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Wednesday, October 1, 2014
Agency Priority Goal

Eliminate the Disability Claims Backlog

Priority Goal

Eliminate the Disability Claims Backlog
Improve accuracy and reduce the time it takes to complete disability benefit claims.  Eliminate the disability claims backlog and process all claims in 125 days with 98 percent accuracy in FY 2015.

Indicators:

  1. Reduce the percentage of disability claims pending for more than 125 days to 50 percent in FY 2014 and 0 percent in FY 2015.
  2. Improve national issue-based rating accuracy for disability claims to 97 percent in FY 2014 and 98 percent in FY 2015.
  3. Improve national claim-based rating accuracy for disability claims to 94 percent in FY 2014 and 98 percent in FY 2015.
info Themes:
Education, Training, Employment, and Social Services Health Veterans Benefits and Services Income Security

Goal Overview

VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog in FY 2015.  Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner.  In 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency.  However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this APG.  To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy.  As of the end of September 2013, over 60 percent of VBA’s inventory is in electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS).  In addition, VA is delivering training that is more aligned with the needs of the workforce to operate in this electronic environment.  VBA is encouraging Veterans to submit Fully Developed Claims (FDC) that include all supporting evidence when the claim is filed.  The FDC is typically the fastest way for Veterans to receive a decision on their claims.  Increasing the number of FDCs filed electronically by Veterans, or by Veterans’ representatives on their behalf, reduces the major source of delay associated with gathering evidence to support a claim and helps reduce the overall time it takes to process a claim.  Through people, process, and technology integrated initiatives, the workforce will achieve the goal of eliminating the disability claims backlog.

Strategies

Veterans Benefits Administration (VBA) is positioned to achieve the 2015 goal of completing all rating-related disability compensation and pension claims within 125 days with 98% accuracy.  VBA’s Transformation Plan integrates people, process, and technology initiatives that incorporate VA’s strategic plan, goals, and objectives.  Ideas for initiatives that help improve business processes were solicited from employees and other internal and external stakeholders including Veterans Service Organizations (VSO), state and county service officers, and industry partners, as well as Veterans themselves.  Implementation of VBA’s Transformation Plan drives standardization among all employees at the 56 regional offices, establishes a methodology for governing implementation, and ensures that the improvements are sustainable for the future.  VBA’s Transformation Plan includes effective communication and change management, detailed implementation planning, establishment of national standards, and effective and measurable training.  Utilizing the new organizational model and mandatory overtime, VBA was able to achieve its two highest output months in FY 2013, completing over 128,000 claims in August 2013 and over 129,000 claims in September 2013.

VBA’s integrated approach includes technology solutions that drive automation, improve the quality of work, reduce variance, and speed efforts to complete claims electronically.  These innovative technologies include VBMS and the Veterans Relationship Management (VRM), integrating business processes to take into account electronic filing of claims, national workload distribution, as well as the receipt of complete and certified medical, dental, and personnel records from the military services.  VBA established the Veterans Claims Intake Program (VCIP) in 2012 to streamline the process for receiving records and data into VBMS.  VCIP converts claims and other paper records into a digital format that is usable within VBMS.  At the end of September 2013, 60 percent of current claims were in the electronic environment and over 250 million images had been converted from paper and uploaded into VBMS.

Because VBA’s organizational transformation is sweeping and multi-faceted, this major change cannot be a “once-and-done,” “flip-of-the-switch” proposition. Transformation is a deliberate and multi-year process.  VBA is pursuing transformation according to a carefully developed timeline and an implementation plan that rolls out changes in people, processes, and technology in a progressive, intentional sequence that enables efficiency gains while minimizing risks to performance.

On April 19, 2013, VBA implemented a special initiative to quickly decide the oldest claims in the inventory.  This initiative was created to accelerate the delivery of benefits to Veterans who have waited the longest for a decision, and is a key part of VA’s overall strategy to eliminate the claims backlog in 2015.  In June, VA completed the first phase of the initiative, which focused on all claims pending over two years.  Over 99 percent of these two-year claims (over 67,000) have been processed for Veterans, eliminating those claims from the backlog.  Since that milestone, VBA claims processors focused on completing the claims of Veterans who have been waiting one year or longer for a decision.  VA had processed approximately 95 percent of the 513,000 one-year claims as of the end of FY 2013.  In FY 2014 and 2015 VBA employees will continue to process oldest claims as a priority.

In addition, VBA implemented mandatory overtime starting in May 2013 for VBA’s claims processing staff.  VBA also redistributed, or brokered, work among regional offices to maximize the capacity of the entire VBA workforce to ensure that the next oldest claim was completed on the basis of a national workload.

On October 1, 2012, VBA initiated issue-based reviews of rating claims using the existing Systematic Technical Accuracy Reviews (STAR) process.  The primary goal was to identify, down to the specific diagnostic code, all existing benefit entitlement errors, and correct actions at the issue level.  These new procedures were also developed to more accurately identify issue-specific deficiencies in rating procedures, and to identify targeted training opportunities.  Each claimed condition is evaluated independently using the STAR rating-decision checklist.  Dual reporting of claim-based and issue-based accuracy statistics continued through FY 2013.

Since inception, the accuracy of issue-based reviews has averaged six percentage points greater than claim-based reviews.  This was primarily due to the evaluation methodology for assessing claim-based accuracy, where one error in a multi-issue claim resulted in a 0% accuracy assessment.  For the three months concluding September 30, 2013, issue-based accuracy was 96.7% compared to 90.6% for claim-based reviews.  Beginning in October 2013, issue-based accuracy will be reported, as it represents a more appropriate way to measure accuracy.  Three-month and twelve-month cumulative accuracy reports for the nation and each regional office will be available.

