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Tuesday, June 07, 2016

VA program to speed up wait times for rural patients slows down process; docs not getting paid

The Veterans Choice program, which was created to speed up the process for patients seeking care, is having the opposite effect, forcing veterans—mainly from rural areas—to have even longer waits, Quil Lawrence reports for NPR. The program was intended to help veterans living 40 miles from a Department of Veterans Affairs clinic, or those waiting more than 30 days for an appointment, to receive private clinic outside the VA system. "Nearly two years in, there are more vets waiting than before," Lawrence reports. "Health-care providers are frustrated with the program, which makes it hard to keep them in the network. Without enough providers to see them, vets end up waiting anyway."

In some cases "vets get the care and the doctors don't get paid in a timely fashion, if at all," Lawrence says. North Carolina clinical psychiatrist Cher Morrow-Bradley, "has submitted her bills to a company called Health Net, which administers Veterans Choice across most of the eastern United States." She told Lawrence, "I just assumed I was being paid. I found out six months later I had five, six (thousand dollars) outstanding to Veterans Choice." Morrow-Bradley said it took her almost a year to get paid.

Dr. David Shulkin, head of the Veterans Health Administration, "acknowledges this problem has hindered the Choice program in getting providers big and small," Lawrence writes. Shulkin told Lawrence, "One thing I know is that when you perform a service, when you see a patient, you want to be paid. And these hospital systems don't have the cash flow to be waiting around for months and months to get paid."

Doctors have also had a hard time enrolling in the program, Lawrence writes. Renton, Wash., psychologist Diane Adams was asked to join the program in July 2015. She immediately starting the process of getting her credentials. By March she still hadn't heard anything back. She finally found out she'd be credentialed since January, but hadn't been notified. Now she faces a new hurdle, with some of her regular patients unable to get Veterans Choice to approve visits to see her, mostly because they have to go through hoops of phone calls, faxes and filling out forms. Adams told Lawrence, "I guess what I'm worried about is what happens to the veterans who can't handle it and they just don't have the internal resources to put up with it and so they throw up their hands and they give up." (Read more)

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