Will VA Choice be Replaced with CARE Plan?

CARE Program

By Debbie Gregory.

Key senators were bolstered by veterans groups to conditionally endorse a plan from VA Secretary David J. Shulkin to replace the current VA Choice program with the Veterans Coordinated Access and Rewarding Experiences (CARE) Program.

Representatives of the American Legion, Veterans of Foreign Wars, Disabled American Veterans and Paralyzed Veterans of America endorsed Shulkin’s vision to drop Choice and its metrics of wait times and geographic distance, and use clinical need instead to determine whether to refer patients to community care.

Dr. Shulkin’s CARE program would resemble a managed care program, with VA healthcare providers assigned to see their patients, and then deciding whether to treat them inside the VA or refer them to an outside network of private sector care providers under contract to VA.

“When I treat patients,” said Dr. Shulkin, an internist who still sees patients as a VA physician, “I listen to my patients and I understand what their needs are…I think what good doctors and providers do is they recognize it is a joint decision.”

But these same groups adamantly oppose the VA’s plan to fund the new plan by cutting disability compensation, paid through the Individual Unemployability (IU) program,  to more than 200,000 severely disabled veterans, ages 62 and older, who also are eligible for minimum social security benefits.

The Choice program, which allowed veterans to seek private sector healthcare if they reside more than 40 miles from a VA hospital or had to wait longer than 30 days for access to VA care after seeking an appointment, has generally been called a failure.

Ranking Democratic Senator. Jon Tester (MT), called the current Choice plan “a train wreck” that “hasn’t improved access. In fact, it’s made it worse. And in the process, it’s caused a lot of veterans and community [healthcare] providers to lose faith in the VA.”

But the veteran groups have urged Congress and the VA not to fund any of  new program by cutting IU compensation or other benefits.

Shulkin said he heard their “strong concerns” about the IU cuts and would take them “very seriously. Nobody wants to be taking away unnecessary benefits from veterans, and certainly not putting them into poverty,” he said.

But, he added that mandatory VA benefits have climbed by $12 billion in the past two years.

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