The VA MISSION Act aims to boost patient access to
care and community care benefits.
By Sara Heath
June 06,
2019 - The Department of Veterans Affairs MISSION Act has
officially launched, working to expand patient access
to care and boost community care options.
“The changes not only
improve our ability to provide the health care Veterans need, but also when and
where they need it,” VA Secretary Robert Wilkie said in a statement on the day
of the program's launch. “It will also put Veterans at the center of their care
and offer options, including expanded telehealth and urgent care, so they can
find the balance in the system that is right for them.”
The program, which
revamps the previous Veterans Choice program, was made official nearly one year
ago when President Trump signed the $5.2 billion MISSION Act
into law.
“In every generation
there have been heroes like them, patriots who answer the call to serve, who do
whatever it takes, wherever and whenever we need them to defend America,” the
President said upon signing the bill. “They put everything on the line for
us. And when they come home, we must do everything that we can possibly do
for them. And that's what we're doing.”
Foremost, the MISSION
Act overhauls the Veterans Choice program, which had long received scrutiny from industry
leaders. Choice came with long wait times and was too complicated to be
functional, many lawmakers agreed.
Under the MISSION
Act, veterans will face more simplified parameters to qualify for third-party
care. Additionally, the MISSION Act gets rid of some administrative properties
tied to the referral process, ideally reducing the amount of time patients must
wait between VA referral and connecting with the third-party clinician.
The law expands VA’s
community care program and streamlines it into one program. The MISSION Act
also extends caregiver access to veterans who served prior to 9/11; previous to
the law, the caregiver programs only applied to post-9/11 veterans.
Ultimately, the
MISSION Act was designed to make it easier for veterans to access healthcare
and to put those veterans at the center of their care.
“We owe our veterans
the best possible care and support that they have earned,” said Senator
Johnny Isakson, one of the bipartisan bill’s co-sponsors. “This is a
truly meaningful victory for our nation’s veterans, who will benefit from more
choice and fewer barriers to care. The signing of this legislation marks
the completion of the final piece in a great mosaic of veterans reforms that we
set out to accomplish over the last two years.”
This law has not come
without its controversies. Senate probes and
investigations from the Government Accountability Office (GAO) have looked into
whether the program will result in VA privatization and whether the agency is
genuinely prepared for the program’s rollout.
“Since the Mission
Act was signed into law, my concern is that VA’s primary focus is supplanting
in-house care, as opposed to supplementing that care when it makes the most
sense for veterans,” said Senator Jon Tester during a hearing on the MISSION
Act. “In its rush to open the door to the private sector, my concern is that VA
is outsourcing its responsibility to ensure veterans receive timely and
high-quality care.”
Tester acknowledged
VA’s limited knowledge about the timeliness of veteran community care access as
well as the quality of care delivered, despite VA promises to allocate funds to
community providers who deliver top-notch care.
“So on one hand, VA
doesn’t have a clear understanding of how much this Program will cost. And on
the other, VA openly states that it would make funding decisions based on
whether its facilities are meeting the standards it fails to enforce on the
private sector,” Tester said. “What I see is behavior that smacks of a
deliberate effort – not to implement the best policy but to carry out a
political agenda.”
For its part, VA has
worked to address concerns about VA privatization, stating that this program is
about expanding veteran choice for care access.
“It is important to
note that the proposed Veterans Community Care Program does not supplant VA’s
mission to provide care in VA facilities to Veterans who have earned it,”
Richard A. Stone, MD, VA’s executive in charge, explained during the hearing.
“VA’s proposed access standards will complement existing VA care by providing
Veterans with greater choice to receive care in the community based on their
individual needs and preferences.”
GAO has likewise
noted some issues with the MISSION Act, launching an investigation into the
VA’s preparedness to roll out the program. Specifically, GAO found that the
agency lacked sufficient systems to carry out the Veterans Community Care
Program (VCCP) and did not have enough information about referral times.
Additionally, GAO stated that VA had now carried out recommendations for
improving the VCCP.
Other critics have
pointed to issues with the VA’s new EHR rollout as a detriment
to VCCP, but the agency has noted that the community care program is not
contingent on the revamped EHR software.
“While electronic
health records modernization is an important improvement, it’s not central to
the success of the MISSION Act,” VA Secretary Robert Wilkie, said in a
recent response to media critics. “No one
from the VA has ever said implementation of the new private care option
Veterans will have under the MISSION Act is ‘years’ away because of our effort
to modernize health records.”
Instead, VA promised
fewer bureaucratic hurdles for its veteran beneficiaries upon the MISSION Act’s
launch, Wilkie said in an emailed statement to veterans earlier this week.
“What can Veterans
expect on June 6?” he posited. “Less red tape, more satisfaction and
predictability for patients, more efficiency for our clinicians, and better
value for taxpayers.”
Additionally,
veterans can expect expanded access to community care options, access to
walk-in or urgent care clinics, and what Wilkie said will be a stronger
patient-provider relationship.
It is difficult to say
how the program will impact veterans on only the first day of implementation.
If VA can, in fact, overcome the hurdles laid out by its critics, the program
has the promise to expand veteran access to care and choice in care. But the
challenges are clear, and limited systems for addressing wait times and
third-party clinician referrals may prove daunting for the agency.
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