By Patricia K. Ruiz, J.D.
A bill passed by Congress seeks to improve the quality and availability of care for veterans by increasing access to community care, establishing standards for quality of care, and providing incentives for the participation of health care professionals. The bill was introduced in the House as H.R. 5674 but was passed by Congress as an amendment to S. 2372, an existing bill entitled VA MISSION Act of 2018.
The Department of Veterans Affairs (VA) operates the nation’s largest integrated health care system, which provides care to nine million veteran patients. The care is provided through medical professionals and support staff employed by the VA and working in VA facilities. The VA also collaborates with non-VA medical professionals and support staff in the community to provide timely, accessible, and high-quality care. A number of these community care programs (most recently, the Choice program), allows veterans to receive community care when care through a VA facility is not available.
Improved access to quality care. The bill would consolidate VA community care programs into the Veterans Community Care Program (the Program). Under the Program, the VA would be required to grant community care access to veterans enrolled in the VA health care system or otherwise entitled to VA care if certain criteria related to the availability of needed care are met. Eligible veterans would be authorized two visits per calendar year at certain walk-in or federally qualified health care clinics. The Program would require the VA to enter into contracts to establish a network of community care providers and would authorize the VA to establish tiered networks under those contracts. However, the VA would be prohibited from prioritizing providers in one tier over another in a way that limits a veteran’s choice of providers.
The Program would require the VA to incorporate value-based reimbursement models and reimburse participating community care providers at Medicare rates and would allow the VA to pay higher rates in highly rural areas. The bill also makes improvements to telemedicine efforts and access to care in underserved areas.
Recruitment of health care professionals. To increase access to care, the bill would provide scholarships to medical students in exchange for service to the VA, increase amounts available through the Education Debt Repayment Program, establish a specialty debt repayment program, and roll back limitations on bonuses for recruitment, relocation, and retention. The bill would also establish a pilot program to support four years of medical school education costs for veterans at certain schools.
Privatization fears. In response to the bill passing in the House, J. David Cox Sr., the national president of the American Federation of Government Employees, released a statement arguing that the legislation "will set the only health care system tailored to veterans on a path of total privatization."
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