked types of activity used to determine if an appointment had been followed up.VHA implemented monitoring procedures for follow-up of canceled appointments during the pandemic, but it can strengthen its oversight by using the cancellation report to monitor follow-up by type of care and by month, as well as by reassessing the activities that determine what appointments are followed up. VHA concurred with the OIG’s two recommendations on monitoring follow-up rates and assisting facilities that fell below the established metrics, as well as reassessing what constitutes follow-up activities.