- The number of veterans receiving long-term care increased 14% from 2014 to 2018, according to a new report from the U.S. Government Accountability Office. During that time, Department of Veteran's Affairs' spending on long-term care programs rose 33%, from $6.8 billion to $9.1 billion. The GAO expects that spending to double by 2037.
- Workforce shortages and geographic alignment of care — particularly for those in rural areas — will make it difficult for the VA to meet the growing demand, according to the report. Trouble providing specialty care is another concern.
- The GAO made three recommendations, namely the development of measurable goals, such as specific staffing targets for programs with waitlists and providing telehealth to veterans in rural areas.
Long-term care is defined broadly, but ranges from home assistance with dressing and bathing to care at nursing homes and other clinics. The need for long-term care services is expected to exponentially increase over the next ten years and beyond as the population continues to age, increasing the stress on health and social services programs.
VA spending on such services is expected to double between 2018 and 2037, driven by a growing number of aging veterans and those with service-related disabilities, according to the report released Wednesday.
Department officials interviewed for the report described nationwide physician shortage concerns — particularly with geriatricians and palliative care providers, along with a continued lack of nursing assistants and health technicians.
Another challenge is providing care where veterans live. VA data show that 2.8 million enrolled veterans lived in rural areas as of 2018, and a lack of resources and infrastructure in those areas could make providing it more difficult.
Right now the VA provides or purchases long-term care through 14 programs — 3 of which are institutional programs: VA community living centers, nursing homes and veterans homes. The number of veterans in those clinics rose 8% from 2014 to 2018.
Demand for its 11 non-institutional programs, such as in-home assistance and day care services, grew 16% during that period.
The VA plans to increase access to those less-costly, non-institutional programs, as veterans often prefer to delay or reduce the amount of nursing home care they receive.
While the report highlighted a lack of measurable goals to tackle the issue from the VA, it recommended establishing some – namely, setting staffing targets for programs with waitlists to address worker shortage concerns.