The VA’s zero-risk, zero-cost solution to veteran healthcare delays

Today, more than 222,000 licensed nurse practitioners (NPs) are transforming the delivery of healthcare nationwide.

Increasingly, states are recognizing the opportunity to tap the skyrocketing NP workforce to improve healthcare access for their patients, and many are taking the necessary steps to retire outdated laws that have prevented NPs from practicing to the full extent of their education and training.

With 80 percent of NPs prepared in primary care, the US Department of Veteran Affairs (VA) is now eyeing the opportunity to update its own policies to tap the full potential of nurse practitioners across the veterans health system. The VA is the largest health care system in the country, representing more than 1,700 sites and serving 8.76 million veterans annually.

Over two years ago, the media first reported that veterans were waiting far too long for healthcare in VA facilities. Despite the public outcry and media attention, the VA's own data shows that the access challenge continues for our nation's veterans. As of October 15, 2016, well over 530,000 veterans are still waiting 30 days or longer for appointments, and more than 43,000 veterans nationwide are waiting more than 120 days for care.

The impact of access delays on veterans' health is well-known and documented, especially for older veterans. A study by Prentice and Pizer dating back to 2007 found that older veterans visiting VA facilities with average wait times of 31 days or longer suffered significantly higher mortality rates compared to those who visited VA facilities with shorter waits. And, at approximately 30 days, geriatric veterans were more likely to require hospitalization.

In May, the US Department of Veterans Affairs took the first step to update its policies, issuing a proposed rule that would grant veterans direct access to NP care in the VA health system. The policy aligns the VA with the growing trend in states nationwide and reflects much of the DoD's current practice, which ensures active-duty personnel receive high-quality care in all military service branches through direct access to NP care. Nearly 7,000 NPs now practice in healthcare settings specifically designed for those who have served or are currently serving our nation's military.

The VA has reviewed 180,000-plus public comments in response to its proposed solution. There is an immediate need for primary care providers to meet the rising demand for care and the increasing risk health delays pose to veteran health, a growing number of Americans and their organizations say it is time for the VA to act. The American Association of Nurse Practitioners is among many groups, including the Air Force Sergeants Association and the Military Officers Association, as well as 88 percent of U.S. adults, who support this proposal. Well-respected organizations such as the National Academy of Medicine (formerly the IOM) and the Robert Wood Johnson Foundation have supported moves that authorize NPs to practice to the top of their education. And, lawmakers of both parties support implementation of this proposal.

November 11 is Veterans Day, a time when Americans honor the service of our nation's heroes. This year, it seems only fitting that the VA and our nation fulfill their commitment to provide timely healthcare access for our veterans. America's NPs will continue to deliver high-quality care to our veterans, as they do for all patients. With a track record of over five decades of care delivery, NPs are not only compassionate and patient-centered, health care providers, they are also highly skilled professionals who represent a zero-risk, zero-cost solution to solving the healthcare access crisis in our nation's VA health system.

The VA has had sufficient time to weigh the options and to hear from those on both sides of the issue. Veterans can't wait for a change of Administration to receive the care they so desperately need today. Those who sacrificed so much for our country have waited long enough.

The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.​

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