Improvements made in increasing access to Community Care, but more work to be done
WASHINGTON – The Department of Veterans Affairs’ (VA) Veterans Choice Program (VCP) has reached a key milestone in improving access to health care for Veterans. More than two million appointments have been scheduled through the program.
“While two million appointments have been scheduled using the Choice Program and we are making progress, we will not rest until all Veterans who choose VA to be their healthcare provider are receiving the care they need, when they need it,” said VA Secretary Robert McDonald. “We will continue to make strides towards an integrated care network, and I urge Congress to enact our Plan to Consolidate Community Care so we can continue to build upon our progress.”
The Choice Act, which included the VCP, was passed in August 2014 to help Veterans access timely health care both within VA and the community. VA was required to implement a new, national program in just 90 days, with new requirements that complicated the way VA provides community care. VA recognized many of these challenges very early in the implementation of the program and VA and all our stakeholders have been working together to make needed changes while implementing this new nationwide program.
VA has outlined a path to improve community care and create a program that is easy to understand, simple to administer, and meets the needs of Veterans, community providers, and VA staff. VA submitted this plan to Congress in October 2015.
Within the Plan are several legislative proposals that VA and Congress need to work on together to improve the experiences for Veterans and community providers.
- The first proposal would increase Veterans’ access to community care providers by allowing VA to enter into agreements with local community providers.
- The second would streamline when and how much VA pays for health care services by having VA be the primary payer.
- The third fix would allow VA to more accurately account for healthcare purchased in the community.
- Finally, the last request is for funding and funding flexibility to improve access to care, reimburse the cost of emergency treatment, and create value-based payment models to best serve Veterans that need community care.
“VA is developing innovative ideas and solutions to enhance the Veterans experience and strengthen partnerships with community providers” said Dr. Baligh Yehia, Assistant Deputy Undersecretary for Health, Community Care. “The Choice Program of today is a very different program than the one rolled out in November 2014. Many improvements have been made and we continue to work to deliver care to Veterans where and when they need it.”
VCP PROGRESS TO DATE
- Over 2 million appointments scheduled using the VCP significantly increases Veterans access to care.
- Since the start of VCP we have seen a dramatic increase in utilization. From October 2015 to March 2016 VCP authorizations for care have increased 103 percent.
- Over the course of the last 12 months, the Choice Provider Network has grown by 85 percent. The network now has over 350,000 providers and facilities.
- Improved timeliness of payments to community providers by removing the requirement that VA receive the Veteran’s entire medical record prior to payment.
- Reduced administrative burden for medical record submission for community providers by streamlining the documentation required.
- To enhance care coordination for Veterans, we have embedded contractor staff with VA staff at select locations.
- Created dedicated teams from across the county to deliver community care improvements.
- VA has also partnered with Congress to change laws to improve the community care experience by:
- Removing the enrollment date requirement for Choice, allowing more Veterans to receive community care.
- Implementing criteria of 40-mile driving distance from medical facility with primary care physician to increase number of Veterans accessing the program
- Implementing the unusual or excessive burden criteria to increase access for Veterans that do not meet other eligibility criteria.
- Expanding the episode of care authorization from 60 days to up to one year to reduce the administrative burdens of Veterans, community providers, and VA staff.
“VA needs Congress’s continued support to keep driving progress forward,” added VA Secretary Robert McDonald. “Several legislative barriers remain which inhibit improvements outlined in ourPlan to Consolidate Community Care Programs.”