Choice Act lets veter­ans get com­pre­hen­sive care at com­mu­nity health cen­ters

While more Amer­i­cans have health in­sur­ance cov­er­age than ever be­fore, there is still a short­age of venues to ob­tain the pri­mary and pre­ven­tive-care ser­vices ev­ery­one needs. This has cer­tainly been true for many of our na­tion’s veter­ans who, as we salute

Modern Healthcare - - COMMENT - By Tom Van Cover­den In­ter­ested in sub­mit­ting a Guest Ex­pert op-ed? View guide­lines at mod­ern­health­ Send drafts to As­sis­tant Man­ag­ing Ed­i­tor David May at dmay@mod­ern­health­

Now there is hope for change. Thanks to con­gres­sional ac­tion, veter­ans who have to travel more than 40 miles for care at a VA med­i­cal fa­cil­ity, or who are forced to wait longer than 30 days for an ap­point­ment, can re­ceive care at a com­mu­nity health cen­ter. Congress passed the Veter­ans Choice Act last year in re­sponse to highly pub­li­cized re­ports of veter­ans ex­pe­ri­enc­ing in­tol­er­a­ble wait times for care. To ad­dress the prob­lem and help the VA meet in­creased de­mand for ser­vices, Congress au­tho­rized the VA to con­tract with lo­cal providers— en­abling veter­ans to choose their care out­side of the Veter­ans Health Ad­min­is­tra­tion sys­tem. No so­lu­tion is per­fect, but con­nect­ing veter­ans with health cen­ters makes sense for many rea­sons, not the least of which is that the cen­ters have been in the busi­ness of de­liv­er­ing qual­ity, af­ford­able health­care for half a cen­tury.

Close to 400,000 veter­ans—and more than 24 mil­lion Amer­i­cans over­all—now de­pend on com­mu­nity health cen­ters for pri­mary and pre­ven­tive care. About 1,300 health cen­ter or­ga­ni­za­tions op­er­ate more than 9,000 sites na­tion­wide. Strong pub­lic sup­port and bi­par­ti­san back­ing over the years from the White House and con­gres­sional law­mak­ers has led to a grow­ing na­tional in­vest­ment in health cen­ters. In­deed, Congress last April voted on an over­whelm­ing, bi­par­ti­san ba­sis to ex­tend fund­ing that sup­ports health cen­ter oper­a­tions and ser­vices as de­mand for care con­tin­ues to grow.

The in­vest­ment has paid off. Serv­ing a largely low-in­come and vul­ner­a­ble pop­u­la­tion, health cen­ters have achieved a strong track record in re­duc­ing mor­tal­ity rates, de­vel­op­ing pro­grams for early screen­ing and treat­ment of can­cer, and man­ag­ing chronic con­di­tions such as obe­sity and diabetes. Yet it is their work in ad­dress­ing the whole health of pa­tients—in­clud­ing the en­vi­ron­men­tal, so­cial and be­hav­ioral fac­tors so of­ten linked to poor health out­comes—that makes them a fit­ting so­lu­tion to the com­plex health is­sues fac­ing veter­ans re­turn­ing home. At last count, more than 400 health cen­ter or­ga­ni­za­tions had signed up with the Veter­ans Choice pro­gram.

No provider can solve ev­ery prob­lem, but health cen­ters have never shied away from bold so­lu­tions or in­no­va­tion. They look for an­swers be­yond tra­di­tional medicine to pre­vent ill­ness and con­front the host of prob­lems that cause it—stress, home­less­ness, drug abuse, job­less­ness and il­lit­er­acy, among oth­ers.

In ad­di­tion to a range of pri­ma­rycare ser­vices that can in­clude den­tal, pe­di­atric, geri­atric, ob­stet­ric and vi­sion care; phar­macy ser­vices; and men­tal health and sub­stance-abuse coun­sel­ing, health cen­ters fre­quently of­fer ser­vices not com­monly found in a doc­tor’s of­fice. There are farm­ers’ mar­kets and food pantries, com­mu­nity gar­dens, ex­er­cise pro­grams and cook­ing classes. Some health cen­ters also of­fer job train­ing and le­gal ser­vices. The aim is to reach be­yond health­care de­liv­ery and im­prove the qual­ity of life in com­mu­ni­ties. And it is work­ing.

Many health cen­ters serv­ing large pop­u­la­tions work in part­ner­ship with lo­cal VA hos­pi­tals and the broader health­care com­mu­nity to en­sure co­or­di­na­tion of veter­ans’ health­care needs. One cen­ter in south­east Ok­la­homa even of­fers the per­sonal touch of wel­com­ing veter­ans with spe­cially des­ig­nated park­ing spa­ces.

On Vir­ginia’s East­ern Shore, veter­ans can get care close to home at a health cen­ter sys­tem in­stead of trav­el­ing across the 20-mile Ch­e­sa­peake Bay Bridge-Tun­nel.

In the coastal area of Bandon, Ore., a health cen­ter has three veter­ans on staff who fo­cus on out­reach to their fel­low veter­ans, in­clud­ing the home­less.

Health cen­ters are also work­ing hard to re­cruit veter­ans as part of their work­force. One ini­tia­tive has re­sulted in the hir­ing of more than 4,000 veter­ans at health cen­ters. We need the var­ied skill sets that veter­ans hold to fill po­si­tions from top to bot­tom, and staff who can ef­fec­tively and com­pas­sion­ately re­late to di­verse pop­u­la­tions.

Get­ting ac­cess to af­ford­able care should not be a chal­lenge for any­one in our coun­try. Most im­por­tant, veter­ans who have served and sac­ri­ficed for our na­tion should not come home and be forced to stand in line for their care.

Tom Van Cover­den is pres­i­dent and CEO of the Na­tional As­so­ci­a­tion of Com­mu­nity Health Cen­ters.

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