VA is testing new program to reduce veterans' wait times

Some ailing veterans can now use their federal health care benefits at CVS “MinuteClinics” to treat minor illnesses and injuries, under a pilot program announced April 18 by the Department of Veterans Affairs.

The new program, currently limited to the Phoenix area, comes three years after the VA faced allegations of chronically long wait times at its centers, including its Phoenix facility, which treats about 120,000 veterans.

The Phoenix pilot program is a test-run by VA Secretary David Shulkin who is working on a nationwide plan to reduce veterans’ wait times.

Veterans would not be bound by current restrictions under the VA’s Choice program, which limits outside care to those who have been waiting more than 30 days for an appointment or have to drive more than 40 miles to a facility. Instead, Phoenix VA nurses staffing the medical center’s help line will be able to refer veterans to MinuteClinics for government-paid care when “clinically appropriate.”

David Shulkin Photo by Robert Turtil | Department of Veterans Affairs

David Shulkin. (Photo by Robert Turtil | Department of Veterans Affairs)

Shulkin has made clear he’d like a broader collaboration of “integrated care” nationwide between the VA and private sector in which veterans have wider access to private doctors. But, he wants the VA to handle all scheduling and “customer service” — something that veterans groups generally support but government auditors caution could prove unwieldy and expensive.

On April 19, President Donald Trump plans to sign legislation to temporarily extend the $10 billion Choice program until its money runs out, pending the administration’s plan due out by fall. That broader plan would have to be approved by Congress.

“Our number one priority is getting veterans’ access to care when and where they need it,” said Baligh Yehia, the VA’s deputy undersecretary for health for community care. “The launch of this partnership will enable VA to provide more care for veterans in their neighborhoods.”

Sen. John McCain, R- Ariz., a long-time advocate of veterans’ expanded access to private care, lauded the new initiative as an “important step forward.”

“Veterans in need of routine health care services should not have to wait in line for weeks to get an appointment when they can visit community health centers like MinuteClinic to receive timely and convenient care,” he said.

Also read: 9 ways the VA says it’s joining the modern world

The Veterans Health Administration said it opted to go with a CVS partnership in Phoenix after VA officials there specifically pushed for the additional option. They cited the feedback of local veterans and the success of a smaller test run with CVS last year in Palo Alto, Calif.

Shulkin has said he wants to expand private-sector partnerships in part by looking at wait times and the particular medical needs of veterans in different communities. Successful implementation of his broader plan will depend on the support of key members of Congress such as McCain, who chairs the Armed Services Committee.

The VA did not indicate whether it received requests from other VA medical centers or how quickly it might expand the program elsewhere.

Palo Alto VA hospital. (Photo from Wikimedia Commons)

The current Choice program was developed after the 2014 scandal in Phoenix in which some veterans died, yet the program has often encountered long waits of its own. The bill being signed by Trump seeks to alleviate some of the problems by helping speed up VA payments and promote greater sharing of medical records. Shulkin also has said he wants to eliminate Choice’s 30-day, 40 mile restrictions, allowing the VA instead to determine when outside care is “clinically needed.”

Despite a heavy spotlight on its problems, the Phoenix facility still grapples with delays. Only 61 percent of veterans surveyed said they got an appointment for urgent primary care when they needed it, according to VA data.

Maureen McCarthy, the Phoenix VA’s chief of staff, welcomed the new CVS partnership but acknowledged a potential challenge in providing seamless coordination to avoid gaps in care. She said a veteran’s medical record will be shared electronically, with MinuteClinic providing visit summaries to the veteran’s VA primary care physician so that the VA can provide follow-up services if needed.

The VA previously experimented with a similar program last year in the smaller market of Palo Alto, a $330,000 pilot to provide urgent care at 14 MinuteClinics. CVS says it’s pleased the VA has opted to test out a larger market and says it’s ready to roll the program out nationally if successful.

CVS, the biggest player in pharmacy retail clinics, operates more than 1,100 of them in 33 states and the District of Columbia.

“We believe in the MinuteClinic model of care and are excited to offer our health care services as one potential solution for the Phoenix VA Health Care System and its patients,” said Tobias Barker, chief medical officer of CVS MinuteClinic.

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