Local vets could seek private medical care options under new rules

Local veterans could seek private medical care options under new rules

Veterans who live more than a 30-minute drive from the Dayton VA Medical Center will be able to seek private medical care under proposed rules released by the Department of Veteran Affairs.

Veterans would be permitted to get private care covered by taxpayer fund if they have drive more than 30 minutes to a VA facility or wait more than 20 days for an appointment. The proposed changes are still in the public comment period. 

Under the rules, other changes include:

• Veterans who need urgent care could go to a private medical provider without pre-authorization.

• VA is also proposing appointment wait-time standards of 20 days for primary care, mental health care, and non-institutional extended care services, and 28 days for specialty care from the date of request with certain exceptions.

Currently, veterans who have to wait 30 days or live 40 miles from a VA facility are eligible for the private-sector care option — the provider must be within the VA Community Care Network. Veterans have always been eligible for private sector care if it’s determined that it is the “best option.” 

VA officials estimated the new rules could increase the number of veterans eligible for private care to as many as 2.1 million. Currently, about 560,000 veterans are eligible, according to officials. The announcement comes after President Donald Trump signed the $51 billion VA Mission Act that will become law in June.

 

About 1 of every 13 people in Ohio is a veteran and five of the state’s top 18 counties in veterans population are in the region, ensuring that veterans issues will remain important in this area, according to a Dayton Daily News comparison with U.S. Census population estimates from 2014.

“Most Americans can already choose the health care providers that they trust, and President Trump promised that Veterans would be able to do the same,” said VA Secretary Robert Wilkie, in a statement. “With VA’s new access standards, the future of the VA health care system will lie in the hands of veterans – exactly where it should be.”

Current primary care wait times for established patients at the Dayton VA is 6.1 days, according to VA spokesman Ted Froats. For veterans with more urgent needs, the Dayton VA provides same-day access, he said. Froats said it is not possible to estimate how many veterans would be affect by the proposed changes because criteria like wait times, available services and “best medical interest” are fluid.

Congressman Mike Turner, R-Dayton said he “strongly” supports the proposed changes.

“This change will directly benefit veterans in rural areas and will expand the number of health care facilities where they can receive treatment, while still being able to have access and use VA facilities,” he said.

 

The proposed rules immediately drew criticism from other lawmakers who fear the sweeping changes would lead to the privatization of veteran health care.

Rep. Mark Takano, D-Calif., chairman of the House Committee on Veterans’ Affairs, chastised the department’s decision, saying it would lead to privatization. “[The] announcement places VA on a pathway to privatization and leads Congress to assume the worst,” he said in a statement.

U.S. Sen. Sherrod Brown, D-Ohio, has expressed opposition for privatization in the past. Brown wrote a letter to the administration last week demanding more transparency and information from VA about its implementation of the bipartisan VA MISSION Act

“Community care has to be in the best interest of veterans – and the best way to do that is for VA to listen to veterans as it works to establish access standards for the new community care program,” Brown said. “The Trump Administration needs to better communicate and accept feedback from VSOs, Congress, and veterans as it develops the standards that will directly impact veterans and their health care going forward.”

U.S. Sen. Rob Portman, R-Ohio, said he supports the proposed changes. 

“Our veterans deserve to have access to the best care when they need it and this is a critical step towards providing that choice,” he said. “We honor the service and sacrifice our veterans have made to protect our freedoms and will continue to support changes that fit the needs our veterans, their families and caregivers.”

VA officials don’t expect a large number of veterans to choose private care. A study published last month in the Journal of the American Medical Association shows VA hospitals significantly reduced wait times for veteran patients in primary care and three specialty care services between 2014 and 2017.

For all specialties — except orthopedics — VA wait times were similar to private-sector wait times in 2014, and were shorter in 2017. In 2017, the average VA wait time was 17.7 days, while the private-sector average was 29.8 days, the study found.

The rules could also mean more business for local companies. Dayton-based insurer CareSource announced in July that it was chosen by Amvets to develop a privately managed health insurance plan for veterans seeking health care outside the VA system.

“In July we announced a partnership with AMVETS to better understand veterans and their unique needs as we explore ways to improve veteran access to care. The new access standards are an effort to better coordinate care between VA and community providers,” Erhardt Preitauer, President and CEO of CareSource, said in a statement to this news organization. “CareSource looks forward to continuing to support VA, our AMVETS partner, and our veterans as the Mission Act is fully implemented.”

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