Group says family doctors may opt out of troubled Veterans Choice program
By TRAVIS J. TRITTEN | STARS AND STRIPES Published: February 26, 2015
WASHINGTON — Doctors may opt out of a program providing outside health care to veterans caught up in long waits at the VA because the department is not paying high enough reimbursements, a national association of family physicians said this week.
Family physicians approached to participate in the multi-billion-dollar Veterans Choice program reported they were offered rates far below the benchmark set by Medicare, the American Academy of Family Physicians wrote Tuesday in a letter to Department of Veterans Affairs Secretary Bob McDonald.
The Veterans Choice program began in November but is already drawing criticism from Congress for the very low number of veterans who have made appointments for outside health care. The letter from the AAFP — one of the largest U.S. medical associations — indicates the VA may also have trouble drawing in providers.
“Simply put, any public or private payer health plan contract that does not at least meet the Medicare payment rate will remain financially impossible for most medical practices that already operate on extremely thin margins,” Reid Blackwelder, chairman of the AAFP board, wrote to McDonald.
The group said doctor reimbursement rates under the federal government’s Medicare health insurance system are used as a benchmark for public and private payers.
Some of its nearly 116,000 members are reporting that the VA approached them about being in the Veterans Choice program and offered rates that were 30 percent below Medicare.
“If the VA continues to offer contracts at less than the Medicare rate, the AAFP is concerned that most practices will not be able to participate in the program, which undermines the law’s intent of expanding access to veterans,” Blackwelder wrote.
On Thursday, Senators said the Veterans Choice program appears not to be working and that it is “shockingly underutilized” by VA beneficiaries. After 500,000 calls, only about 30,000 appointments or requests have been resolved so far.
The program is designed to provide outside health care to veterans who are having trouble getting appointments in the nationwide system of VA hospitals and clinics. Last year, the department was mired in a scandal over tens of thousands of vets waiting months to receive needed care.
The program was passed last summer as part of a massive federal law overhauling the VA following a nationwide scandal of long patient wait times and records manipulation. The VA began mailing out Veterans Choice cards to beneficiaries in November and completed those mailings in January.