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Merger of VA and DoD Health Systems Being Considered

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By Debbie Gregory.

The Department of Veterans Affairs (VA) provides healthcare to veterans through medical centers and clinics owned and run by the federal government, although veterans can also see private doctors through the Choice if VA wait times are too long. The Department of Defense provides healthcare to current servicemembers, retirees and their families through TRICARE,  insurance that is paid for by the government and uses private doctors and hospitals.  But soon, the two may be one and the same.

The VA generally serves older, sicker veterans, while TRICARE’s patients are generally healthier.

VA Secretary David Shulkin has been exploring the option of integrating VA and Pentagon health care. This follows the VA’s planned adoption of utilizing a similar electronic health record (EHR) platform as the Defense Department’s MHS GENESIS.

“VA’s adoption of the same EHR system as DoD will ultimately result in all patient data residing in one common system and enable seamless care between the Departments without the manual and electronic exchange and reconciliation of data between two separate systems,” said Shulkin.

Since an overhaul of VA’s EHR won’t be completed for another seven to eight years, a TRICARE merger would more than likely take at least as long.

News of the plan is worrying various veterans groups. The American Legion, Veterans of Foreign Wars, AMVETS and Disabled American Veterans have expressed that a TRICARE merger is likely to be a “non-starter” if the goal is to transform VA care into an insurance plan.

Louis Celli, director of veterans’ affairs and rehabilitation for The American Legion, said outsourcing services away from the current VA system via its medical centers and clinics would be financially unsustainable.

Bob Wallace, the executive director of VFW’s Washington office  said that his organization  would oppose any effort to reduce the VA’s role of providing care for veterans.

What do you think?

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Lawmakers Want to Reduce the Number of VA Facilities

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By Debbie Gregory.

The Department of Veterans Affairs and the House Committee on Veterans’ Affairs are taking a hard look at VA facilities across the country to determine which ones have been outlived their usefulness. Many aging and underused facilities could be subject to closure.

Department of Veterans Affairs Secretary David Shulkin said that the agency is considering a plan to close more than 1,100 facilities across the country, given that the VA continues to allow a larger number of veterans access to private sector health care.

Shulkin told a House hearing that the department has identified 735 underused facilities. There are also 430 empty buildings, most of which were constructed around 90 years ago.

Committee Chairman Rep. Phil Roe, R-Tenn., and Rep. Tim Walz, D-Minn., the ranking Democrat, want to create a paid commission to recommend which facilities should be closed.  Their bill, the Asset Infrastructure Review Act (AIR) is in its early stages. As it is currently written, the bill would require Shulkin publish the criteria to be used in choosing which facilities to close, modernize or realign in the Federal Register by January 15, which is less than two months away.

Shulkin said the VA and Congress would work together to review buildings for possible closure, possibly using a process like Base Realignment and Closure (BRAC), which the Pentagon has used in the past to determine which underutilized military bases should be closed.

But the BRAC process has been controversial, raising concerns among members of Congress about the negative financial impact of closing military bases in their districts.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Elizabeth Dole to Chair New VA Veterans’ Family, Caregivers & Survivor Advisory Committee

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By Debbie Gregory.

VA Secretary David Shulkin continues to demonstrate his commitment to supporting our nation’s veterans and their caregivers through the formation of the Veterans’ Family, Caregiver, and Survivor Federal Advisory Committee. The committee will be chaired by former U.S. Senator Elizabeth Dole.

Dole is the founder of the Elizabeth Dole Foundation and the Hidden Heroes Campaign, both of which focus on military caregiving.

“Senator Dole is an accomplished and experienced advocate for Veterans’ caregivers,” said Secretary Shulkin. “I am honored that she will Chair this landmark Committee.”

The committee will advise the secretary on matters related to:

Veterans’ families, caregivers, and survivors across all generations, relationships, and Veteran status; the use of VA care and benefits services by veteran’s families, caregivers, and survivors, and possible adjustments to such care and benefits services; veterans’ family, caregiver, and survivor experiences, and VA policies, regulations, and administrative requirements related to the transition of Service members from the Department of Defense to enrollment in VA that impact veterans’ families, caregivers, and survivors; and actors that influence access to, quality of, and accountability for services and benefits for veterans’ families, caregivers, and survivors.

Senator Dole has walked the walk, as she was a caregiver to her husband, former U.S. Senate Majority Leader Robert J. Dole, a World War II veteran injured in combat.

