The four-month old VA program that allows certain veterans to seek medical care from outside facilities has been vastly underused by eligible veterans, according to a VFW report issued Monday.
The report’s survey of veterans found that 80 percent of the 1,068 respondents who were interested in and eligible to receive outside medical care through the Veterans Choice Program had not been offered non-VA care.
Late last month Sen. Richard Blumenthal, D-Conn., described the program as “shockingly underutilized,” with only about 30,000 veteran appointments made through the program in its first three months.
In an effort to reduce long wait times at VA medical facilities, Congress in August passed the Veterans Access, Choice and Accountability Act of 2014, establishing the Choice Program.
The program gives veterans who cannot be seen by a VA clinic within 30 days or who live more than 40 miles from the nearest VA facility the option of seeking care from certain approved health care providers.
The program was rolled out on Nov. 5.
About 8.6 million Veterans Choice Cards were issued, and about 27,000 veterans had requested non-VA care as of Feb. 5, the report said.
The VFW received 2,511 responses from veterans during its survey of the first three months of the program.
Among the survey findings were:
- About a third of 2,157 respondents lived farther than 40 miles from the nearest VA medical facility.
- 35 percent of 746 respondents who attempted to schedule an appointment after Nov. 5 reported waiting more than 30 days for a VA appointment.
- 57 percent of the 97 participants who received non-VA care said they were satisfied with the Veterans Choice Program.
The report said that veterans approved for non-VA care are put on the Veterans Choice List, a database used by outside healthcare facilities to determine whether a veteran is eligible.
The report said that the VA had discovered lag times in transferring this information and had taken steps to correct that.
“However, the VFW remains concerned about possible inconsistencies in the way VA medical facilities report VCI data to the contractors,” the report said.
The VFW also found that the VA’s wait-time standard “still requires veterans to wait unreasonably long and remains susceptible to data manipulation.”
One idiosyncrasy contributing to long wait times is the so-called “clinically indicated date” requirement.
“For example, if a VA health care provider deems it clinically necessary that a veteran receive a colonoscopy within 60 days, such veteran will be required to wait for a minimum of 90 days before being given the option to see a non-VA provider through the Veterans Choice Program,” the report said.
The report found that the 40-mile rule in some cases was not realistic because the distance is measured “as the crow flies” when determining eligibility for the Choice Program, which “does not accurately capture the travel burden.”
This is contrary to the method used by veterans when applying for beneficiary travel benefits, which literally measure the number of miles driven.
“Thus, it is illogical to veterans that they can qualify for beneficiary travel of 40 miles but cannot quality for the Veterans Choice Program as a 40-miler,” the report said.
The report concluded with a list of recommendations for the VA and Congress to improve the program, including modifications to the 40-mile rule and wait-time standards.
On Tuesday a group of about 50 House representatives sent a letter to VA secretary Robert McDonald urging him to alter the 40-mile rule.
“When Congress passed the Veterans Choice Program, we intended the program to be widely available to ensure that all veterans receive timely access to medical appointments,” said Rep. Julia Brownley, D-Calif., in a news release Tuesday.
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