Wednesday, January 28, 2015
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

Civilian doc networks to back up VA care, too

By
From page B10 | August 17, 2014 |

More than two decades ago, when a shrinking military health-care system saw patient demand exceed its capacity to deliver timely care, particularly for a burgeoning retiree population, the Department of Defense contracted with the private sector to provide alternative networks of civilian physicians to deliver managed care to military beneficiaries.

The Department of Veterans Affairs is moving down a similar path of contracting for civilian provider networks. For the VA, however, the networks are to handle only an overflow of needed care and not offer an alternative enrollment option to the VA’s integrated health care system.

The networks also are helping to address an access-to-care crisis that, in recent months, shredded VA credibility and forced leadership changes.

On Wednesday, less than a week after President Barack Obama signed into law the Veterans Access, Choice and Accountability Act of 2014 to mandate that VA offer more timely and convenient to veterans, VA announced expansion of its new Patient-Centered Community Care contracts so they deliver primary care, too, to veterans when and where VA cannot.

The PC3 networks only started operating in January as a backstop to provide specialty care, mental health care, limited emergency care and also limited newborn care to infants of female veterans. With their new responsibility to deliver primary care, these PC3 networks clearly have gained importance as tools VA will routinely use over the next several years to restore timely access to care.

These provider networks will be familiar to many veterans whose families relied on them for Tricare services while members were still served on active duty. The TriWest Healthcare Alliance, headquartered in Phoenix was support contractor for the Tricare West Region until two years ago. Now it will backstop VA care in 28 states and U.S. Pacific territories.

HealthNet Federal Services of Arlington, Virginia, still manages patient care for Tricare North Region. It now will provide both primary and specialty backup care to veterans in the other 22 states when VA decides it own facilities and staff can’t deliver timely or convenient care.

The addition of primary care to PC3 contracts is “another example of how we are working to ensure veterans get the care they need, when they need it and where they want to be seen,” said new VA Secretary Robert A. McDonald in a statement announcing the change.

The press release also said VA continues to review how PC3 “may be used to help implement the new law.” It also emphasized, however, that all PC3 care to veterans will be “coordinated with their VA providers.”

That’s a critical point for veteran service organizations. They favor VA hiring more staff and building more VA clinics over any migration of health services into the private sector. The fear is that this could degrade VA’s capacity over time to provide veterans, including those catastrophically injured in war, with full spectrum health care they will need for a lifetime.

In a phone interview Wednesday, David McIntyre, president and chief executive officer of TriWest, was sensitive to this, emphasizing that PC3 networks will differ in a critical way from Tricare networks.

Tricare providers offer beneficiaries a “stand alone, parallel plan” of enrollment to using military health care on base. By contrast, veterans who need occasional care through the PC3 networks will remain enrolled and have their care monitored by the VA health care system, McIntyre said.

“That’s the core of what the VA PC3 is. It’s not to serve as a threat, frankly, to the VA system. It’s really a wraparound network.”

McIntyre also touted the value to VA of having consolidated networks of providers ready to serve as a “relief valve” when veterans can’t get timely, convenient care from inside VA. He noted that discovery of thousands of veterans awaiting care through the Phoenix VA Health Care System “lit off the furnace” of the crisis over veterans facing long wait times for care.

Yet last month, McIntyre said, civilian providers working under the TriWest PC3 network provided specialty care to about 3000 veterans in the Phoenix area, as part of an aggressive VA effort to end patient backlogs.

“Today,” he said, “every veteran who cannot be seen in the (Phoenix) VA on the specialty side gets care within standards downtown. . . . The backlog in specialty care has been worked off and 4400 providers in Maricopa County surrounding the (Phoenix) VA medical center are that safety net.”

Starting this month, under newly modified contracts, TriWest and HealthNet will begin to backstop VA on primary care appointments at select locations. By December, primary care will be available in “all of the areas in which we operate,” McIntyre said. PC3 contracts also were changed to aligned networks to tighter “drive times” for care access set in the new law.

McIntyre and Thomas Carrato, president of HealthNet Federal Services, testified before the House Veterans Affairs Committee in June and each of them suggested expanding PC3 contracts into primary care.

At the time, Carrato said that while PC3 contractors continue to build out specialty care networks, they have met resistance in some locations from civilian providers who are reluctant to join a network while they have separate contracts with individual VA facilities also to provide backup care.

“The communication is a lot better, but that’s an issue that continues to linger,” Carrato told lawmakers.

