VA announces Veterans Coordinated Access & Rewarding Experiences Act

Replaces current ‘30-day/40-mile' system with patient/provider-centric decision-making


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Today, VA announced that it has presented the House and Senate Veterans Affairs Committees with the administration’s draft proposal of the Veterans Coordinated Access & Rewarding Experiences (CARE) Act, designed to improve Veterans’ experiences with and access to health care, building on the best features of VA’s existing community care programs and strengthening VA’s ability to furnish care in its facilities.

In order to meet Veterans’ needs quickly and in a way that is easy to understand, the bill aims to:

  • Clarify and simplify eligibility requirements,
  • Set the framework for VA to continue to build a high-performing network,
  • Streamline clinical and administrative processes,
  • Implement new care coordination support for Veterans, and
  • Merge and modernize community care programs.

“We want Veterans to work with their VA physicians to make informed decisions that are best for their clinical needs, whether in the VA or in the community, and this bill does just that, while strengthening VA services at the same time,” said VA secretary Dr. David J. Shulkin.

The bill would replace the current wait-time and distance eligibility criteria under the Choice Program (“30-day/40-mile”) with criteria that:

  • Place the Veteran and his or her physician at the center of the decision process on how and where to get the best care available,
  • Ensure VA is improving medical facilities and staffing levels to meet Veterans’ needs in areas where VA care is substandard, and
  • Offer options for Veterans to use a network of walk-in clinics for minor illnesses and injuries.

The CARE Act also includes:

  • Proposals for new workforce tools to assist in maintaining and strengthening VA’s world-class medical staff,
  • A number of business process enhancements to improve financial management of the Community Care program,
  • Provisions that would strengthen VA’s ability to partner with other federal agencies and streamline VA’s real property management authorities.

More information about access to care at the VA can be found at https://www.accesstocare.va.gov/.

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Comments

  1. JACK TAYLOR, PH.D    

    WHENEVER, A WORLD CLASS MEDICAL CENTER AS IS THE UNIVERSITY OF CHICAGO MEDICAL CENTER FOR THE STUDY OF “PERIPHERAL NEUROPATHY” IS BROUGHT TO THE ATTENTION OF A LOCAL VA OUTPATIENT CLINIC, THOSE VA STAFF INVOLVED SHOULD PAY ATTENTION ON BEHALF OF A PAIN SUFFERING VETERAN. DON’T YOU THINK?

    PLEASE AD VISE.

    THANKS.

  2. Joy martin    

    This it’s all bureaucratic red tape stuff. It does not improve medical care at the VA and the ability to obtain it. Veterans are dying because they can’t get proper care. The substandard doctors and facilities need to Be drastically improved. If I live in West Broward County I should not have to travel to West Palm Beach or Miami Dade 50 miles away in order to get the care I deserve.

    1. kenneth ketchum    

      @Joy Martin; the issues you mention are part of the act, and the red tape is, of course, bureaucratic but it’s at least a sign they are actively pursuing a fix to the issues you mention.

      >>Merge and modernize community care programs.
      Place the Veteran and his or her physician at the center of the decision process on how and where to get the best care available,
      Ensure VA is improving medical facilities and staffing levels to meet Veterans’ needs in areas where VA care is substandard, and
      Offer options for Veterans to use a network of walk-in clinics for minor illnesses and injuries.
      The CARE Act also includes:
      Proposals for new workforce tools to assist in maintaining and strengthening VA’s world-class medical staff,<<

      I think your specific comment is very relative to the act because your complaint is what most of us "disabled" veterans have also voiced complaints about because we have experienced it first hand and some of us to disastrous and disabling results. It's going to take time now to implement but I think the VA is trying to remedy the situation as best they can.

      I am keeping my eye on this very act and waiting because it's in line with exactly why the POTUS signed the bill in June 2017. Now we do have to wait for all that red tape to be worked out but this is a positive sign at least.

  3. Roger Wilson    

    LOL! I haven’t seen a VA Doc in years. I keep getting referred to the Veteran’s Choice Program. I arrive for my scheduled (local, civilian) Dr. appointments and they haven’t received any paperwork and don’t know why I’m there. Then they request a followup – because they get 2 visits (which I deny) but the Choice people blow up my phone to get the followup rescheduled. I won’t even get into how they screwed up my mailing address. I have a local VA clinic but it’s severely understaffed with doctors.

