VA proposes standards for vets accessing community care

THE VETERANS AFFAIRS Department released its proposals for key criteria that will determine whether a veteran gets treatment from the VA health system or the private sector under a newly expanded community care program due to roll out in June.

Known as the “designated access standards,” the criteria drove the most controversy as Congress discussed the VA Mission Act, signed into law last June by President Donald Trump.

Under the proposal released Jan. 30, the VA wants to set a 30-minute average drive-time standard or a 20-day wait-time standard for primary care, mental health and non-institutional extended care.

The wait time for routine care is longer than the standard set for the military healthcare system’s TriCare Prime HMO model, which the VA was reportedly considering mirroring. The VA’s proposed criteria have been held up at the White House Office of Management and Budget over cost concerns, according to sources close to discussions.

For specialty care, the drive-time standard would be a 60-minute average and a 28-day wait standard from the day of the appointment request, with some exceptions. For urgent care, veterans can receive certain treatment from any provider in the community care network, with the possibility of a co-pay.

“With VA’s new access standards, the future of the VA healthcare system will lie in the hands of veterans—exactly where it should be,” VA Secretary Robert Wilkie said in a statement.

The VA’s draft measures were applauded by the Concerned Veterans for America, a conservative group that played a key role in the Mission Act legislation, as largely in line with what they were hoping for, although the group would have preferred a shorter wait time standard for primary care, said Dan Caldwell, the group’s executive director.

The proposal came two days after a group of Democratic senators, led by Senate VA Committee ranking member Jon Tester of Montana, demanded more transparency into how the VA has been developing the access standards.

Tester on Jan. 31 said he’s still got questions now that the draft standards are out.

“I think the access standard will work for rural America,” he told Modern Healthcare. “I think it’s got challenges in urban areas. So we just need to get more meat on the bones, so to speak.” ●