Just 27K Vets Have Used VA Choice Cards To See Private Doctors

Last week, Department of Veterans Affairs Secretary Robert McDonald announced that 27,000 veterans have scheduled appointments with private health care providers through VA's Choice Card program, far fewer than initially expected, the Washington Post's "Federal Eye" reports (Wax-Thibodeaux, "Federal Eye," Washington Post, 2/13).

Background

The choice cards were implemented under a VA reform bill signed into law in August 2014 that aims to increase veterans' access to care by providing them with federally subsidized care at non-VA facilities. Veterans are eligible to use the cards if they have been waiting more than 30 days for a VA health care appointment or if they live 40 miles or farther from a VA facility.

VA rolled out the choice cards in three stages, with the first round beginning on Nov. 5, 2014, and the third set of veterans receiving their cards in December 2014 or January of this year (California Healthline, 11/19/14).

Reasons for Low Use

According to "Federal Eye," few veterans might be using the choice cards in part because of confusion about the program among providers, among other issues.

For example, one VA primary care physician said that VA physicians "are confused by the choice card system and don't understand how to implement it." According to "Federal Eye," several other VA physicians also said they did not know how to use the program.

In addition, some veterans have gone to emergency departments and attempted to use the choice cards, even if they are not eligible to use them in such instances. Meanwhile, Rep. Tim Huelskamp (R-Kan.) said that some veterans have called private hospitals to inquire about scheduling appointments but did not ask about whether they could use the cards for such appointments.

Further, VA has been implementing the 40-mile requirement as 40 "miles in a straight line" rather than 40 miles of driving distance on a map, "Federal Eye" reports.

Meanwhile, Ian Albright, a former Amy private, said that some veterans likely were not using the choice cards out of fears of not being reimbursed, delays in receiving approval from VA doctors or too much paperwork (Wax-Thibodeaux, "Federal Eye," Washington Post, 2/16).

McDonald, Obama Call for Funding 'Flexibility'

In the midst of the low number of veterans who have used the choice cards, McDonald last week asked for "flexibility" to redistribute funds from the $10 billion program to other issues, such as working through the VA benefits backlog and addressing other patient needs.

President Obama in his fiscal year 2016 budget request also asked for the authority to re-allocate funding from the program.

VA has said that veteran wait times are down across the U.S. as the department has been adding tens of thousands of medical staff to address shortages of such personnel. According to VA, the department carried out more than 37 million appointments between May 1, 2014, and Dec. 31, 2014, a 1.8 million increase in appointments compared with the same time period in 2013.

Some GOP Lawmakers Urge Expansion of Program

However, Rep. Jeff Miller (R-Fla.), chair of the House Veterans' Affairs Committee, called the proposal to allow for the re-allocation of funds for the program a "complete non-starter, which I will not support."

He added, "If there's going to be any re-allocation, it's going to be to further improve and strengthen the program itself" to increase the number of veterans receiving care from private providers "and not address other unspecified needs" ("Federal Eye," Washington Post, 2/13).

Meanwhile, Huelskamp also has called for the program to be revamped. He has co-sponsored legislation that would require the VA Secretary to alter the program by having the 40-mile requirement to be based on driving distance, rather than radius. In addition, the bill would have the 40-mile requirement be tied to the type of service requested by a veteran. For example, the presence of a nearby clinic within 40 miles that does not offer a requested service would not preclude a veteran from using the choice card for a service at a clinic 40 or more miles away ("Federal Eye," Washington Post, 2/16).