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VA Unveiling Plan to Consolidate Private Doctor Networks

'New Veterans Choice Program' still needs congressional approval

The Department of Veterans Affairs (VA) is about to unveil the New Veterans Choice Program, a plan to combine its private physician networks. Under the program, which the agency plans to give to Congress this week, seven existing VA private health care arrangements would be merged into one system to cut gaps in care and improve care access.

"All of these programs have been layered on top of each other without someone saying, 'How do we rationalize them?'" VA Secretary Robert McDonald said in a Washington Post article summarized by FierceHealthcare. "We want the very best providers connected with us. This is a big deal, and it will be a big improvement over what we have now."

The plan is one of several fixes the agency has proposed since last spring, when a scandal broke involving the use of falsified waiting lists to conceal long care delays at the VA's Phoenix facility. Despite these proposed solutions, an independent report commissioned by the VA found the department’s size and scope make meaningful reforms a logistical nightmare. Numerous leadership positions remain vacant and fears of whistleblower reprisals persist.

The Choice program has encountered problems getting off the ground, according to the article, due in large part to the VA staff's failure to make patients aware of it. When privately insured patients examine their health plans, aspects such as benefits and copays are clear, said Baligh Yehia, MD, the agency's assistant deputy undersecretary for health for community care. Within the VA, however, those benefits can be far harder to pin down. VA officials hope the new program will resolve some of this confusion, he told the Post.

The agency further hopes to develop a single system with one set of rules on who gets referred to outside care and where, as well as streamlining claims, billing, reimbursement, and medical recordkeeping. The plan also increases the VA emphasis on care quality and doctor competency, and would provide patients with a list of doctors to choose as well as their ratings by health plans. The plan, which could cost up to $2.4 billion, still requires congressional approval.

Source: FierceHealthcare, November 19, 2015.

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