VA PLANS TO TEST SEVERAL NEW WAYS TO LIMIT ‘CHOICE’ PLAN COSTS
VA Secretary (Dr.) David J. Shulkin used congressional testimony Tuesday and recent meetings with veterans’ service organizations to preview new steps the Department of Veterans Affairs might test for containing costs as it reforms the Choice program to smooth access to VA-paid private sector healthcare.
Shulkin last month said he would ask Congress to scrap driving distance (of more than 40 miles) and appointment wait times (of more than 30 days) for determining eligibility to use Choice. But without new screening criteria, VA health costs could soar by as much as $1 trillion over the next decade, congressional auditors have estimated.
So Shulkin intends to test new screening criteria over the next several months. One “model” under consideration is to give veterans with service-connected injuries or ailments priority to use Choice over veterans seeking care for conditions unrelated to service.
“He’s looking at service-connected disabled veterans to have this option first because he thinks the American public looks at those veterans as being most worthy of getting the best treatment possible,” said one executive of a major veteran organization who Shulkin had briefed on tentative Choice reform plans.
A second idea under review is to charge other health insurance that a veteran might have, either through employers or even Medicare, for the cost of care that Choice provides through participating private sector providers.
A third notion Shulkin wants tested, he told veteran groups, are new sets of co-payments for Choice. One might be used when VA healthcare is available and a veteran still elects to use non-VA care. In that case, co-pays could be one level for veterans with service-connected conditions and higher for others.
Shulkin told vet groups he would prefer that Choice stay free to all patients. But if co-pays are needed to contain costs, they might be applied based on whether veterans have service-connected conditions.
He premiered a few of these ideas Tuesday at an evening hearing of the House Veterans Affairs Committee. “Choice 2.0” will have a better title when VA presents a full reform plan to Congress “within six months,” Shulkin promised.
Also testifying at the hearing were representatives of the Government Accountability Office and Office of VA Inspector General who presented their latest findings of flaws across Choice, including the disturbing fact that many veterans who opted to use it waited longer for care than those stuck with the VA system.
Shulkin served as VA under secretary of health in the final 18 months of the Obama administration after a private sector career managing medical centers and large health operations. The Senate unanimously confirmed him for VA secretary.
With a Republican in the White House and Republicans still holding majorities in both chambers of Congress, and an unfailingly polite Rep. (Dr.) Phil Roe (R-Tenn.) now chairing the House committee, Shulkin got a warmer reception than arguably any VA official has over the last six years. It got cheerier still as Shulkin unveiled several new initiatives to sustain, and in some cases to exceed, the “veteran-centric” reforms begun during the previous administration.
Here are highlights from the hearing:
Mental Health Care for Vets with OTH Discharges – Taking a fresh step to try to lower suicide rates among America’s veterans, Shulkin said VA will grant access to urgent mental healthcare to otherwise ineligible veterans, those who received other-than-honorable discharges.
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