VA's Choice program running out of money ahead of schedule

[nitpicker]

http://www.militarytimes.com/articles/va-choice-program-funds-gone-early

VA's Choice program running out of money ahead of schedule

By: Leo Shane III, June 14, 2017

WASHINGTON — The Veterans Affairs Choice program, hailed by President Trump as a key lifeline to veterans, is on pace to run out of money later this summer, potentially causing major disruptions in thousands of veterans’ medical care. Congress believed they had solved this problem earlier this year, by passing an extension of the program’s rules to keep it operating until late 2018. But on Wednesday, in testimony before the Senate Veterans’ Affairs Committee, VA Secretary David Shulkin said higher than expected usage of the program will likely cause a funding shortfall before the end of the summer.
(snip)

As a result, VA officials are asking to move around money from other outside care programs to cover the Choice program, the opposite problem lawmakers anticipated when they passed the extension. Committee ranking member Sen. Jon Tester, D-Mont., called the news upsetting. “For this to happen this late in the game is frustrating to me,” he said.

The news came as Shulkin presented Trump’s plans for a $186.5 billion VA budget for fiscal 2018, nearly a 6 percent increase from current funding levels. The VA secretary said that includes $13.2 billion for outside care programs next year, a figure he says should be sufficient to meet department needs.
(snip)

With the money running out early, the major impetus behind the legislation now appears moot, although the measure did also include changes to how private-sector physicians receive payments from the government. But VA officials have warned that gaps in funding could disrupt veterans medical care, potentially delaying or cancelling appointments.

At the hearing, Senate Veterans’ Affairs Committee Chairman Johnny Isakson, R-Ga., seemed open to the idea of authorizing the funding transfers. Shulkin and his predecessor, former VA Secretary Bob McDonald, have both lobbied Congress for more funding flexibility, to avoid similar problems in the future.

But officials from the American Legion in a statement said they oppose "this cannibalization of services to fund the Choice Program" and instead support plans to consolidate existing care programs "into one simple, efficient, responsive, and transparent process."

[Kaleva]

1. My local hospital no longer accepts Choice

Problems with being reimbursed. From my experience, Choice is a pain in the ass. The idea behind it is good but how it is set up is terrible. It took months and repeated phone calls just to get an appoinment with a local doctor for a physical.

[AC_Mem]

2. Choice

Hi there, I work for the VA, and from the feedback I hear and experience from Veterans, it's pretty clear to me that the 3rd party administrator of Choice is one of the biggest complaints we receive. I think, and this is my opinion, that perhaps they were not prepared for the volume. There is an issue with timeliness in getting their appointments on the outside, ironically. Many many try Choice and ask to come back inside VA for their care. Funding is a core issue for VA and the programs because of the VOLUME of patients we serve and their complex needs.

I think there is a need for Choice for specialized treatment that we do not have inside, and for Veterans who have to travel too far to a VA clinic or hospital, but what we offer our Veterans is unique and not something they get on the outside, and they see that. All everyone hears about is the negative, I wish more could see how hard we work and honor our beloved Veterans.

If you are a Veteran, thank you for your service.

[Victor_c3]

4. I'm a veteran that is very happy with the VA

I'm rated 100% P&T for PTSD and I frequent the VA usually about 4 days a week for various appointments and groups relating to PTSD and alcoholism. The mental health healthcare I receive is top-tier from my experience. The vast majority of VA employees are helpful and, to me at least, appear to genuinely care about the services their provide for veterans. I've only ever had a few negative experiences with staff - actually only two that I can think of out of roughly 4 years of my heavy utilization of their services.

Before I became unable to work, I worked for the federal government. I was a chemist for the Department of Treasury. Others around me and I took pride in our work and took our service to the American people seriously. I don't think most people outside of the government understand that employment to the government means more than just a paycheck to many federal employees.

I haven't seen it yet, but I recently worked with votevets.org on a commercial asking people to support the VA. They spent an entire day interviewing me and having me recite lines for an advertisement that should be airing sometimes in the very near future.

The people who I notice who aren't the happiest with the VA are the people that, in my opinion, are trying to milk the system. I'm sure some people are not getting what they deserve, but that is the exception from my experiences. There are some legitimate problems with the VA, but given the size and scope of the organization that is almost unavoidable. I'm very happy with the VA and I'm extremely thankful to have the services they offer available to me. My life is a wreck as a result of my severe PTSD, but the VA is doing pretty much everything possible to help me keep my life from falling totally apart.

VA employees, thank you for your service. Unlike my military service in Iraq, your service has a positive impact on the lives of people.

[AC_Mem]

6. Agree!

When Bernie led the cause of getting us funding for more medical staff, it really made a difference. I disagree overall on how they did the staffing (but I'm not a decision maker, I just pay close attention), but I can say this - because of that funding, we became competitive in hiring very high quality physicians and specialists. You cannot imagine how many physicians are walking away from their private practice and coming to the VA. On the outside, they have to manage the building and maintaining of their practice, they have to bill the insurance companies and wait for them to pay, they have to pay for their malpractice insurance (which is very expensive), and they are only compensated a fraction of what they charge based on the patient's insurance. The VA gives them the ability to care for their patients and provides them a salary, good insurance/benefits, they do not have to pay for their own malpractice insurance, and they do not have the overhead of renting office space, paying staff, etc.

Its very interesting to me that many of the physicians I've encountered who are R's, love to work at the VA - which is, if you think about it - socialized medicine. These doctors are working for the federal government for a salary. In my opinion, we already have a great template for universal healthcare - the VA. Just take this system, give it better funding, and roll it out to America. I see it work every day.

Do we have some issues? Of course! And so does the private sector. But we are improving every day and most of our issues are from VOLUME and lack of funding to address the issues related to managing that volume. From what I see, the doctors, specialists and surgeons are very very interested in working for the VA - and we get a huge number of Residents who do their training at the VA and then decide that they want to stay, rather than set up an outside practice. It has made a big difference in the quality of care that we are able to provide.

[DashOneBravo]

5. Thank you for doing that

It's just the bad ones get all the attention.
Every vet I know speaks highly of the people doing those jobs.

[nitpicker]

3. Link to update (still no action)

http://www.militarytimes.com/articles/va-choice-funding-shortfall-problems-congress-deadline