House holds hearing on VA plan to consolidate community care programs

The House Committee on Veterans’ Affairs today held a hearing on a Department of Veterans Affairs’ proposal to consolidate its purchased care programs and business processes into a new Veterans Choice Program, with the goal of making it easier for veterans to access care and non-VA health care providers to participate. According to the plan, possible enhancements include establishing a single set of eligibility criteria for all community care based on a veteran’s geographic access/distance to a VA primary care provider, wait-time for care, and availability of services at VA. Other proposals include expanding access to non-VA emergency/urgent care; streamlining referral and authorization rules to minimize care delays and administrative burden for non-VA hospitals; developing a tiered provider network based on quality and performance criteria; and moving toward value-based payment. The plan also calls for enabling non-VA community providers to easily exchange health information with VA through electronic means, and implementing a claims solution to auto-adjudicate a high percentage of claims and pay community providers promptly and correctly. Some of the proposals would require legislative changes.