A new system designed to ensure that the Department of Veterans Affairs reimburses veterans for appointment-related travel quickly and properly is not living up to expectations, frustrating veterans and causing headaches for travel staff.
The Veterans Health Administration rolled out its Beneficiary Travel Self Service System, a web-based travel reimbursement program, in November 2020 to replace a long-standing system accessible through stand-alone kiosks at VA medical facilities or by submitting paper claims.
Goals for the new program, known as BTSSS, were to make it easier for veterans to file travel claims and decrease the amount the VA improperly paid out for claims. Incorrect payments increased from $70 million in fiscal 2013 to $123 million in fiscal 2021.
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The Veterans Health Administration spent more than $1.3 billion on patient travel in fiscal 2021, an increase from roughly $1 billion in fiscal 2019 and $890 million in fiscal 2020.
Shortly after the system was introduced and the VA began removing travel kiosks from hospitals and clinics, veterans began notifying Military.com of their concerns with the new system, which is primarily accessed via smartphone or computer.
"The easy-to-use, fast kiosks were implemented systemwide, then, after a few short years, were jerked out with [very] few days warning to veterans," wrote a former service member who did not want to be identified. "Doesn't sound like a big deal for every veteran to cope with? It is!!"
The VA reimburses veterans and, in some cases, their caregivers for travel expenses to and from many medical appointments, including mileage, tolls and parking. It even covers airfare in certain cases.
The VA Office of Inspector General began receiving complaints that BTSSS actually slowed down processing and decreased production, prompting the office to investigate whether the new system met expectations.
The system, developed by Liberty IT Solutions, now part of Booz Allen Hamilton, was designed to solve claims automatically, without human involvement, at least 90% of the time and was to be used by veterans without them requiring assistance at least 80% of the time.
But a VA OIG review published last month found that just 17% of claims filed from February 2021 through July 2022 were automatically adjudicated, "well short of ... the goal of 90 percent." It also calculated that veterans used the web-based portal for only about 49% of total claims.
The OIG found that travel staff implemented work-arounds to deal with the new program and frequently relied on the old system to fill claims.
It also determined that the VA failed to effectively communicate with veterans and veterans service organizations before changing over to the new system and, instead, solicited feedback only from veterans who worked at the VA program office responsible for implementation, not patients or VSOs.
"Further, the program office did not provide training to veterans on how to enter claims in BTSSS until almost five months after system launch. Consequently, during system rollout, the review team found that some veterans experienced difficulties creating user accounts and lacked needed training on how to use the new system to enter travel claims," according to the report, "Goals Not Met for Implementation of the Beneficiary Travel Self-Service System."
VA officials say they have implemented a new patient check-in process designed to simplify the steps taken before a veteran is seen for an appointment, and that is why the kiosks were removed.
A decision has been made, however, to integrate BTSSS with the new patient check-in process, "expected for completion later this summer," according to John Saulmon, chief of staff for member services at the VHA.
The VA also is developing a program that will allow it to more efficiently handle paper claims in the system. Travel claims will then be submittable online, via email, by fax or in person during patient check-in.
The VA estimates that 90% of veterans have access to a smartphone or other mobile device, and it encourages them to use the system. VA medical centers were urged to conduct outreach when the program was first introduced, and how-to videos are available online, according to Saulmon.
In the VA's response to the report, officials said they concurred with the OIGs recommendations to improve the system and would work harder to effectively communicate with patients on how to access the system through their computer or smartphone.
"We will utilize the customer feedback [of the baseline BTSSS veteran survey] to perform targeted user testing by veterans to develop and prioritize future changes to [the system]," VA officials wrote in their response.
Sen. Jon Tester, the Montana Democrat who chairs the Senate Veterans Affairs Committee, has pressed the VA to address issues with the system and make it more user-friendly.
Last week, Tester called it unacceptable that veterans weren't consulted before the BTSSS was introduced, and he implored the department to make immediate changes.
"The bottom line is that VA needs to fix this system without further delay, and I look forward to seeing renewed efforts to repair the trust lost from veterans in this process," Tester said in a press release.
-- Adrian Bonenberger contributed to this report.
– Patricia Kime can be reached at Patricia.Kime@military.com. Follow her on Twitter @patriciakime
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