The number of vets who received long-term care support from the VA rose 14% from 2014 to 2018, while the VA's long-term care spending jumped 33% during that period, going from $6.8 billion to $9.1 billion. That growth is expected to continue as veterans get older and have more disabilities related to their military service. Long-term care spending on veterans is expected to reach $14.7 billion in 2037.
"As one of the largest healthcare systems in the United States, VA faces challenges similar to other healthcare providers when seeking to meet the growing need for long-term care as the U.S. population ages," GAO said.
The agency is having trouble finding enough workers to care for aging and disabled veterans and providing care in the areas where it's most needed. The VA is also struggling to provide specialty care to its long-term care population.
"Most veterans receive long-term care through noninstitutional programs in their homes or communities, while others receive more extensive care in institutional programs such as nursing homes," GAO said.
Officials plan to improve veterans' access to noninstitutional programs like veterans' homes to reduce the agency's reliance on nursing homes and rein in costs. But it hasn't set any measurable goals to address the workforce shortages, geography problems or specialty care access, according to GAO.
The watchdog recommended that the VA establish measurable goals to address its long-term care challenges and improve its management structure for handling veterans' long-term needs. The VA should also standardize the tool it uses to assess the noninstitutional needs of vets across the Veterans Affairs Medical Center, GAO said.
VA officials agreed with GAO's recommendations.