Launched in January 2013, VBA’s Statistical (STAT) Reviews are robust performance analysis mechanisms that use operational data and graphical visual displays to monitor progress and drive performance improvement.  These reviews involve rigorous performance evaluations with VBA senior leadership and regional office directors to analyze and measure results.  VBA leaders discuss challenges, successes, best practices, and action plans using targeted data-driven performance measures focused on accountability for improved performance.

VBA continued its strong collaboration with the Veterans Health Administration (VHA).  VHA supported the oldest claims initiative by expediting the scheduling of examinations.  VHA also used all available resources by temporarily assigning clinicians to conduct examinations, maximizing the use of disability contract examiners, and employing innovative solutions such as the Acceptable Clinical Evidence (ACE) process.  ACE facilitates the completion of Disability Benefits Questionnaires (DBQs) using existing medical evidence of record when the clinician determines that the evidence is sufficient to complete the requested evaluation, reducing the need to conduct an in-person VA examination.  VHA provides clinicians at VBA regional offices to expedite claims processing by clarifying medical opinions and answering claims processors’ questions.

Through these prioritization initiatives, VBA has made notable progress in reducing both the backlog and the pending inventory and is on track to eliminate the backlog in 2015.  As of September 30, 2013, the number of disability claims in the VBA inventory had been reduced from the peak of 884,000 to 722,000, the lowest number of claims since October 2010.  In addition, the number of claims in the backlog was reduced by more than 31 percent from 611,000 to 418,000 claims.

Progress Update

VBA has made substantial progress on execution of its benefits Transformation Plan to change the way benefits and services are delivered to Veterans, their families, and Survivors for generations to come.

First, VBA made significant progress on eliminating the number of backlogged disability rating claims.  From March 2013 through June 2014, the backlog – defined as claims that have been pending over 125 days – has been reduced by 340,956 claims, a 55.8 percent decrease.  The total inventory of claims has dropped 37.3 percent, from 883,930 in July 2012 to 554,087 in June 2014.  VBA broke monthly production records four times throughout FY 2013, and hit an all-time annual production record of 1.17 million claims processed.

In March 2014, VBA set another record for its monthly production with 135,324 rating claims processed – over 5,800 more claims than the previous record in September 2013.  A portion of this production can be attributed to VBA’s short-term Surge initiative which was implemented to offset the production impact of winter closures.

More importantly, VBA has increased production while also increasing quality.  Claim-based accuracy has increased to 91 percent today – an increase of seven percentage points since FY 2011.  When measuring quality at the individual issue level – which measures each individual rated issue in a claim – rating accuracy is actually 96 percent.  It is noted that the 3-month rolling issue-based rating accuracy decreased by 0.3 percentage points from March 2014 to June 2014.  Although this is not a significant reduction, quality continues to be a strong focus area for VBA.

An important milestone in FY 2013 was the achievement of a true electronic claims process, using the Veterans Benefits Management System (VBMS) as the technology centerpiece.  VBA deployed VBMS to all 56 of its regional offices in FY 2013, 6 months ahead of schedule, and has converted 90 percent of the current inventory of claims into a digital format for electronic processing – a percentage that is growing daily.  Now, any paper claims VBA receives are immediately sent for scanning and digitally uploaded to VBMS.  As of the end of 3rd quarter, more than 800 million images have been scanned through the Veterans Claims Intake Program (VCIP), which continues to ensure new paper claims are scanned, uploaded, and turned into electronic records in VBMS.

In June 2014, VBA deployed VBMS Major Release 7.0. VBMS major release 7.0 includes the foundation for workflow and workload management capabilities, as well as updates to the rating calculator user interface to accept bilaterally-related conditions from a single disability benefits questionnaire (DBQ) – downloadable forms that capture all medical evidence needed to rate a condition.   VBMS is developed and released to the field in an iterative approach known as AGILE development.  Each major release introduces new features and system functionality, allowing VBMS to evolve to meet end-user and organizational needs over time.  As major software releases are implemented, VBMS progresses towards the future end-state goal of a complete, end-to-end electronic claims processing system.

Due to VBA’s extensive outreach efforts, more and more Veterans are using the preferred electronic intake method – the joint Department of Defense (DoD)/Department of Veterans Affairs (VA) Web portal eBenefits – to submit claims electronically.

As of June 30, 2014, there are over 3.8 million registered eBenefits users with access to benefits information and the capability to submit claims online through Electronic Claims Submission (ECS).  With 58 self-service features, eBenefits allows Veterans to file a claim online and upload evidence that will feed directly into VBMS.  VBA is now receiving well over 1,000 electronically filed claims every week and scanning the remaining claims to be processed in the electronic environment.  During the month of June, VBA completed approximately 19,000 claims in VBMS per week.  Registered eBenefits users with a free Premium account can also track the status of their claim and access a variety of other benefits information, including pension, education, health care, home loan eligibility, and vocational rehabilitation and employment programs.  VBA also launched the Stakeholder Enterprise Portal (SEP), an electronic Web portal that mirrors eBenefits and allows VA partners and Veterans Service Organizations (VSO) with Power of Attorney to electronically file claims for benefits and services on behalf of Veterans.

VBA has also collaborated closely with Congressional and VSO partners to launch and promote VBA’s fully developed claims (FDC) program, which reduces the longest phase of the claims-processing timeline by allowing Veterans to certify that they have submitted their claims with all available supporting medical evidence.  Many Veterans are submitting their claims as FDCs, and more continue to do so thanks in large part to strong support and endorsement by our VSO partners.  From October 1, 2013, through June 30, 2014, approximately 30% of claims received were FDCs.

Under current law, Veterans filing their initial disability compensation claim as an FDC now, through August 5, 2015, may be eligible for up to one year of retroactive benefits.

