A $15 billion federal program intended to improve veterans' health care is off to a rocky start, and some members of Congress are calling for significant reforms.
The Veterans Choice program is supposed to help vets get timely health care, sometimes closer to home. Nearly 9 million veterans received identification cards in the mail from the U.S. Department of Veterans Affairs. About 460,000 have tried since it began in November.
Under the program, veterans who live far away from VA hospitals – or who can’t get appointments with VA doctors within a month – can seek care from providers outside the VA.
But a lot of vets are having trouble getting those outside appointments when they call the number on their cards.
“The message that the veteran hears is, 'We can't help you,' so I think that's really the frustrating part,” said John Beckham, the Director of Health Plan Management Services at Puget Sound VA.
Beckham said the VA is working to fix the glitches, but he understands it’s difficult right now for veterans who call in and can’t get medical care.
He said about a thousand vets in the area are getting care under the program, but his office still is receiving about a hundred calls a week from veterans.
In some cases the Choice Card program doesn’t yet have the veteran’s medical records, while other veterans are being turned down even though they have to drive more than forty miles to a VA facility. That’s the distance that’s supposed to qualify them for the program.
“That forty miles is calculated in a straight mile fashion as the crow flies," Beckham said, noting that a lot of veterans in the Pacific Northwest live in areas that aren't easily accessible by road.
"They might live twenty miles from a community based clinic, but they have to drive eighty miles around to get to it,” he said.
Confusion at VA, local hospitals
That's the case with Gloria Hoeppner, an 89-year-old veteran who lives in Friday Harbor, Wash., a community on the San Juan Islands that's connected to the mainland only by a ferry boat. During World War II, Hoeppner was part of an all-female division of the Navy known as the WAVES.
After Hoeppner had a heart attack, the staff at the local hospital set up appointments with a cardiologist on the island. But when Hoeppner called the Choice program, she was told she didn’t qualify for local care, even though it takes her hours to get to the nearest VA facility 38 miles away.
“Everyone at the hospital thinks we’re covered if we have to take a ferry," Hoeppner said. "There’s quite a few people at the VA who think that, so people don't know what's really happening."
As it turns out, Hoeppner does qualify for the Choice program and so do all the veterans in the San Juan Islands. Washington Senator Patty Murray made sure that people who have to ride ferries to get to VA facilities are included.
But despite several phone calls to the VA and the Choice program, Hoeppner is still waiting to hear whether she can keep her cardiology appointment at the end of the month.
“When I talked to the lady that’s the intermediary, she says I have to cancel that appointment," Hoeppner said.
"Our veterans are still waiting"
The intermediary that Hoeppner and other vets are calling is TriWest, an Arizona based corporation that has a VA contract to manage the Choice program.
TriWest President and CEO Dave McIntyre concedes there’s a lot of confusion about the program. He blames it on the short timeline Congress provided for the roll out.
“What it took to do this would blow people’s minds,” McIntyre said. “We had to stand up a contact center with about 850 people in it, and we had ten days to go from hiring to training to go live.”
McIntyre says TriWest is taking 10,000 calls a day from veterans and thousands are getting care through the Choice program.
But some members of Congress aren’t satisfied. They say the problems with the Choice program are another example of how difficult it can be for veterans to get access to VA care.
“Clearly, there’s more work to be done, so I will keep pushing the VA to improve services and support for our veterans as this new program gets off the ground,” Murray said.
Other members of Congress say the Choice program’s issues are part of the VA’s longstanding resistance to providing care outside its own facilities.
“The problem is when you call you’re often told you don’t qualify," Kansas Senator Jerry Moran said at a hearing last month. "There’s nothing the veteran can do about it to say, 'Wait a minute; I should be.'"
Secretary of Veterans Affairs Robert McDonald denies the VA opposes the Choice program. He told senators that the agency is working to help veterans better understand their health care options.
In the meantime, there’s growing talk in Congress about easing the strict 40 mile rule, which Congress itself wrote into the Choice program last year.
"The end result is our veterans are still waiting, “Moran said.