Committee members were chosen from a diverse group, including family members, caregivers, survivors, veteran-focused organizations, military history and academic communities, the National Association of State Directors of Veterans Affairs, the Federal Executive Branch, research experts and service providers; and leaders of key stakeholder associations and organizations.

Former Marine Sherman Gillums, the executive director of Paralyzed Veterans of America, will serve as vice chair.

Committee members, in alphabetical order are: Ms. Mary Buckler, Ms. Bonnie Carroll, Ms. Melissa Comeau, Ms. Harriet Dominique, Ms. Jennifer Dorn, Ms. Ellyn Dunford, Dr. Robert Koffman,  Lt. Gen. (U.S. Army, Ret.) Mike Linnington, Mr. Joe Robinson, Ms. Elaine Rogers, Brig. Gen. (U.S. Army, Ret) Dr. Loree Sutton, Mr. Francisco Urena, Ms. Shirley White, Ms. Lee Woodruff, and Ms. Lolita Zinke.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

VA Withdrawal of Staab Appeal Could Affect 370,000 Cases

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By Debbie Gregory.

VA Secretary David Shulkin said he was dropping VA’s appeal of the Staab case decided last year by the U.S. Court of Appeals for Veterans Claims.

The case, filed by Richard W. Staab, appealed a December 6, 2013, Board of Veterans’ Appeals decision that denied Staab reimbursement of medical expenses incurred for emergency medical services provided at non-VA medical facilities.

Shulkin said Staab had been wrongly decided. In Staab’s case, the court agreed with lawyers for the 83-year Air Force veteran who was forced to pay $48,000 in healthcare costs following open-heart surgery in December 2010.

For a number of years, the VA has maintained that, by law, it can only reimburse VA-enrolled veterans for outside emergency care if they have no alternative health insurance. That includes Medicare, TRICARE, employer-provided health insurance or contracted health plans of any kind.

Unfortunately for veterans with other health insurance, they are often stuck paying hefty out-of-pocket costs that their plans won’t cover, while veterans with no other insurance see the VA routinely pick up their entire emergency care tab.

Pulling the appeal means VA intends to begin covering private sector emergency care for any VA-enrolled veteran, even if they have alternative health insurance that pays part of their emergency care costs.

As many as 370,000 veterans with pending claims could benefit from the decision to appeal.

The VA has completed draft regulations to implement the new emergency care benefit. The benefit must clear the Office of Management and Budget (OMB) and be published in the Federal Register for comment before VA can begin reimbursements. could take nine months or more.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Shulkin Backs Off Plan to Cut Benefits of Elderly Veterans

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By Debbie Gregory.

It’s good to know that Veterans Affairs Secretary David Shulkin has announced that he wants to avoid any policy changes that will hurt the most vulnerable veterans, those who are part of the Individual Unemployability (IU) program.

“The budget is a process, and it became clear this (plan) would hurt some veterans,” he said. “I’m really concerned about that … I’m not going to support policies that hurt veterans.”

President Donald Trump’s $186.5 billion VA budget for fiscal 2018 has provisions that would dramatically change eligibility rules for the IU program, affecting some 210,000 veterans over the age of 60, at least 7,000 of whom are over 80.

Under current rules, the IU program awards payouts at the 100 percent disabled rate to veterans who cannot find work due to service-connected injuries, even if their actual rating decision is less than that. The change would make them ineligible once they reach Social Security’s retirement age

Although the move would save $3.2 billion just in its first year, the cost to the veterans currently qualified for UI would be enormous. IU payouts can total almost $20,000 a year.

American Legion officials praised the administration “for coming to their senses and committing to protect the Individual Unemployability program that provides for our most vulnerable veterans and their families.”

Shulkin is still committed to looking for ways to be more efficient with taxpayer funds, but not at the expense of veterans’ financial health.

We at Military Connection applaud these actions! Our veterans deserve all of the benefits they receive.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

A Little About our VA Secretary Shulkin

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By Debbie Gregory.

Secretary of Veterans Affairs David Shulkin may be an unlikely choice to overhaul veterans services. Although he is the son of an Army psychiatrist, for the first time, the head of the agency is not a veteran. His family has a history of military service and providing military medical care. Both his grandfathers served in World War I. And maybe most importantly, Dr. Shulkin, has spent a lifetime studying how to make health care organizations deliver better care at lower costs.

The entire U.S. Senate, all 100 Senators, voted to confirm Dr. Shulkin as President Trump’s VA Secretary. Prior to his confirmation as Secretary, Dr. Shulkin served as VA’s Under Secretary for Health for 18 months, leading the Nation’s largest integrated health care system, with over 1,700 sites of care serving nearly nine million Veterans.