None of the progress VBA has made would be possible without the tremendous support VA receives from its partners including Congress, its VSO partners, and county and state departments of Veterans affairs.  VBA’s progress is also the result of unprecedented effort and dedication from VBA employees, 52 percent of whom are Veterans themselves, and the support provided by our partners in VA’s Office
of Information and Technology (OIT) and the Veterans Health Administration (VHA).

Next Steps

As a direct result of the transformation initiatives VBA has implemented over the last three years, VBA is deciding more disability rating claims for Veterans, at higher accuracy levels, than ever before in the history of VBA – but there is still more work to do.  The groundwork laid thus far is helping VBA launch important initiatives in FY 2014 and FY 2015 that will change the way benefits are delivered to Veterans, their family members and Survivors for generations to come.  First, since a large majority of our claims inventory is now digitized, VBA is converting regional offices to fully electronic processes, moving them out of paper and doing away with all the printing, boxing, shipping and storing of paper claims that slows its processes down.

Second, as VA transitions to a paperless claims process, VBA is in a better position to adopt a national workload strategy that is “boundary-free” and improves overall production capacity to serve Veterans in the same way they served – side by side without regard to state affiliation.  Now that VBA has fully deployed VBMS, it can more efficiently manage the claims workload, prioritizing and distributing the claims electronically across its network of regional offices to maximize resources and improve and normalize processing timeliness at the national level by matching the workload with regional office capacity.  In short, this workload management approach minimizes wait times and brings greater consistency to the delivery of benefits.  National workload management also means that VBA can incorporate greater efficiencies in its business processes by centralizing functions like mail receipt and responses to Privacy Act requests for copies of records.

Third, as VBA moves into advanced generations of VBMS, it is improving access; driving automation; and enabling greater exchange of information and increased transparency to Veterans, our workforce, and other stakeholders.  Valuable tools like automated disability benefits questionnaires (DBQs) and an embedded rules engine inject much-needed efficiency into VBA’s system, helping VBA meet today’s
demand while also preparing it to meet the demands of the future.

Using the “AGILE” model, programmed software releases will continue building out these automated capabilities, allowing employees to focus on more difficult claims by automating more routine processes.  VBA has also developed an automated interface capability to enable the secure electronic transmission of disability benefit claimants’ service treatment records (STRs) between DoD’s Healthcare Artifacts and Image Management Solution and VBMS.  With this connection, VA can now receive certified and complete electronic STRs for Servicemembers separating on or after January 1, 2014.  This major milestone for VA and DoD reduces the amount of time it takes VA to gather required evidence and helps improve the accuracy of claims decisions.

Fourth, VBA will continue to drive and incentivize claims filing through eBenefits – especially the filing of electronic, ready-to-rate, FDCs.  Today, VBA is receiving well over 1,000 claims a week filed electronically.  VBA is currently working on comprehensive communications and training plans to increase Veterans’ and stakeholders’ awareness of the ability to file claims online.  As VBA continues to refine these technologies, VBA is also improving its Customer Relationship Management program by increasing integration across VA systems to provide a single view of Veterans’ information, benefits utilization, and interactions across VA.  With data from many separate systems available in a single place, VA will have a comprehensive view of each Veteran – from his or her enlistment date onward.  This will ultimately enable VBA to serve Veterans more efficiently and effectively by anticipating their needs, prompting them when they’re eligible for new benefits and services, and reaching out to them instead of waiting until they reach out to VBA.

In FY 2014, VBA will continue to implement its Transformation Plan, with more initiatives and enhancements that increase the timeliness and accuracy of claims processing, while improving the level of service that Veterans, their families, and Survivors have earned and deserve.

FY 2014 Future Actions & Milestones:
  1. Pre-populate 50 percent of DBQs in VBMS by the end of the 4th quarter of FY 2014.
  2. Distribute work among regional offices based on production capacity by the end of the 4th quarter of FY 2014.
  3. Increase the percentage of disability compensation claims in VBMS to 100 percent by the end of the 4th quarter of FY 2014.
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Performance Indicators

Reduce the percentage of disability claims pending for more than 125 days

Fiscal Year Quarter Period Ending (Month, Year) Target Value Actual Value Explanation of Actual
2014-Q1 December, 2013 57.5 58.5
2014-Q2 March, 2014 55.0 56.1

VBA’s backlog percentage decreased by 2.4 percentage points from 58.5 percent in December 2013, to 56.1 percent at the end of Q2 FY14.

2014-Q3 June, 2014 52.5 48.8
  1. Reduce the percentage of disability claims pending for more than 125 days.

Metric(s):

“Percentage of Disability Compensation and Pension Claims Inventory Over 125 Days”      

Fiscal Year Quarter Period Ending Target Value Actual Value
2014-Q1 December, 2013 57.5% 58.5%
2014-Q2 March, 2014 55.0% 56.1%
2014-Q3 June, 2014 52.5% 48.8%

Explanation of Results and Variance Analysis:  Veterans Benefits Administration’s (VBA) backlog percentage decreased by 7.3 percentage points from 56.1 percent in March 2014, to 48.8 percent at the end of June 2014.

Historical Data:

Performance Data History (5 Year)
Results History FY 14-15 Targets
FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015
36% 60% 66% 58% 50% 0

 

2014-Q4 September, 2014 50.0
2015-Q1 December, 2014 50.0
2015-Q2 March, 2015 45.0
2015-Q3 June, 2015 20.0
2015-Q4 September, 2015 0
Indicator Statement:

Reduce the percentage of disability claims pending for more than 125 days to 50% in 2014 and 0% in 2015.

