Strategies to improve compensation and pension timeliness: lessons learned from high-performing facilities

The compensation and pension (C&P) process is the mechanism by which injured Veterans are assigned their medical and disability benefits. As part of the documentation and rating process performed by the Veterans Benefits Administration (VBA), many Veterans need supplemental medical examinations performed by the Veterans Health Administration (VHA). Improving C&P examination timeliness is a goal of many VHA facilities. To identify strategies to improve examination timeliness, we used national performance measures to identify high-performing VHA facilities. We then interviewed seven facilities using Donabedian's structure-process-outcome framework to determine characteristics attributed to their high-performance. We developed a list of high-performance characteristics common to all facilities, which relied on a tailored relationship between each VHA facility and VBA office. Additional characteristics were grouped thematically into three management foci - financial incentives, role specialization, and process reliability. Distillation of these characteristics provides guidance to other VHA facilities seeking to improve their C&P timeliness.