While at the Medical College of Pennsylvania, Shulkin studied how to improve efficiency in health care management. Utilizing best practices resulted in saving money and patients.

Dr. Shulkin rose through top jobs there, at Temple University Hospital in Philadelphia, at Beth Israel Medical Center in New York and eventually at Morristown Medical Center, in the affluent suburbs of northern New Jersey.

He is all for increasing reliance on private health care for routine procedures, like hearing aids, so it can focus on its core mission of caring for the wounded.

Shulkin, a board certified internist, has been extremely concerned about veteran suicide after a news report showed high rates among young combat veterans. In a September 2016 op-ed, Shulkin wrote, “Losing even one veteran to suicide is unacceptable, which is why suicide prevention is a top priority at VA.”

Dr. Shulkin has been named as one of the “50 Most Influential Physician Executives in the Country” by Modern Healthcare. He has also previously been named among the “One Hundred Most Influential People in American Healthcare.” He has been married to his wife, Dr. Merle Bari, for 29 years. They are the parents of two grown children.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Trump Holds Meeting on VA Issues

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By Debbie Gregory.

President Trump held a series of “White House listening sessions” with various groups and then met with veterans advocates the following day. But apparently when it came to discussing the ways his administration could reform the embattled Department of Veterans Affairs, he failed to invite officials from the American Legion, Disabled American Veterans and the Veterans of Foreign Wars.

Trump’s pick to head the Department of Veterans Affairs, David Shulkin, did attend the White House meeting hours before his confirmation vote in the Senate Committee on Veterans’ Affairs.

Kellyanne Conway, a top adviser to Trump, told reporters outside the White House that the president had a “very productive conversation” with advocates about veterans issues.

Conway said veteran care should be “a bipartisan issue, if not a nonpartisan issue.”

Toby Cosgrove, CEO of the Cleveland Clinic, said after the meeting that the discussion had ranged “from governance to modernization to accountability across the organization.”

Cosgrove was once a rumored front-runner for the VA secretary job.

During the campaign, Trump described the VA as “the most corrupt” and “probably the most incompetently run” of all federal agencies.

The president has proposed an ambitious 10-point plan for VA reform that includes giving veterans the option to seek private healthcare if they want to bypass the government-run system.

Trump promoted Shulkin, Obama’s VA undersecretary of health, to a Cabinet position.

Shulkin, a physician who would be the first nonveteran to lead the government’s second-largest agency, is expected to receive broad support in the Senate and is one of few Cabinet nominees who has not faced coordinated opposition from Democratic lawmakers. The Senate Veterans Affairs Committee voted unanimously to advance Shulkin’s nomination out of committee on Tuesday.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.

Trump Taps Shulkin for VA Secretary

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By Debbie Gregory.

President-elect Donald Trump has announced his intention to nominate David Shulkin as his secretary of veterans affairs.

Shulkin currently serves as the undersecretary for health at the VA. The new position requires Senate confirmation.

Shulkin is a board-certified internist. He served as the President and Chief Executive Officer of Beth Israel Medical Center in New York City. He also served as President of Morristown Medical Center and the Atlantic Accountable Care Organization.

He has been Chief Medical Officer of the University of Pennsylvania Health System, the Hospital of the University of Pennsylvania, Temple University Hospital, and the Medical College of Pennsylvania Hospital.

His other academic positions have included Chairman of Medicine and Vice Dean at Drexel University College of Medicine, and Professor of Medicine at Albert Einstein School of Medicine. Shulkin has been the editor of Journal of Clinical Outcomes Management and Hospital Physician, and has been on the editorial boards of several journals, including Journal of the American Medical Association.

Dr. Shulkin founded and served as the Chairman and CEO of DoctorQuality, Inc a consumer-oriented information service.

In a departure from the norm, Dr. Shulkin is not a veteran, breaking the pattern that the VA has previously established, having a veteran at the helm.

“I have no doubt Dr. Shulkin will be able to lead the turnaround our Department of Veterans Affairs needs,” Trump said in a statement following the announcement. “Dr. Shulkin has the experience and the vision to ensure we will meet the healthcare needs of every veteran.”

Trump considered a series of possible VA secretaries before deciding on Shulkin

“The first responsibility that we have to our veterans is to make sure those that need urgent care are getting care on time,” Shulkin said.

Military Connection salutes and proudly serves veterans and service members in the Army, Navy, Air Force, Marines, Coast Guard, Guard and Reserve,  and their families.