Government and Regulations

Shulkin Outlines Veterans Choice Program 2.0

VA Secretary tells Senate: "We believe redesigning community care will result in a strong VA."


 

In testimony before the Senate Veterans Affairs Committee, VA Secretary David J. Shulkin, MD, outlined a vision for a revamped Veterans Choice Program that would allow veterans to access an integrated network of private health care providers for services not currently available at the VA. “We believe redesigning community care will result in a strong VA that can meet the special needs of our veteran population,” Shulkin told the committee. “Where VA excels, we want to make sure that the tools exist to continue performing well in those areas…. We need to move from a system where eligibility for community care is based on wait times and geography to one focused on clinical need and quality of care.”

During the hearing, Dr. Shulkin laid out the basic elements of the new Veterans Choice Program. The proposed changes include the following:

  1. Shifting from determining eligibility for community care based on wait times and geography to clinical need and quality of care;
  2. Streamlining process for veterans to access urgent care when they need it;
  3. Creating what VA is calling a "high performing integrated network,” which would include VA; other federal health care providers, such as military treatment facilities and IHS; academic affiliates; and community providers;
  4. Coordinating care across all providers; and
  5. Adopting recognized industry standards for quality, patient satisfaction, payment models, health care outcomes, and exchange of health information.

Over the past year, major veterans service organizations (VSOs), VA officials, the Commission on Care, and members of the House and Senate have worked together to develop the newly introduced Veterans Choice program. The major stakeholders came together at the hearing to “support the concept of developing an integrated network that combines the strength of the VA health care system with the best of community care to offer seamless access for enrolled veterans,” explained Adrian Atizado, the deputy national legislative director at Disabled American Veterans (DAV) in his prepared remarks.

The joint effort was in part a response to calls from some VA critics to provide veterans with unlimited choice to outside providers or to fully privatize veteran care.

In the hearing, Committee Chairman Johnny Isakson (R-GA) suggested that he would be willing to work with the VA on the changes to the Veterans Choice Program and was largely in support of the effort. “We need to see to it that the VA…is unleashed to provide the highest quality service that it can and make the decisions that it needs to make on the ground at the time we need to make them,” he reported in a release following the hearing. “We need to give them the funding, commitment and resources to be able to do that.”

At the hearing, VSOs praised the VA for its efforts to improve the Veterans Choice Program but still expressed frustration with problems that continue to dog the program. “The VFW [Veterans of Foreign Wars] has also heard from veterans that the breakdown in communication between VA, contractors and Choice providers often delays their care because their Choice doctors do not receive authorization to provide needed treatments,” reported Carlos Fuentes, VFW director national legislative services. “What is concerning is that veterans are left to piece together the entire story or else they do not.”

“While many veterans initially clamored for ‘more Choice’ as a solution to scheduling problems within the VA healthcare system, once this program was implemented, most have not found it to be a solution,” noted Jeff Steele, assistant director national legislative division of The American Legion. “Instead, they have found it to create as many problems as it solves.…What we have found over the past decade, directly interacting with veterans, is that many of the problems veterans encountered with scheduling appointments in VA are mirrored in the civilian community outside VA.

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