Unit Of Measurement: percentage of disability claims pending for more than 125
Indicator Reporting Frequency: Quarterly
Indicator Direction: DECREASING

Improve national issue-based rating accuracy for disability claims

Fiscal Year Quarter Period Ending (Month, Year) Target Value Actual Value Explanation of Actual
2014-Q1 December, 2013 96.0 96.1
2014-Q2 March, 2014 96.0 96.1

Explanation of Results and Variance Analysis: VBA’s 3-month rolling rating issues accuracy remained steady from December 2013 to March 2014. Quality Review Teams continue to evaluate decision accuracy at both the regional office and individual employee levels, and perform in-process reviews to eliminate errors at the earliest possible stage in the claims process.

2014-Q3 June, 2014 96.5 95.8
  1. Improve national issue-based rating accuracy for disability claims

Metric(s):

“National Accuracy Rate - Disability Compensation Rating Claims -- Issue-Based (Percentage)”

Fiscal Year Quarter Period Ending Target Value Actual Value
2014-Q1 December, 2013 96.0% 96.1%
2014-Q2 March, 2014 96.0% 96.1%
2014-Q3 June, 2014 96.5% 95.8%

Explanation of Results and Variance Analysis:  VBA’s 3-month rolling issue-based rating accuracy decreased by 0.3 percentage points from March 2014 to June 2014.

Historical Data:

Performance Data History (5 Year)
Results History FY 14-15 Targets
FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015
N/A N/A N/A 96% 97% 98%

 

  1. Improve national claim-based rating accuracy for disability claims

Metrics(s):

“National Accuracy Rate - Disability Compensation Rating Claims --  Claim-Based (Percentage)”

Fiscal Year Quarter Period Ending Target Value Actual Value
2014-Q1 December, 2013 91% 88.9%
2014-Q2 March, 2014 92% 90.7%
2014-Q3 June, 2014 93% 90.7%

Explanation of Results and Variance Analysis:  VBA’s 3-month rolling claim-based rating accuracy remained steady at 91 percent from March 2014 to June 2014.

Historical Data:

Performance Data History (5 Year)
Results History FY 14-15 Targets
FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015
84% 84% 86% 90% 94% 98%

 

2014-Q4 September, 2014 97.0
2015-Q1 December, 2014 97.0
2015-Q2 March, 2015 97.0
2015-Q3 June, 2015 97.5
2015-Q4 September, 2015 98.0
Indicator Statement:

Improve national issue-based rating accuracy for disability claims to 97% in 2014 and 98% in 2015..

Indicator Reporting Frequency: Quarterly
Indicator Direction: INCREASING

Contributing Programs & Other Factors

Contributing partners outside the agency: Department of Defense, Department of Labor, Social Security Administration, and Department of Education.

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Strategic Goals

Strategic Goal:

Empower Veterans to Improve Their Well-being

Statement:

Empower Veterans to Improve Their Well-being

Strategic Objectives

Increase Customer Satisfaction through Improvements in Benefits and Services Delivery Policies, Procedures, and Interfaces

Summary:

VA is a customer service organization. Complicated application processes, long processing timelines or difficulties getting information and appointments all impact the client’s experience and satisfaction. Veterans and eligible beneficiaries deserve a support system that is responsive to their needs. VA must keep pace with Veterans’ expectations and transform its customer services – soliciting regular customer feedback, streamlining processes, and delivering consistent service across customer-preferred channels.

We live in a connected world. The rapid pace of technological advancement is reshaping Veterans’ expectations regarding how services, benefits, and support should be delivered. Today’s client expects instant access to information and self-service options via the Internet, and increasingly through mobile devices like tablets and smartphones (and the next generation “smart” devices that are yet to be deployed).

To provide a personalized experience, we must listen, learn, and understand the needs and expectations of those we serve. We must have the knowledge, information and insight to understand why some choose not to fully engage with VA.

Strategies:

VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog. We will then implement a robust plan, and revisit procedures to ensure claims are addressed in no more than 125 days with at least 98 percent accuracy. The plan includes redesigning policies and procedures, continuing to enhance training for claims processors, and utilizing the most advanced IT. We will also increase the use of video teleconference hearings to address claims appeals.

VA will continue to expand implementation of PACT to improve partnerships with Veterans and eligible beneficiaries, increase team-based care coordination and management, and expand access to care. VA will improve patient-facing and clinician-facing e-health systems by expanding the development and use of health-related virtual modalities. These modalities include telehealth[1], E-Consult[2], secure messaging, MyHealtheVet, and mobile applications.

VA will enhance client satisfaction by capturing client data once, sharing it enterprise-wide, and using this client data for a lifetime, which will promote more efficient use of data across business lines. We will identify sources of consistent, reliable, and authoritative Veteran data. We will establish architecture, business rules, roles and responsibilities, and governance to enable VA lines of business to use the authoritative common client data to improve delivery of benefits and services to Veterans. VA will gain access to additional external data, knowledge, and experiences so we can broaden our understanding of our client’s needs and expectations. We will enable secure, privacy-protected electronic exchange of personal, health, and economic data on Veterans from induction oath through the final survivor benefit.

VA will rethink its operations as a Department, defining the fundamental crosscutting capabilities and interdependencies required to perform them. We will identify and address any internal organizational, policy, procedural, perceptual, and cultural boundaries that constrain our ability to coordinate, integrate, and deliver benefits and services.

VA will streamline its virtual presence (Web sites, portals and call centers), reducing duplication and enhancing personalization to enable clients to get the information they need, on their schedule.

VA will increase access to burial benefits in national cemeteries through its plans to construct five new national cemeteries and by recognizing and addressing the unique needs of Veterans and eligible beneficiaries who reside in densely populated urban areas as well as sparsely populated rural locations. We will ensure that the service and appearance of our national cemeteries meets the highest standards commensurate with these national shrines.

 


[1] Telehealth uses information and telecommunication technologies to provide health care services in situations in which the patient and practitioner are separated by geographical distance. Telehealth in VA increases access to high quality health care services using Clinical Video Telehealth (CVT), Home Telehealth (HT) and Store and Forward Telehealth (SFT).

