VA proposes changes to standards of care

The Department of Veterans Affairs (VA) announced a proposal to change access standards for community care and urgent care by allowing veterans to seek care with the VA or other community providers.

The provisions would take effect in June and allow veterans to seek community care with access standards based on, in part, average drive time and appointment wait times. Under the MISSION Act, which was signed into law in June 2018, veterans could meet eligibility criteria for community care. The standards are proposed to meet those requirements under the MISSION Act.

The proposal comes at a time when wait times for VA patients have been shown to be shorter than for those with private insurance––a result of years of improvement initiatives at VA.

For veterans seeking primary care, mental health and non-institutional extended care services, the proposal offers a 30-minute average drive time standard. For specialty care, the average drive time standard would be 60 minutes. If drive times are above those thresholds to access VA care, veterans could seek treatment from other eligible local providers.

For appointment wait-time standards, the VA proposed 20 days for primary care, mental healthcare and non-institutional extended care services. For specialty care, the standard is 28 days from the date of request with certain exceptions under the proposal.

For urgent care, veterans will have the choice to receive certain services when and where they need it––a new benefit where veterans will choose a provider in VA’s community care network with the potential of a copayment.

“Our medical services must meet our Veterans’ needs and reinforce the trust that forms the basis for every interaction with VA,” VA Secretary Robert Wilkie said in statement. “Our new access standards are a vital part of this effort. … With VA’s new access standards, the future of the VA health care system will lie in the hands of Veterans––exactly where it should be.”