Although non-institutional care patients in the Home Telehealth Program show the best outcomes, the number of patients served in non-institutional care grew by only 14 percent in 2012 and declined by 4 percent in 2013. Simultaneously, the number of chronic care management and health promotion/disease prevention patients grew 51 percent and 37 percent respectively, according to the OIG report.
The change in the mix of patients receiving care under the program largely came because of a change in the VA’s performance methodology. The VA began measuring program performance by the total number of patients enrolled rather than focusing on the increase in enrollment for non-institutional care patients. The change encouraged the VA to enroll more health promotion/disease prevention patients, and because their needs were less complex, the VA reached its performance metrics but did not include more patients with more medical needs under the program, according to the report.
The OIG recommended the VA implement methods to identify demand for non-institutional care patients and develop specific performance measures to promote enrollment in the Home Telehealth Program.