[2] E-Consult is an approach to provide clinical support from provider to provider.  Through a formal consult request, processed and documented in the Computerized Patient Record System, a provider requests a specialist to address a clinical problem or to answer a clinical question for a specific patient.  Utilizing information provided in the consult request and/or review of the patient’s electronic medical record, the consultant provides a documented response that addresses the request without a face-to-face visit.

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Improve client and stakeholder awareness of, and access to, Veterans Affairs benefits and health care services.  By September 30, 2015, VA will increase the use of virtual service options by increasing the percent of claims received electronically, by increasing the number of accredited Veterans service officers registered on the Stakeholder Enterprise Portal, by increasing the number of registered eBenefits users, and by increasing the percent of patients who access VA health care using a virtual format such as video telehealth or online services.

Indicators:

  1. Increase the annual percent of disability compensation claims received virtually/electronically from a baseline of 2 percent in 2013, to 12 percent in fiscal year (FY) 2014 and 20 percent in FY 2015.
  2. Increase the number of accredited Veterans advocates who are registered users on the Stakeholder Enterprise Portal (SEP) from a baseline of 1,000 in FY 2013, to 2,000 in FY 2014 and 3,500 in 2015.
  3. Increase the number of registered eBenefits users to 3.8 million in FY 2014 and 5 million in FY 2015.
  4. Increase the percent of patients who access VA health care using a virtual format (e.g., video, smart phone or online services) from 23 percent baseline utilization in FY 2013, to 30 percent in FY 2014 and 35 percent in FY 2015.

VA’s focus in FY 2014-2015 is to deliver seamless and integrated services while increasing the efficiency and effectiveness of virtual access. To achieve the best possible outcomes for Veterans, Servicemembers, and eligible beneficiaries, VA will improve access to, and encourage the use of, its virtual benefits and services.  VA and DoD have established a jointly supported portal known as eBenefits, which allows Veterans, Servicemembers, and other eligible beneficiaries to access and submit information when, where, and how they want.

The development and proliferation of virtual access to care supports an organizational approach that is personalized, proactive, and patient-driven.  VA virtual health services use technology and health informatics to provide Veterans with better access and more effective care management.  Advances in virtual care expand where health care services can be accessed, reduce the need for travel to medical facilities, and transform VA’s delivery of health care and its effect on patients’ health outcomes.  Improved access to care through telehealth and other virtual services is of particular benefit to rural Veterans, as well as those with chronic conditions and/or impaired mobility.

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Improve accuracy and reduce the time it takes to complete disability benefit claims.  Eliminate the disability claims backlog and process all claims in 125 days with 98 percent accuracy in FY 2015.

Indicators:

  1. Reduce the percentage of disability claims pending for more than 125 days to 50 percent in FY 2014 and 0 percent in FY 2015.
  2. Improve national issue-based rating accuracy for disability claims to 97 percent in FY 2014 and 98 percent in FY 2015.
  3. Improve national claim-based rating accuracy for disability claims to 94 percent in FY 2014 and 98 percent in FY 2015.

VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog in FY 2015.  Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner.  In 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency.  However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this APG.  To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy.  As of the end of September 2013, over 60 percent of VBA’s inventory is in electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS).  In addition, VA is delivering training that is more aligned with the needs of the workforce to operate in this electronic environment.  VBA is encouraging Veterans to submit Fully Developed Claims (FDC) that include all supporting evidence when the claim is filed.  The FDC is typically the fastest way for Veterans to receive a decision on their claims.  Increasing the number of FDCs filed electronically by Veterans, or by Veterans’ representatives on their behalf, reduces the major source of delay associated with gathering evidence to support a claim and helps reduce the overall time it takes to process a claim.  Through people, process, and technology integrated initiatives, the workforce will achieve the goal of eliminating the disability claims backlog.

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Improve Veteran Wellness and Economic Security

Summary:

Numerous programs provide a broad spectrum of benefits and support services that assist Veterans and eligible beneficiaries. To enable Veterans and eligible beneficiaries to choose the best benefits and services for their needs, VA will improve coordination between our programs, leverage supportive interactions between programs, and reduce overlap across programs. Success will be measured by the differences made in the lives of the Veterans we serve, including decreasing Veteran unemployment, decreasing home foreclosures, decreasing homelessness, reducing processing times for disability compensation claims, increasing preventive care and healthy lifestyle changes, and increasing access to and utilization of virtual care modalities.

Strategies:

VA will eliminate Veteran homelessness by the end of FY 2015. VA, in collaboration with its Federal partners, will continue to provide rehabilitation services for homeless and at-risk Veterans, including employment assistance, access to permanent and transitional housing, and other supportive services. As the number of homeless Veterans continues to decline, the focus will shift from rescue to prevention.

VA will improve Veteran career readiness to reduce Veteran unemployment. We will synchronize and align Veteran employment programs managed by VA, and improve coordination across the various Federal Veteran employment initiatives. We will increase support to our Veterans with disabilities and those who are GI Bill eligible through programs offering educational and vocational counseling. VA will increase support to Veteran entrepreneurs through public-private partnerships to provide capacity building and by providing access to Federal contracting opportunities.

 

VA will provide Veterans and eligible beneficiaries with personalized, proactive, patient-driven health care to optimize health and well-being, while providing state-of-the-art disease management. VA’s Patient Aligned Care Teams (PACT) will ensure patient engagement in self-care, preventive services, primary care, and mental health services. PACT is a partnership between the Veteran and the health care team with an emphasis on prevention, health promotion, and self-management. PACTs use a team-based approach, with various members of the team stepping in at different points in time to provide needed care. We will expand and refine, in coordination with DoD, research into the long-term consequences of TBI and PTSD. VA will increasingly seek to understand underlying health, injury and disorder mechanisms to create evidence-based diagnosis, treatment, and rehabilitation methods for Veterans and eligible beneficiaries with support from their families.