    1. Michele Barker    

      It is a pure joke, but VERY true. The VA refers you. But you are required to transport all MRI’s,Labs,X-rays,Chart Notes, and be the Doctor. Patient and Medical staff.

  4. Mike Polk    

    This is the start of privatization of the VA. This is flat wrong. Retired USAF

    1. Eric Roberts    

      Mike, no…some use of local docs is very good. If you happen to live near a VAMC, then you are good, but most vets don’t. I live about 60 miles from my VAMC, but I do have a local satellite clinic, which provides primary care and lab work…but that is it. I cant afford to get to appointments at my VAMC, which is 60 milers away…even worse when i need to go multiple times. The Veterans Choice Program, while done really half-assed, was a step in the right direction. I shouldn’t have to travel 60+ miles away to get care. I don’t have someone to drive me and driving that far is very painful for me. I should be able to make use of local assets to be able to get better care. Now the VCP is FAR from perfect…I cannot emphasize “FAR” enough to cover what needs to be fixed. I think this is a good step forward with that. The messed up thing in the distance calculation is that is from ANY VA facility. So if you are in my situation…with your VAMC being 60 miles away (well outside the 40 mile threshold) but have a satellite clinic 10 miles away, now i don’t qualify for VCP, even though the service i am trying to get is not covered by the satellite clinic, but by the VAMC that is 60 miles away. If this is truly getting rid of that, then that is great. My doctor should be the one in control of that. If I request to go to a local doctor for carpal tunnel surgery or for bariatric surgery, I should be able to request that and if justified, my doc should say sure, lets request this through VCP instead of having you travel to Hines (or in the case of the Bariatric surgery, Jesse Brown in Chicago because Hines is not certified for bariatric surgery (which is really stupid…bit that’s a different discussion) )

      They also need to get a better service center for the VCP. The center you guys hired are a bunch of inept idiots who, even after running this program for several years, still are clueless how it works. For instance, I was going to local orthopedic surgeon to get carpal tunnel surgery in both of my wrists. I went to the ortho doc and he wanted to do the nerve shock test (not a fun test BTW) that they use to determine that carpal tunnel is indeed present, which they do in house. Now according to the regs, if they need testing or other procedures that go elsewhere, they need a separate request (a really stupid reg if you ask me), but if it is in house, they don’t need it. The people at the VCP call center were insisting that they needed a separate request from my primary care to do the test. This brought the procedure to a halt and by the time it was sorted pout, everything had expired and I would have to go through everything again.

      This is what we deal with to get efficient and effective care. It should not be this hard. The VCP should be transparent. I shouldn’t have to call them. My only interaction should be when they call me to set up an appointment. I shouldn’t have to call them to initiate anything or to do any paperwork or whatever. That should all be handled by the VA…not me. When my primary care doc orders something that is going through the VCP, I shouldn’t be the one doing all of the work. Currently, once the request is made, I have to wait several weeks for the information to get into their system (their being the call center that “manages”…to use the term VERY loosely…the VCP). Once that happens, i have to call them up and that initiates the process, which can then take a couple of weeks for their people to do their stuff and then we set up an appointment (notice, this takes longer than 30 days to do, which is ridiculous). There is apparently zero oversight in what this company is doing. They really need to be fired and get a competent company that can competently and efficiently run the VCP.

  5. George Castaneda    

    Are you aware of anything being done with Veterans who have bladder cancer and were affected by Agent Orange while in Vietnam..

    Thanks for your suport
    George

  6. JACK HATCHITT    

    I WAS IN THE CHOICE PROGRAM, BUT COULD NOT FIND A DOCTOR THAT WOULD ACCEPT IT! THE ONLY ONE I FOUND WERE NOT M.D.’S NOR D.O.’S. SO I QUIT THE PROGRAM!

  7. Michele Barker    

    When is the Dept. of Veteran Affairs going to PUSH Congress for a REAL Veterans’ Benefit, like Space A travel for 100%P&T DV’s? Senate Bill 2596 has been dead in the Arms Committee since Feb 2016! This is part of MWR, and OUR earned Benefit.

  8. Stacy Lunsford    

    We are issued a VA ID card that has our information on it. The is a policy and group number on our ID cards. All the VA has to do is we are free to choice any doctor, clinic or hospital in our local community. The ID card is used just like a medicare and the doctor, clinic or hospital send VA the bill just like medicare. Problem solved. But we have a bunch of dumb asses thinking stupid crap and making our health care more difficult to get.

Comments are closed.