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Military update: Civilian doc networks to backstop VA primary care too

More than two decades ago, when a shrinking military healthcare system saw patient demand exceed its capacity to deliver timely care, particularly for a burgeoning retiree population, the Department of Defense contracted with the private sector to provide alternative networks of civilian physicians to deliver managed care to military beneficiaries.

The Department of Veterans Affairs is moving down a similar path of contracting for civilian provider networks. For the VA, however, the networks are to handle only an overflow of needed care, and not offer an alternative enrollment option to the VA’s integrated health care system.

The networks also are helping to address an access-to-care crisis that, in recent months, shredded VA credibility and forced leadership changes.

On Wednesday, less than a week after President Obama signed into law the Veterans Access, Choice and Accountability Act of 2014 to mandate that VA offer more timely and convenient to veterans, VA announced expansion of its new Patient-Centered Community Care (PC3) contracts so they deliver primary care too to veterans when and where VA cannot.

These provider networks will be familiar to many veterans whose families relied on them for TRICARE services while members were still served on active duty. The TriWest Healthcare Alliance, headquartered in Phoenix was support contractor for the TRICARE West Region until two years ago. Now it will backstop VA care in 28 states and U.S. Pacific territories.

HealthNet Federal Services of Arlington, Virginia, still manages patient care for TRICARE North Region. It now will provide both primary and specialty backup care to veterans in the other 22 states when VA decides it own facilities and staff can’t deliver timely or convenient care.

The addition of primary care to PC3 contracts is “another example of how we are working to ensure veterans get the care they need, when they need it and where they want to be seen,” said new VA Secretary Robert A. McDonald in a statement announcing the change.

David McIntyre, president and chief executive officer of TriWest, touted the value to VA of having consolidated networks of providers ready to serve as a “relief valve” when veterans can’t get timely, convenient care from inside VA. He noted that discovery of thousands of veterans awaiting care through the Phoenix VA Health Care System “lit off the furnace” of the crisis over veterans facing long wait times for care.

Starting this month, under newly modified contracts, TriWest and HealthNet will begin to backstop VA on primary care appointments at select locations.

VA officials still must decide how to use a “Veterans Choice Card” that the new law requires be issued to veterans as a guarantee of timely access to care. McIntyre wouldn’t speculate on how it would be used.

He did suggest, however, that PC3 contracts will result in fewer veterans having to find their own doctors out of frustration that the VA or its partner networks can’t deliver on timely, convenient care.

Tom Philpott can be contacted at Military Update, P.O. Box 231111, Centreville, Va. 20120-1111, or by e-mail at:

[email protected]

 
 
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