Congress, the Department of Veterans Affairs and veterans service organizations will begin to spar this month over final details of a plan that not only will replace the much-maligned Veterans Choice program but empower VA to modernize large parts of its health care system.
The plan, which VA titled the Veterans CARE (Coordinated Access & Rewarding Experiences) Act, was unveiled last week and has an overall structure that major veteran groups applaud, in part because they helped to shape it.
They don't like everything, however. And the House and Senate veterans' affairs committees are expected to offer their own replacement plans for Choice this fall, perhaps to include more statutory safeguards and more details to improve access to care, that advocates worry aren't spelled out in the VA plan.
The idea behind Choice remains a primary goal for CARE: to ensure access to health care for veterans in their communities when timely, quality care isn't available at a nearby VA medical facilities. But CARE directs that clinicians, consulting with patients, decide when outside care is needed, rejecting Choice's reliance on driving distance and wait times to set eligibility and hold down costs.
CARE also seeks authorities for VA to build out high-performing provider networks, relying on private sector partners and other federal agencies, and to ensure closer integration of VA health services with those in nearby communities.
Before 2014, the VA health care system had various ways to access non-VA care. But too often referring patients to the private sector was a business decision, said Louis Celli, director of veterans' affairs and rehabilitation for The American Legion.
When a patient wait-time scandal erupted across the VA medical system by spring that year, Congress hastily created Choice to expand access to private sector care. Initially the idea was to give every VA-enrolled veteran a card entitling them to use community care at VA expense when necessary. The projected cost turned out to be enormous, however, so lawmakers added last-minute cost controls.
CARE would consolidate non-VA care options but still spend at least $4 billion on private sector health care annually.
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