What GAO Found
Veterans living in rural areas can face challenges that lead to disparities in access and quality of health care compared with their urban counterparts. For example, previous GAO work and research have highlighted staffing shortages and limited access to broadband internet that may affect rural veterans’ access to health care. The Department of Veterans Affairs (VA) identified the Office of Rural Health, within the Veterans Health Administration (VHA), as one of the main offices responsible for increasing rural veterans’ access to care. The office’s mission is to improve the health and well-being of rural veterans through research, innovation, and the dissemination of best practices. To support its mission, the office provides two types of funding:
Initiatives. Funds are used by VHA program offices to expand existing VHA services to rural veterans, such as providing transportation to medical care.
Research. Projects are used by VA researchers to develop, test, and disseminate research in areas outlined in the office’s goals and mission. The office’s five resource centers, which are field-based hubs, manage a portfolio of research projects in support of the office’s mission.
In a May 2023 report GAO recommended that the office require its five resource centers to communicate available research funding opportunities across VA. Each of the resource centers is responsible for identifying research projects to fund; however, GAO found the centers only communicate funding opportunities to VA researchers by word-of-mouth, rather than through a formal process. Relying on informal processes to communicate the availability of funding potentially creates a disadvantage for researchers with whom the resource center staff do not have existing relationships. VA concurred with the recommendation. As of October 2023, it reported that the office has begun taking steps to develop standard operating procedures for communicating research funding opportunities. VA anticipates developing standardized procedures by May 2024.
GAO also recommended that the Office of Rural Health develop performance goals that reflect leading practices, such as being objective and measurable. For years 2020 through 2024, the office’s strategic goals are to promote federal and community care solutions for rural veterans, reduce rural health care workforce disparities, and enrich rural veteran health research and innovation.
However, in its May 2023 report, GAO found the office had not developed performance goals that define the level of performance the office aims to achieve during a particular year. For example, while the office collects data on the number of clinicians trained through its funded initiatives and research projects, it had not defined how many clinicians should be trained each year to achieve its strategic goal of reducing health care workforce disparities. By developing performance goals that reflect leading practices, the office can determine which strategic goals may need additional focus or resources to ultimately improve rural veterans’ health and well-being. VA concurred with the recommendation. As of October 2023, the office began taking steps to develop performance goals to include in its 2025 – 2029 strategic plan.
What GAO Found
Veterans living in rural areas can face challenges that lead to disparities in access and quality of health care compared with their urban counterparts. For example, previous GAO work and research have highlighted staffing shortages and limited access to broadband internet that may affect rural veterans’ access to health care. The Department of Veterans Affairs (VA) identified the Office of Rural Health, within the Veterans Health Administration (VHA), as one of the main offices responsible for increasing rural veterans’ access to care. The office’s mission is to improve the health and well-being of rural veterans through research, innovation, and the dissemination of best practices. To support its mission, the office provides two types of funding:
Initiatives. Funds are used by VHA program offices to expand existing VHA services to rural veterans, such as providing transportation to medical care.
Research. Projects are used by VA researchers to develop, test, and disseminate research in areas outlined in the office’s goals and mission. The office’s five resource centers, which are field-based hubs, manage a portfolio of research projects in support of the office’s mission.
In a May 2023 report GAO recommended that the office require its five resource centers to communicate available research funding opportunities across VA. Each of the resource centers is responsible for identifying research projects to fund; however, GAO found the centers only communicate funding opportunities to VA researchers by word-of-mouth, rather than through a formal process. Relying on informal processes to communicate the availability of funding potentially creates a disadvantage for researchers with whom the resource center staff do not have existing relationships. VA concurred with the recommendation. As of October 2023, it reported that the office has begun taking steps to develop standard operating procedures for communicating research funding opportunities. VA anticipates developing standardized procedures by May 2024.
GAO also recommended that the Office of Rural Health develop performance goals that reflect leading practices, such as being objective and measurable. For years 2020 through 2024, the office’s strategic goals are to promote federal and community care solutions for rural veterans, reduce rural health care workforce disparities, and enrich rural veteran health research and innovation.
However, in its May 2023 report, GAO found the office had not developed performance goals that define the level of performance the office aims to achieve during a particular year. For example, while the office collects data on the number of clinicians trained through its funded initiatives and research projects, it had not defined how many clinicians should be trained each year to achieve its strategic goal of reducing health care workforce disparities. By developing performance goals that reflect leading practices, the office can determine which strategic goals may need additional focus or resources to ultimately improve rural veterans’ health and well-being. VA concurred with the recommendation. As of October 2023, the office began taking steps to develop performance goals to include in its 2025 – 2029 strategic plan.
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