Last June, President Trump signed landmark legislation, known as the VA MISSION Act of 2018, that makes dramatic improvements to how Veterans receive community care—health care provided outside of VA. VA’s goal is to give Veterans greater choice over their health care, allowing VA to deliver world-class, seamless customer service either through a VA facility or community provider.
While the law affects many other VA programs, the changes to community care are among the most complex and far-reaching in recent history. After the legislation was enacted, VA immediately began taking the steps needed to implement the vast changes required.
Current Activities
Understanding the enormous scale of VA health care operations and VA’s responsibility for America’s Veterans, VA has been working hard on many large, interrelated tasks to implement the new Veteran community care program by June 2019. These tasks include the following:
- Design and launch a new internal operating structure for community care, including the new urgent care/walk-in care benefit
- Propose access standards as one of the six eligibility criteria for community care
- VA’s proposed rules for the new Veterans community care program, including access standards, are currently open for public comment until March 25, 2019
- Award contracts to Third Party Administrators (TPAs) to manage regions of VA’s new Community Care Network (CCN)
- Plan to implement Veterans Care Agreements to allow VA to purchase hospital care, medical services, or extended care services in certain situations
- Define competency standards for certain conditions applicable to community providers to make sure Veterans are getting high-quality care when they receive care outside of VA
- Set up new requirements for prompt payments to community providers
- Draft regulations to implement the law
What to Expect
So what can Veterans expect when the new program starts this summer? Given the magnitude of the changes, VA is working hard to make sure the rollout goes smoothly. If you are a Veteran enrolled in VA health care, or a Veteran who can receive care without needing to enroll, you can expect:
- To continue to have access to community care under current programs and then transition to the new program when regulations are final and published
- To follow an improved process to receive community care under the new program, with better access to community providers and improvements to customer service, such as more streamlined eligibility requirements
- A new benefit that provides eligible Veterans with access to urgent, non-emergency care for non-life-threatening conditions in VA’s network of community providers
- Improved care coordination as VA transitions to a single information technology system that better links together VA and community providers
- Your provider to receive timely payments for bills as VA transitions to better claims processing systems
Going Forward
VA will be providing regular updates on community care as part of this series of articles. Community care will continue to supplement VA health care as part of VA’s broad commitment to modernize and strengthen the VA health care system, expand access, and ensure timely delivery of care to America’s Veterans. VA health care regularly outperforms the private sector, and VA staff are experienced and devoted to meeting Veterans’ specific needs. VA believes Veterans will continue to choose VA when they need timely, high-quality care.
Resources
- Fact Sheet – Veteran Community Care – General Information (VA MISSION Act of 2018)
- VA’s proposed rules for Veteran community care now open for public comment
