Posted on 3 Oct, 2018
It seems that that the Veterans Choice Program, intended to help veterans seek private health care, is in terrible shape. Such bad shape, in fact, that even a recent bill meant to fix it might not even be able to do so. This is according to the Government Accountability Office.
The aim of the Choice program was to lessen wait times by allowing more access to private services. However, the CAO performed an audit which concluded that in many cases, veterans had to wait longer to see a private clinic than they would have for VA appointments. The report pointed out that for a program that was primarily aimed at reducing wait times, it was failing. Veterans under the Choice program were waiting up to 70 days to visit with a private doctor, as opposed to 51 for a VA doctor. The report also went on to mention that these delays are affecting the veterans’ “morbidity, mortality, and quality of life.”
The new bill, which is backed by President Trump, is called the VA Mission Act. The act would give a $4.2 billion boost to the Choice program to make it faster for veterans to access private care. It will also consolidate the current seven care options into one. However, the GAO noted in its report that some of the main issues, such as communication between the VA and the private care providers, staff shortage, and bureaucratic issues, will make fixing the problems, even with the added money, difficult. Their main concern is that the VA will ignore some of those issues and challenges and not learn lessons from them.
VA Vows to Fix Issues With Choice Program
One of the major issues is the lack of communication between all of the entities that are involved in the program. There is the Veterans Health Administration (VHA), the VA medical centers, and the Office of Community Care (OCC). Outside of the VA there is the Computerized Patient Record System, the Community Care Network, and the private doctors. Those doctors also claim there is a problem with getting paid late.
The VA has agreed to comply with four of the recommendations made by the GAO to improve the Choice program. The one that they did not concur with was in regards to urgent care. The GAO recommended that referrals to private care be categorized as urgent if a VHA doctor felt that any delays could lead to negative health issues. The VA says it has already fixed the issue with their contract with the Community Care Network that allows them to better categorize referrals.
With this contract, staff at the VHA can directly schedule appointments with private providers. In the past, they would send referrals to third-parties for scheduling. The VA Mission Act will also establish the Health Share Referral Manager (HSRM). The HSRM will help track how long it takes from consults to appointments with private providers.
The VA In Transition
Estimates have the VA Mission Act costing up to $55 billion over 5 years. They have not yet identified any sources of funding, but backers of the bill are confident they will find some. As the bill comes into law, the VA itself is in a state of transition. VA secretary Dr. David Shulkin was fired by Trump in March, and Robert Wilkie has been the acting secretary ever since. Trump plans on nominating Wilkie for the permanent post, however he had to step down for a time because of a law stating that interim secretaries cannot take the permanent job. As it stands, no date has been set for his confirmation. Peter O’Rourke is currently working as the acting secretary.
Repairing or replacing Veterans Choice program will be a huge undertaking, but the work needs to start soon to make it function for all of our veterans.