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In partnership, the Department of Housing and Urban Development (HUD) and Department of Veterans Affairs (VA) aim to reduce the number of Veterans living on the streets, experiencing homelessness to zero (as measured by the 2016 PIT Count).

Indicators:

1. Reduction in homeless Veterans living on the streets, experiencing homelessness to zero (as measured by the FY 2016 PIT Count).

The “Number of Homeless Veterans” on a single night is determined by the Point-In-Time (PIT) Count which is conducted annually the last week of January each year “The PIT Count reflects the results of the work performed and the fiscal obligation/budget made in the prior fiscal year”.

2. Reduction in total homeless Veterans temporarily living in shelters or transitional housing to 12,500 (as measured by the FY 2016 PIT Count).


 

 

Overview

VA has taken decisive action toward its goal of ending homelessness among Veterans.  The Eliminate Veteran Homelessness (EVH) initiative is intended to prevent Veterans and their families from entering homelessness and to assist those who are homeless in exiting as safely and quickly as possible.  VA’s “no wrong door” philosophy will ensure that homeless and at risk for homeless Veterans have timely access to appropriate housing and services.  Any door a Veteran comes to - at a medical center, a regional office, or a community organization - will lead to the tools to offer Veteran assistance.  Eliminating homelessness among Veterans will advance the mission of VA by ensuring that all Veterans and their families achieve housing stability.

On a single night in January 2013 during the Point in Time (PIT) Count[1], there were 57,849 homeless Veterans in the US.  Effectively ending homelessness among Veterans requires rapid access to permanent housing, health care, employment, benefits and other supportive services.  VA works closely with community partners to meet current and new demands for any Veteran who is experiencing or is at imminent risk of homelessness.  Housing First and Rapid Re-housing are two of the many evidence-based approaches VA uses to end homelessness.  The Housing First model follows the philosophy of providing permanent housing as quickly as possible to Veterans/individuals experiencing homelessness and then wrapping health care and other supportive services as needed around the Veteran to sustain housing and improve their quality of life.  Rapid Re-housing is a set of strategies to help families quickly move out of homelessness and into permanent housing.  It typically involves: housing search and landlord mediation assistance, short-term or flexible rental assistance, and transitional case management services.  Rapid Re-housing provides crisis intervention services to quickly place an individual or family who is currently homeless into a permanent, sustainable housing situation.


[1] The annual PIT estimates are a snapshot of homelessness.   They are submitted to HUD each year by communities and account for homeless Veterans in emergency shelters or transitional housing on the night of the PIT count (i.e., sheltered) as well as homeless Veterans who are in places not meant for human habitation such as the streets, abandoned buildings, cars, or encampments (i.e., unsheltered). Communities typically conduct their PIT count during the last week in January when a large share of the homeless population is expected to seek shelter rather than stay outside. Because counting people in shelters is more precise than conducting street counts, the timing of the PIT count is intended to improve the accuracy of the estimates.  (Source:  Veteran Homelessness:  A Supplemental Report to the 2010 Annual Homeless Assessment Report to Congress).

 

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Agency Priority Goals

Improve client and stakeholder awareness of, and access to, Veterans Affairs benefits and health care services.  By September 30, 2015, VA will increase the use of virtual service options by increasing the percent of claims received electronically, by increasing the number of accredited Veterans service officers registered on the Stakeholder Enterprise Portal, by increasing the number of registered eBenefits users, and by increasing the percent of patients who access VA health care using a virtual format such as video telehealth or online services.

Indicators:

  1. Increase the annual percent of disability compensation claims received virtually/electronically from a baseline of 2 percent in 2013, to 12 percent in fiscal year (FY) 2014 and 20 percent in FY 2015.
  2. Increase the number of accredited Veterans advocates who are registered users on the Stakeholder Enterprise Portal (SEP) from a baseline of 1,000 in FY 2013, to 2,000 in FY 2014 and 3,500 in 2015.
  3. Increase the number of registered eBenefits users to 3.8 million in FY 2014 and 5 million in FY 2015.
  4. Increase the percent of patients who access VA health care using a virtual format (e.g., video, smart phone or online services) from 23 percent baseline utilization in FY 2013, to 30 percent in FY 2014 and 35 percent in FY 2015.

VA’s focus in FY 2014-2015 is to deliver seamless and integrated services while increasing the efficiency and effectiveness of virtual access. To achieve the best possible outcomes for Veterans, Servicemembers, and eligible beneficiaries, VA will improve access to, and encourage the use of, its virtual benefits and services.  VA and DoD have established a jointly supported portal known as eBenefits, which allows Veterans, Servicemembers, and other eligible beneficiaries to access and submit information when, where, and how they want.

The development and proliferation of virtual access to care supports an organizational approach that is personalized, proactive, and patient-driven.  VA virtual health services use technology and health informatics to provide Veterans with better access and more effective care management.  Advances in virtual care expand where health care services can be accessed, reduce the need for travel to medical facilities, and transform VA’s delivery of health care and its effect on patients’ health outcomes.  Improved access to care through telehealth and other virtual services is of particular benefit to rural Veterans, as well as those with chronic conditions and/or impaired mobility.

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Improve accuracy and reduce the time it takes to complete disability benefit claims.  Eliminate the disability claims backlog and process all claims in 125 days with 98 percent accuracy in FY 2015.

Indicators:

  1. Reduce the percentage of disability claims pending for more than 125 days to 50 percent in FY 2014 and 0 percent in FY 2015.
  2. Improve national issue-based rating accuracy for disability claims to 97 percent in FY 2014 and 98 percent in FY 2015.
  3. Improve national claim-based rating accuracy for disability claims to 94 percent in FY 2014 and 98 percent in FY 2015.

VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog in FY 2015.  Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner.  In 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency.  However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this APG.  To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy.  As of the end of September 2013, over 60 percent of VBA’s inventory is in electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS).  In addition, VA is delivering training that is more aligned with the needs of the workforce to operate in this electronic environment.  VBA is encouraging Veterans to submit Fully Developed Claims (FDC) that include all supporting evidence when the claim is filed.  The FDC is typically the fastest way for Veterans to receive a decision on their claims.  Increasing the number of FDCs filed electronically by Veterans, or by Veterans’ representatives on their behalf, reduces the major source of delay associated with gathering evidence to support a claim and helps reduce the overall time it takes to process a claim.  Through people, process, and technology integrated initiatives, the workforce will achieve the goal of eliminating the disability claims backlog.

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In partnership, the Department of Housing and Urban Development (HUD) and Department of Veterans Affairs (VA) aim to reduce the number of Veterans living on the streets, experiencing homelessness to zero (as measured by the 2016 PIT Count).

Indicators:

1. Reduction in homeless Veterans living on the streets, experiencing homelessness to zero (as measured by the FY 2016 PIT Count).

The “Number of Homeless Veterans” on a single night is determined by the Point-In-Time (PIT) Count which is conducted annually the last week of January each year “The PIT Count reflects the results of the work performed and the fiscal obligation/budget made in the prior fiscal year”.

2. Reduction in total homeless Veterans temporarily living in shelters or transitional housing to 12,500 (as measured by the FY 2016 PIT Count).


 

 

Overview

VA has taken decisive action toward its goal of ending homelessness among Veterans.  The Eliminate Veteran Homelessness (EVH) initiative is intended to prevent Veterans and their families from entering homelessness and to assist those who are homeless in exiting as safely and quickly as possible.  VA’s “no wrong door” philosophy will ensure that homeless and at risk for homeless Veterans have timely access to appropriate housing and services.  Any door a Veteran comes to - at a medical center, a regional office, or a community organization - will lead to the tools to offer Veteran assistance.  Eliminating homelessness among Veterans will advance the mission of VA by ensuring that all Veterans and their families achieve housing stability.

On a single night in January 2013 during the Point in Time (PIT) Count[1], there were 57,849 homeless Veterans in the US.  Effectively ending homelessness among Veterans requires rapid access to permanent housing, health care, employment, benefits and other supportive services.  VA works closely with community partners to meet current and new demands for any Veteran who is experiencing or is at imminent risk of homelessness.  Housing First and Rapid Re-housing are two of the many evidence-based approaches VA uses to end homelessness.  The Housing First model follows the philosophy of providing permanent housing as quickly as possible to Veterans/individuals experiencing homelessness and then wrapping health care and other supportive services as needed around the Veteran to sustain housing and improve their quality of life.  Rapid Re-housing is a set of strategies to help families quickly move out of homelessness and into permanent housing.  It typically involves: housing search and landlord mediation assistance, short-term or flexible rental assistance, and transitional case management services.  Rapid Re-housing provides crisis intervention services to quickly place an individual or family who is currently homeless into a permanent, sustainable housing situation.


[1] The annual PIT estimates are a snapshot of homelessness.   They are submitted to HUD each year by communities and account for homeless Veterans in emergency shelters or transitional housing on the night of the PIT count (i.e., sheltered) as well as homeless Veterans who are in places not meant for human habitation such as the streets, abandoned buildings, cars, or encampments (i.e., unsheltered). Communities typically conduct their PIT count during the last week in January when a large share of the homeless population is expected to seek shelter rather than stay outside. Because counting people in shelters is more precise than conducting street counts, the timing of the PIT count is intended to improve the accuracy of the estimates.  (Source:  Veteran Homelessness:  A Supplemental Report to the 2010 Annual Homeless Assessment Report to Congress).

 

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Strategic Objectives

Increase Customer Satisfaction through Improvements in Benefits and Services Delivery Policies, Procedures, and Interfaces

Summary:

VA is a customer service organization. Complicated application processes, long processing timelines or difficulties getting information and appointments all impact the client’s experience and satisfaction. Veterans and eligible beneficiaries deserve a support system that is responsive to their needs. VA must keep pace with Veterans’ expectations and transform its customer services – soliciting regular customer feedback, streamlining processes, and delivering consistent service across customer-preferred channels.

We live in a connected world. The rapid pace of technological advancement is reshaping Veterans’ expectations regarding how services, benefits, and support should be delivered. Today’s client expects instant access to information and self-service options via the Internet, and increasingly through mobile devices like tablets and smartphones (and the next generation “smart” devices that are yet to be deployed).

To provide a personalized experience, we must listen, learn, and understand the needs and expectations of those we serve. We must have the knowledge, information and insight to understand why some choose not to fully engage with VA.

Strategies:

VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog. We will then implement a robust plan, and revisit procedures to ensure claims are addressed in no more than 125 days with at least 98 percent accuracy. The plan includes redesigning policies and procedures, continuing to enhance training for claims processors, and utilizing the most advanced IT. We will also increase the use of video teleconference hearings to address claims appeals.

VA will continue to expand implementation of PACT to improve partnerships with Veterans and eligible beneficiaries, increase team-based care coordination and management, and expand access to care. VA will improve patient-facing and clinician-facing e-health systems by expanding the development and use of health-related virtual modalities. These modalities include telehealth[1], E-Consult[2], secure messaging, MyHealtheVet, and mobile applications.

