The US Department of Veterans Affairs (VA) began an Accelerated Care Initiative in May of 2014 to ensure that Veterans are being well cared for. With access to non-VA physicians, Veterans are able to bypass long waitlists more quickly and get the care they need in a timely manner. Some reimbursement rates; however, may fall below the Medicare rates.

In January 2014, the VA launched the Patient-Centered Community Care (PC3) program, enabling veterans to access healthcare outside of the VA. The program has contracted with Health Net Federal Services LLC and TriWest Healthcare Alliance Corp. Each network has been allotted certain regions and provides the following services:

  • Primary care
  • Specialty care
  • Mental health care
  • Limited emergency care
  • Limited newborn care

Primary care was only recently added to this list with an expansion of the PC3 program. Both Health Net and TriWest are in agreement that lower reimbursement rates are acceptable.

In the past few months, there have been 838,000 referrals to non-VA physicians, as opposed to 166,000 at the same time last year. The Veterans Access, Choice, and Accountability Act provides the VA with a significant amount of money to improve the system:

  • $10 billion for the increased access to non-VA care
  • $5 billion to hire more VA staff
  • $1.3 billion to expand VA facilities in 18 states and Puerto Rico

According to the House Committee on Veteran’s Affairs website, this bill would create net spending of about $10 billion from 2014 to 2024 which is less costly than past reform efforts. An article in the Washington Post states that the VA spent $4.8 billion on non-VA care in 2013.

Author: Apoorva Anupindi

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