McIntyre, in our interview, suggested VA increasingly sees the advantages of using networks of providers for backup care rather than VA cutting local deals. These include discounts off VA payment rates, prompt provider reimbursements and PC3 networks having responsibility for patient record transfer back into the VA system after every episode of civilian care.

VA officials still must decide how to use a “Veterans Choice Card” that the new law requires be issued to veterans as a guarantee of timely access to care. McIntyre wouldn’t speculate on how it would be used.

He did suggest, however, that PC3 contracts will result in fewer veterans having to find their own doctors out of frustration that the VA or its partner networks can’t deliver on timely, convenient care.

Send comments to Military Update, P.O. Box 231111, Centreville, VA, 20120, email milupdate@aol.com or tweet @Military_Update.

LEAVE A COMMENT

Discussion | 1 comment

The Daily Republic does not necessarily condone the comments here, nor does it review every post. Read our full policy

  • JimboAugust 17, 2014 - 10:21 am

    The VA has a long long history of being an American soldier's second chance to die for their country.

    Reply | Report abusive comment
.

Solano News

 
Youngster battles brain cancer a 2nd time

By Susan Winlow | From Page: A1, 2 Comments | Gallery

 
2 Solano road projects get green light

By Kevin W. Green | From Page: A1

 
Rush Ranch seeks docents

By Kevin W. Green | From Page: A2

Health officials report 1st Solano flu death

By Kevin W. Green | From Page: A3, 5 Comments | Gallery

 
Kroc Health Fair offers free screenings

By Amy Maginnis-Honey | From Page: A3

 
Frazier schedules coffee in Suisun City

By Ryan McCarthy | From Page: A4, 2 Comments

 
Vacaville police to offer law enforcement academy

By Ian Thompson | From Page: A4

Vanden to host science fair

By Bill Hicks | From Page: A4

 
Woman with Solano ties caught up in tax fraud case

By Jess Sullivan | From Page: A4

Coalition members review tobacco control report card

By Kevin W. Green | From Page: A5

 
 
 
 
American Legion Post schedules head-shaving fundraiser

By Kevin W. Green | From Page: A6

Vacaville Toastmasters welcome guests

By Amy Maginnis-Honey | From Page: A6

 
Chipotle fundraiser to benefit Armijo newspaper

By Amy Maginnis-Honey | From Page: A6, 4 Comments

 
Dramas, thrillers lead week’s box office openings

By Amy Maginnis-Honey | From Page: B8

 
Fairfield police log: Jan. 25, 2015

By Susan Hiland | From Page: A12

Fairfield police log: Jan. 24, 2015

By Susan Hiland | From Page: A12

 
Suisun City police log: Jan. 26, 2015

By Susan Hiland | From Page: A12

Suisun City police log: Jan. 25, 2015

By Susan Hiland | From Page: A12

 
Suisun City police log: Jan. 24, 2015

By Susan Hiland | From Page: A12

Fairfield police log: Jan. 26, 2015

By Susan Hiland | From Page: A12

 
.

US / World

Gold nuggets stolen in smash and grab

By The Associated Press | From Page: A7

 
CSU chancellor looks to increase graduation rates

By The Associated Press | From Page: A8

Officials lose track of billions in funding

By The Associated Press | From Page: A8, 3 Comments

 
Bill would treat e-cigs the same as regular cigarettes

By The Associated Press | From Page: A8

 
Secret talks in Jordan try to win release of hostages

By The Associated Press | From Page: A14

‘Wicked storm': Blizzard drops 2 feet of snow on New England

By The Associated Press | From Page: A14

 
NTSB: Systemic flaws in safety oversight of gas pipelines

By The Associated Press | From Page: A14

 
Military has wide discretion on Bergdahl charges

By The Associated Press | From Page: A14, 1 Comment

 
Gunmen storm Libya hotel, killing American, 9 others

By The Associated Press | From Page: A14

Famed civil rights protesters to have arrest records erased

By The Associated Press | From Page: A14

 
.

Living

Today in History: Jan. 28, 2015

By The Associated Press | From Page: A2

 
Community Calendar: Jan. 28, 2015

By Susan Hiland | From Page: A2

Horoscope Jan. 28, 2015

By Holiday Mathis | From Page: B6

 
We live close to my nephew but he chooses to remain distant

By Kathy Mitchell and Marcy Sugar | From Page: B6

 
10 Things: 10 fresh takes on Super Bowl guacamole

By The Associated Press | From Page: B7

 
.

