Currently, the Veterans Choice Program allows eligible veterans to obtain their health care services from providers that are not directly employed by the VA, or community providers. Veteran Affairs (VA) has found that the Choice Program had many challenges such as a lack of timely payments to community providers, incomplete and unreliable data on the timeliness of veterans’ access to health care, and the complex referral and appointment scheduling processes. The VA understands that in the past there has been poor communication between the VA and its medical facilities. The VA also understands that previously the VA’s untimely payments to TPAs would extend the length of time TPAs took to pay providers’ claim.
The VA has currently been taking steps to help address the challenges in the Choice Program. For example, in June of 2018 the VA plans to establish a system that will facilitate care coordination and exchanges of information among VA medical facilities, VA clinicians, TPAs, community providers, and veterans. The VA also plans to implement mechanisms that will allow the VA to systematically monitor the amount of time taken to prepare referrals, schedule appointments, and complete appointments. The VA also plans to begin collecting data and monitoring compliance with its requirements pertaining to customer service for community providers. The VA plans to learn from the challenges with the Choice Program and learn from them with the implementation of the new Veterans Community Care Program. The Care Program will be replacing the Choice Program in June of 2019. The VA hopes the new program will be much more successful in helping provide health care in a timely manner to our Veterans and their families.
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