The House Committee on Veterans Affairs (VA) held a March 7 hearing titled, “Shaping the Future: Consolidating and Improving VA Community Care,” which focused on the VA Choice Program. Witnesses included Senator John McCain (R-Ariz.), VA Secretary David Shulkin, MD, VA Inspector General Michael Missal, and Government Accountability Office Health Care Director Randy Williamson. Dr. Shulkin was also accompanied by Baligh Yehia, MD, VA Deputy Under Secretary for Health for Community Care.
In his initial statement, Dr. Shulkin said the first element to modernizing the community care program is to “maintain a high performing integrated network that includes VA, federal partners, academic affiliates, and community providers.” Inspector General Missal urged, “Congress must understand the historical barriers and control weaknesses that have plagued VA's purchase care programs and ensure they are adequately addressed in future programs.” Among other issues, the hearing touched on contracting, third party administrators, care coordination, credentialing, and reimbursement.
Of importance to academic affiliates, Reps. Mark Takano (D-Calif.) and Brad Wenstrup, DPM, (R-Ohio) raised graduate medical education (GME). Dr. Wenstrup queried, “And as you know, most doctors in America spend some time in the VA as part of their training. So, what are you looking at with that, that we could be of help, as far as what specialties we may want to engage with further such as in mental health, but also association with academic institutions and making those more robust programs?”
Dr. Shulkin responded, “Well, we're doubling down our relationships with our academic centers. We think it's one of the best and strongest features of VA and it benefits not only veterans, but all Americans.” He continued to discuss the VA GME expansion initiative [see Washington Highlights, Dec. 16, 2016] with an emphasis on primary care, mental health, and increasing rural training positions, “That would be big I believe addition to helping us and increasing the quality of the environments that our veterans get care in.”
Dr. Shulkin continued, “So, we'd like to work with you for ways to expand [GME]. As you know, the country needs more graduate of medical education spots. They've been expanding the undergraduate medical education spots but not the GME spots and somehow that formula is not going to work out if we don't expand the GME spots.”
The House VA Committee March 8 approved a bill to eliminate the sunset of the Veterans Choice Program (H.R. 369), which was previously scheduled for Aug. 7, 2017. The committee also approved by unanimous voice vote a bill introduced by Dr. Wenstrup, who chairs the health subcommittee, to improve VA’s authority to hire and retain physicians (H.R. 1367).