VA will enhance client satisfaction by capturing client data once, sharing it enterprise-wide, and using this client data for a lifetime, which will promote more efficient use of data across business lines. We will identify sources of consistent, reliable, and authoritative Veteran data. We will establish architecture, business rules, roles and responsibilities, and governance to enable VA lines of business to use the authoritative common client data to improve delivery of benefits and services to Veterans. VA will gain access to additional external data, knowledge, and experiences so we can broaden our understanding of our client’s needs and expectations. We will enable secure, privacy-protected electronic exchange of personal, health, and economic data on Veterans from induction oath through the final survivor benefit.

VA will rethink its operations as a Department, defining the fundamental crosscutting capabilities and interdependencies required to perform them. We will identify and address any internal organizational, policy, procedural, perceptual, and cultural boundaries that constrain our ability to coordinate, integrate, and deliver benefits and services.

VA will streamline its virtual presence (Web sites, portals and call centers), reducing duplication and enhancing personalization to enable clients to get the information they need, on their schedule.

VA will increase access to burial benefits in national cemeteries through its plans to construct five new national cemeteries and by recognizing and addressing the unique needs of Veterans and eligible beneficiaries who reside in densely populated urban areas as well as sparsely populated rural locations. We will ensure that the service and appearance of our national cemeteries meets the highest standards commensurate with these national shrines.

 


[1] Telehealth uses information and telecommunication technologies to provide health care services in situations in which the patient and practitioner are separated by geographical distance. Telehealth in VA increases access to high quality health care services using Clinical Video Telehealth (CVT), Home Telehealth (HT) and Store and Forward Telehealth (SFT).

[2] E-Consult is an approach to provide clinical support from provider to provider.  Through a formal consult request, processed and documented in the Computerized Patient Record System, a provider requests a specialist to address a clinical problem or to answer a clinical question for a specific patient.  Utilizing information provided in the consult request and/or review of the patient’s electronic medical record, the consultant provides a documented response that addresses the request without a face-to-face visit.

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Agency Priority Goals

Improve client and stakeholder awareness of, and access to, Veterans Affairs benefits and health care services.  By September 30, 2015, VA will increase the use of virtual service options by increasing the percent of claims received electronically, by increasing the number of accredited Veterans service officers registered on the Stakeholder Enterprise Portal, by increasing the number of registered eBenefits users, and by increasing the percent of patients who access VA health care using a virtual format such as video telehealth or online services.

Indicators:

  1. Increase the annual percent of disability compensation claims received virtually/electronically from a baseline of 2 percent in 2013, to 12 percent in fiscal year (FY) 2014 and 20 percent in FY 2015.
  2. Increase the number of accredited Veterans advocates who are registered users on the Stakeholder Enterprise Portal (SEP) from a baseline of 1,000 in FY 2013, to 2,000 in FY 2014 and 3,500 in 2015.
  3. Increase the number of registered eBenefits users to 3.8 million in FY 2014 and 5 million in FY 2015.
  4. Increase the percent of patients who access VA health care using a virtual format (e.g., video, smart phone or online services) from 23 percent baseline utilization in FY 2013, to 30 percent in FY 2014 and 35 percent in FY 2015.

VA’s focus in FY 2014-2015 is to deliver seamless and integrated services while increasing the efficiency and effectiveness of virtual access. To achieve the best possible outcomes for Veterans, Servicemembers, and eligible beneficiaries, VA will improve access to, and encourage the use of, its virtual benefits and services.  VA and DoD have established a jointly supported portal known as eBenefits, which allows Veterans, Servicemembers, and other eligible beneficiaries to access and submit information when, where, and how they want.

The development and proliferation of virtual access to care supports an organizational approach that is personalized, proactive, and patient-driven.  VA virtual health services use technology and health informatics to provide Veterans with better access and more effective care management.  Advances in virtual care expand where health care services can be accessed, reduce the need for travel to medical facilities, and transform VA’s delivery of health care and its effect on patients’ health outcomes.  Improved access to care through telehealth and other virtual services is of particular benefit to rural Veterans, as well as those with chronic conditions and/or impaired mobility.

Learn More

Improve accuracy and reduce the time it takes to complete disability benefit claims.  Eliminate the disability claims backlog and process all claims in 125 days with 98 percent accuracy in FY 2015.

Indicators:

  1. Reduce the percentage of disability claims pending for more than 125 days to 50 percent in FY 2014 and 0 percent in FY 2015.
  2. Improve national issue-based rating accuracy for disability claims to 97 percent in FY 2014 and 98 percent in FY 2015.
  3. Improve national claim-based rating accuracy for disability claims to 94 percent in FY 2014 and 98 percent in FY 2015.

VA will provide timely, accurate decisions on Veterans’ disability claims and eliminate the claims backlog in FY 2015.  Improving quality and reducing the length of time it takes to process disability claims are integral to VA's mission of providing benefits to eligible Veterans in a timely, accurate, and compassionate manner.  In 2013, VBA began measuring the accuracy of individual issues for each claim (“issue-based accuracy”), as it provides a more detailed measure of workload proficiency.  However, VBA will continue to monitor and report out on claim-based accuracy as a key indicator for this APG.  To improve benefits delivery, VA is transitioning to an electronic claims process that will reduce processing time and increase accuracy.  As of the end of September 2013, over 60 percent of VBA’s inventory is in electronic format and is being processed electronically by VBA employees using the Veterans Benefits Management System (VBMS).  In addition, VA is delivering training that is more aligned with the needs of the workforce to operate in this electronic environment.  VBA is encouraging Veterans to submit Fully Developed Claims (FDC) that include all supporting evidence when the claim is filed.  The FDC is typically the fastest way for Veterans to receive a decision on their claims.  Increasing the number of FDCs filed electronically by Veterans, or by Veterans’ representatives on their behalf, reduces the major source of delay associated with gathering evidence to support a claim and helps reduce the overall time it takes to process a claim.  Through people, process, and technology integrated initiatives, the workforce will achieve the goal of eliminating the disability claims backlog.

Learn More