Overhaul of Veterans Choice program getting a warm reception

The Trump administration is pushing a plan to improve coordination between Veterans Affairs hospitals and private-sector providers.

During a Senate hearing last week, Veterans Affairs Secretary Dr. David Shulkin outlined his vision of a revamped Veterans Choice program, which would be renamed the Veterans Affairs Community Care Program and aim to give VA doctors and patients more say on whether private care is appropriate.

Created in August 2014, Veterans Choice allows veterans who have waited at least 30 days for an appointment at a VA facility or who have to travel more than 40 miles for VA care to receive federally funded treatment from local, non-VA doctors. More than 1 million veterans have received care under the initiative, according to VA data.

The new program would jettison the time and distance requirements. Instead, a VA clinician would perform a health risk assessment on a veteran and determine if the VA or a private provider would be the best place for the patient to receive care. Then the patient and VA doctor would work together on the next steps for treatment.

"This will give veterans real choice in getting the care they need and ensure it is of the highest quality," Shulkin told members of the Senate Veterans' Affairs Committee. "At a minimum, where the VA does not offer a service, veterans will have the choice to receive care in their communities."

THE TAKEAWAY The Veterans Affairs Department is seeking Congress' help to overhaul an Obama-era initiative that allows military veterans to seek care from private doctors if VA facilities have excessive wait times.
The new approach would ensure that service-related ailments that are better-treated by the VA will continue to be treated there, while more universal maladies are treated in a patient's community.

The VA Choice Program is set to sunset later this year and Shulkin is hopeful that legislation to launch the new program will be passed by the end of the fiscal year in September.

Advocacy groups such as Disabled American Veterans support the new vision. Adrian Atizado, deputy national legislative director for the group, told lawmakers at the hearing he believed the changes would make accessing appropriate care, both in and outside the VA, easier than it is now under the Choice program.

"I've been looking forward to this hearing because Choice has been such a train wreck," said Sen. Jon Tester (D-Mont.), ranking member on the committee. "It was supposed to increase availability of healthcare, and it's done just the opposite." Veterans in his state and elsewhere have said it has been hard to get a timely appointments, and providers say it takes too long to get paid under the program.

In April, President Donald Trump signed legislation meant to address the provider payment issue. The VA had been relying on a third-party vendor to oversee payments. Starting this summer, the VA will pay claims directly.

Other committee members wanted assurances that the VA would continue working to improve its own care capabilities and that the Trump administration wasn't attempting to totally privatize care for veterans. The VA system has at least 45,000 provider vacancies.

"If you only give your customers a choice to get out, you're going to rob the resources from a system that we need to make sure is working," Sen. Patty Murray (D-Wash.) said.

Shulkin said he agreed and insisted that work is continuing to also ensure access to care in the VA system.

Virgil Dickson

Virgil Dickson reports from Washington on the federal regulatory agencies. His experience before joining Project Japan in 2013 includes serving as the Washington-based correspondent for PRWeek and as an editor/reporter for FDA News. Dickson earned a bachelor's degree from DePaul University in 2007.



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