Entertainment

Christina Aguilera to perform ahead of NBA All-Star Game

By The Associated Press | From Page: B8

 
Common, John Legend to perform ‘Glory’ at Academy Awards

By The Associated Press | From Page: B8

Katie Holmes to guest on ‘Ray Donovan’

By The Associated Press | From Page: B8

 
.

Sports

 
 
Falcon boys drop 69-61 SCAC loss to Bethel

By Marcus Lomtong | From Page: B1 | Gallery

Local Report: Armijo boys roll past Napa 69-41

By Daily Republic staff | From Page: B1, 1 Comment

 
Nadal loses; Sharapova to play all-Russian semi in Australia

By The Associated Press | From Page: B1

Belichick and The Beast talk but don’t say much at Media Day

By The Associated Press | From Page: B1

 
Deflated topic: air pressure in footballs

By The Associated Press | From Page: B1, 1 Comment

Rose’s shot lifts Bulls over Warriors 113-111 in overtime

By The Associated Press | From Page: B1 | Gallery

 
Jury convicts 2 ex-Vanderbilt players of raping woman

By The Associated Press | From Page: B2

 
Rio official says there’s ‘no plan B’ for Olympic sailing

By The Associated Press | From Page: B2

Golfer Allenby stands by story, says truth will come out

By The Associated Press | From Page: B2

 
Tony Stewart returns with a swagger not seen in 2 years

By The Associated Press | From Page: B2

Shooters find not every basketball is same in college game

By The Associated Press | From Page: B2

 
Patrick heads into 2015 in final season with team, sponsor

By The Associated Press | From Page: B2

Manfred hopeful of A’s getting new ballpark in Oakland

By The Associated Press | From Page: B2

 
Christina Aguilera to perform ahead of NBA All-Star Game

By The Associated Press | From Page: B2

Super Bowl, Tiger make Phoenix center of sports universe

By The Associated Press | From Page: B2

 
Long after Twitter feud, Revis, Sherman pledge respect

By The Associated Press | From Page: B2

The distinctive international flavor of Super Bowl Media Day

By The Associated Press | From Page: B2

 
Serena Williams advances, Venus out of Australian Open

By The Associated Press | From Page: B2

Getting fired from New England led to Carroll’s reinvention

By The Associated Press | From Page: B2

 
Sharks in ‘dogfight’ to secure playoff berth

By The Associated Press | From Page: B2

 
This date in sports history for Jan. 28, 2015

By The Associated Press | From Page: B4

 
.

Business

US home price gains slow in November on weaker sales

By The Associated Press | From Page: A14

 
FTC clears Albertsons’ purchase of Safeway

By The Associated Press | From Page: A14

.

Obituaries

Clarence E. Morgan

By Nancy Green | From Page: A4

 
Julia P. Tan

By Nancy Green | From Page: A4

Don Johnson

By Nancy Green | From Page: A4, 11 Comments

 
Woodrow Allen Oakley

By Susan Hiland | From Page: A4

Donald Wesley Johnson

By Susan Hiland | From Page: A4

 
.

Comics

Sally Forth

By Daily Republic Syndicated Content | From Page: B5

 
For Better or Worse

By Daily Republic Syndicated Content | From Page: B5

Pickles

By Daily Republic Syndicated Content | From Page: B5

 
Beetle Bailey

By Daily Republic Syndicated Content | From Page: B5

Baby Blues

By Daily Republic Syndicated Content | From Page: B5

 
Frank and Ernest

By Daily Republic Syndicated Content | From Page: B5

B.C.

By Daily Republic Syndicated Content | From Page: B5

 
Baldo

By Daily Republic Syndicated Content | From Page: B5

Blondie

By Daily Republic Syndicated Content | From Page: B5

 
Dilbert

By Daily Republic Syndicated Content | From Page: B5

Rose is Rose

By Daily Republic Syndicated Content | From Page: B5

 
Get Fuzzy

By Daily Republic Syndicated Content | From Page: B5

Wizard of Id

By Daily Republic Syndicated Content | From Page: B5

 
Peanuts

By Daily Republic Syndicated Content | From Page: B5

Zits

By Daily Republic Syndicated Content | From Page: B5

 
Garfield

By Daily Republic Syndicated Content | From Page: B5

Sudoku

By Daily Republic Syndicated Content | From Page: B6

 
Cryptoquote

By Daily Republic Syndicated Content | From Page: B6

Bridge

By Daily Republic Syndicated Content | From Page: B6

 
Word Sleuth

By Daily Republic Syndicated Content | From Page: B6