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Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

Washington Highlights

VA Plan Underscores Value of Academic Affiliates

November 5, 2015—The Department of Veterans Affairs (VA) Oct. 30 delivered to Congress its Plan to Consolidate Community Care Programs, VA’s vision of how the agency will deliver health care to veterans in the future. Specifically, the plan outlines how VA will purchase veteran health care at non-VA facilities. Pending the requisite congressional approvals and legislative changes, VA hopes to begin implementing the plan immediately with transitional phases over the next few years.

In a Nov. 5 statement, AAMC President and CEO Darrell G. Kirch, M.D., welcomed the report, "The historic and mutually beneficial partnership between the VA and the nation’s medical schools and teaching hospitals goes back seven decades, and these proposals will help pave the way for this partnership to continue for many years to come.”

The VA proposes a tiered network of providers. The “Core Network” would include federal and academic partners, and would be treated as a direct extension of VA care. The “External Network” would include a “Standard Tier” as well as a “Preferred Tier” for providers that demonstrate quality and value.

Under the plan, academic affiliates would be able to continue contracting directly with the local VA Medical Center (VAMC) to provide clinical services. This contracting would be streamlined with national templates, but allow for local flexibility.  

Medical schools and teaching hospitals would also be eligible for fee-basis care under the new External Network that is reimbursed at Medicare rates with customized fee schedules for certain selected areas and scarce specialty services.

The VA would be responsible for case management and referrals instead of third party administrators. Additionally, VA would accept academic affiliates’ credentialing, with a new VA oversight committee to audit compliance with credentialing standards. The VA also plans to streamline referrals and health information sharing by automating these processes.

The plan also calls for greater monitoring of outcomes and quality metrics for non-VA providers. VA is expected to utilize existing metrics, such as those under the Centers for Medicare and Medicaid (CMS) Hospital Value-Based Purchasing (VBP) program.

Congress mandated the consolidation plan under the VA Budget and Choice Improvement Act (P.L. 114-41), in response to which AAMC President and CEO Darrell G. Kirch, M.D., wrote a letter urging the agency to protect VA’s academic affiliations [see Washington Highlights, Sept. 11].

The Senate and House VA Committees are scheduled to hold Nov. 17 and Nov. 18 hearings on the report, respectively.

Contact:

Matthew Shick, JD
Director, Gov't Relations & Regulatory Affairs
Telephone: 202-862-6116
Email: mshick@aamc.org

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For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806
Email: jkleinman@aamc.org