A shrinking VA?

Feds considering shifting more care – and funds — to private sector

Reports that the Trump administration may soon pave the way for veterans to receive care at private facilities has pleased a few veterans groups but dismayed many others.

And the implications for vendors with VA contracts? Unknown. That’s because the details of the change itself remain undecided (though some believe President Trump might offer some specifics during his State of the Union Address, scheduled for Jan. 29.)

In January 2018, Trump fulfilled a campaign pledge by signing into law the VA MISSION Act of 2018, designed to establish a permanent community care program for veterans. It’s not the first time the feds have made a move in this direction. In October 2015, the Obama administration presented to Congress the VA’s “Plan to Consolidate Community Care,” which would have created an integrated healthcare system encompassing both VA and private care.

What’s more, the Veterans Choice Program already allows veterans to receive care from a community provider, paid for by the VA, if the veteran needs an appointment for a specific type of care and VA cannot provide that care in a timely manner, or the VA facility is too far away for the veteran to travel. And the military’s insurance plan, Tricare Prime, also makes provisions for private care.

But the MISSION Act would probably open the gates much wider. It calls for veterans to receive hospital care, medical services, or extended care services from non-VA providers if VA providers are unable to offer care that “complies with the standards” that the office of the Secretary of Veterans Affairs has established, including timeliness of medical service as well as quality of care.

Here’s the rub: Thus far, there has been no talk of a separate source of funding for that care provided by the private sector. That has caused many major veterans’ organizations to oppose the initiative, fearful that switching funds away from the VA to private providers will erode the VA health system.

For national accounts executives, the key question is this: If the cost of sending veterans into the community for treatment could cost over $100 billion a year, as a Congressional panel called the Commission on Care predicted in July 2016, that’s $100 billion less going to the VA. Even if the number is $60 billion per annum, as the Office of Management and Budget has estimated, that’s a lot of money.

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