Department of Veterans Affairs Proposal to Expand Private Health Care Arrangements
November 24, 2015 02:40 PM
On Wednesday, November 18, officials from the Department of Veterans Affairs (VA) testified before the House Committee on Veterans' Affairs and unveiled a new proposal to expand the use of private health care arrangements in order to improve VA's ability to keep up with the growing demand in care from veterans. VA Deputy Secretary Sloan Gibson explained that VA is taking action to modernize the agency’s culture, processes, and capabilities. This includes a plan to consolidate community care programs and business processes, as well as consolidating all purchased care programs into one New Veterans Choice Program (New VCP).
Earlier this year, reports surfaced of veterans across the country facing delays and denials in services. The National Association for Home Care & Hospice (NAHC) received reports of VA denying authorizations and renewal authorizations of home health and other services due to funding shortages (see previous NAHC Report article here). VA stated that it faced a budget shortfall for the rest of the year and requested flexibility to expand the use of non-VA providers.
Last week, Gibson stated that the New VCP will clarify eligibility requirements, build on existing infrastructure to develop a high-performing network, streamline clinical and administrative processes, and implement a continuum of care coordination services. “Consolidation will improve access and make the process easier for veterans to use,” Gibson said. “Veterans will have better access to the best care outside VA, providers will be encouraged to participate and to provide higher-quality care, and VA employees will be able to serve both better, while also being good stewards of taxpayer funds.”
The New VCP would require Congressional approval of the requested legislative changes and funding. VA estimates the cost to redesign the system ranges from $1.2 billion to $2.4 billion for the first three years.
House Committee on Veterans’ Affairs Chairman Jeff Miller (R-FL) stated that as the veteran population continues to grow in both age and number and as the health care landscape continues to shift, the need for non-VA providers to supplement the care that VA provides in-house will only continue to grow. However, he stated that the success of VA’s Care in the Community program is hampered by inconsistent and competing eligibility requirements, business processes, and reimbursement rates across the seven methods that VA currently uses to refer veterans to outside providers. Miller explained that the proposal VA submitted in late October to accomplish non-VA care consolidation and take the first steps toward building the VA healthcare system to its full potential “offers a promising but still poorly defined vision of a future ideal state of VA care that offers little in the way of concrete details, timelines, or goalposts.”
The Committee members pressed the VA witnesses on what actions they are able to take without legislation. VA officials responded that the agency is presently working to effect near-term changes, called “quick hits,” without legislation; for example, moving towards implementing a standard template agreement between the VA and all community providers.
For more information about the hearing and the witnesses, please click here. NAHC Report will continue to provide updates regarding the status of the new VA proposal.