More veterans can shift their health care from the VA to private doctors and hospitals

Vietnam veteran Dick Marshall of Shortsville is pleased with care he gets from the Canandaigua VA Medical Center. Spending time in Florida, he uses a VA there, too, and likes the care there as well, he said. Still, Marshall said he is glad to know that veterans nationwide will have more choices when it comes to where they can go for VA services.

Under a new federal rule taking effect June 6 (the Mission Act), more veterans can shift their health care from the VA to private doctors and hospitals — if they choose. Along with increasing access to community care, the changes are also expected to strengthen the VA’s ability to recruit and retain clinicians and improve coordination between the VA and community providers. Scheduling appointments should be easier, proponents say.

In addition, a new “Anywhere to Anywhere” provision across state lines will allow doctors, nurses and other health-care providers to administer telehealth care — using virtual technology — regardless of where in the United States the provider or veteran is located. That means care can occur across state lines or outside a VA facility.

Nick DiRisio, a Vietnam veteran in Yates County, said the changes sound helpful.

“We need more places to go, we need more doctors,” said DiRisio, who suffers from conditions related to his exposure during the war to Agent Orange. He said he hopes veterans get all the information they need to take advantage of the new options. “There’s a lot offered, and a lot veterans don’t know about,” DiRisio said.

Expanded Choice program

Before June 6, a Choice program allowed veterans to see doctors outside the VA system if they had to wait more than 30 days for an appointment or drive more than 40 miles to a VA facility. Under the expanded access to community care, veterans have that option for a private doctor if their VA wait is only 20 days (28 for specialty care) or their drive is only 30 minutes.

Still, the VA says it does not expect a major increase in veterans seeking care outside the VA, partly because wait times in the private sector are typically longer than at VA. "The care in the private sector, nine times out of 10, is probably not as good as care in VA," VA Secretary Robert Wilkie told Congress in March.

New urgent care option

One completely new option allows veterans to use their VA benefit at urgent care centers — as long as that urgent care facility is in-network.

Dr. Brian Westlake, a care manager at the Canandaigua VA, explained. The VA partners with a community care provider, TriWest. If the urgent care facility contracts with TriWest, that is in-network and so veterans are covered there using their VA benefit.

Westlake said TriWest is working on contracting with urgent care facilities. “The goal is to sign up community care providers, and urgent care is part of that," he said. The VA provides a list of in-network urgent care facilities and other information about that option.

Stronger VA workforce?

The new rules offer perks aimed at building the VA workforce, which needs more physicians, nurses, therapists and other clinicians. Westlake said student loan debt reduction is a big piece of that. The VA had been offering hires $120,000 over a five-year period toward paying off their student loan. That new maximum is now $200,000 over the five years in loan payment reimbursement.

VA also raised the pay for podiatrists to match that of regular MDs and dentists.

A podiatrist — a Doctor of Podiatric Medicine (DPM) — diagnoses and treats conditions affecting the foot, ankle and related structures of the leg. Podiatrists are key in providing services to veterans, Westlake said. Medical conditions affecting the feet and lower leg, such as certain injuries and ailments including diabetes, are common among veterans, he said.

Westlake also mentioned a pilot program testing whether paying for medical school education for veterans could pay off in efforts to increase and retain VA physicians.