The Senate Appropriations Committee July 13 approved its FY 2018 Military Construction, Veterans Affairs, and Related Agencies spending bill. Thanks to an amendment pushed by Sen. Richard Durbin (D-Ill.) and the Friends of VA Medical Care and Health Research (FOVA), the final measure includes $722 million for FY 2018 A Medical and Prosthetic Research, a $49 million (7.3 percent) increase over the FY 2017 enacted level. The AAMC is a member of the FOVA executive committee.
Consistent with the House bill and the president’s budget, the Senate bill provides $9.7 billion for FY 2018 VA Medical Community Care, a $254 million (2.7 percent) increase above the enacted FY 2018 advance level, and $8.4 billion in advance appropriations for FY 2019, a $1.3 billion (13.2 percent) decrease from the FY 2018 proposed level.
The AAMC July 11 submitted a statement for the record to the Senate VA Committee in response to a hearing on pending health care legislation. The hearing examined several pieces of legislation, including three comprehensive VA community care proposals: the Veterans Health Administration Reform Act of 2017 (S.1279) introduced by Sen. Mike Crapo (D-Idaho); the Veterans Choice Act of 2017 introduced by Chairman Johnny Isakson (R-Ga.); and the Improving Veterans Access to Care in the Community Act of 2017 introduced by Ranking Member Jon Tester (R-Mont.).
The AAMC statement focused on how the VA and academic medical centers’ integrated education, research, and patient care improve health care for our nation’s veterans. Additionally, AAMC stressed the importance of maintaining VA-academic relationships through direct sole-source contracts to help ensure veterans have access to clinical services scarcely available at other community providers.
Witnesses included Baligh Yehia, MD, deputy under secretary for health for community care, on behalf of the VA and several veterans’ service organizations. Dr. Yehia noted that the Veterans Choice Act of 2017 would prohibit VA from entering into or renewing any contract or agreement under a non-Department provider program, and stated, “We are very concerned with this provision and do not support it. It would require VA to renegotiate, reissue, or terminate every agreement and contract, regardless of the terms or conditions of such an agreement permitting extensions or other flexible authorities. We believe this could affect such agreements as those with DoD, IHS, and tribal health programs, as well as with our academic affiliates and contractors.”
In his written statement, Adrian Atizado, deputy national legislative director, Disabled American Veterans, reiterated DAV policy: “in order to provide timely and convenient access to enrolled veterans, the VA health care system must evolve by creating integrated networks with high-quality community providers where needed, including the Department of Defense and academic affiliates.” He continued, “It is important to note that VA’s relationship with U.S. medical schools and teaching hospitals has benefitted our nation’s ill and injured veterans … Strengthening VA’s relationships with academically-affiliated medical centers supports this critical pipeline of clinicians that serves not just veteran patients but the U.S. patient population in general.”
Meanwhile, a number of AAMC members presented recommendations to improve VA-academic affiliations at a July 12-13 meeting of a VA federal advisory committee, the National Academic Affiliations Council, which advises the Secretary. Presentations from external stakeholders included Ann B. Nattinger, MD, MPH, MACP, senior associate dean for research, Medical College of Wisconsin; Carolyn C. Meltzer, MD, FACR, chair, Department of Radiology and Imaging Sciences and Associate Dean for Research, Emory University School of Medicine; Terence R. Flotte, MD, dean of the school of medicine and provost and executive deputy chancellor, University of Massachusetts Medical School; and Chris Colenda, MD, MPH, AAMC senior advisor on veterans affairs, and president emeritus of the West Virginia University Health System. AAMC Chief Academic Officer John Prescott, MD, is a member of the NAAC.