Working Draft – Internal VA Use Only Transforming the Future of VA Community Care American Legion Briefing February 22, 2016

Working Draft – Internal VA Use Only 2 VA Community Care Today Community Care today is complicated and consists of multiple programs that don’t work well for Veterans, community providers and VA staff Because of this problem, VA proposed a plan to Congress to consolidate Community Care VA Community Care “Individual Arrangements” PC3 Veterans Choice Program Project ARCH Emergency Care Dialysis Contracts Academic Affiliations Federal Partnerships Other Authorities (e.g., Dependent Programs) Multiple, disjointed approaches

Working Draft – Internal VA Use Only 3 Simplify and Consolidate Community Care Programs The vision is to build a program that is easy to understand, simple to administer, and meets the needs of Veterans, community providers and VA staff

Working Draft – Internal VA Use Only 4 Stakeholder Feedback VA Community Care Plan VA Staff and CliniciansHealth Care Leaders Veterans and Veteran Service Organizations

Working Draft – Internal VA Use Only Veterans We Serve (Eligibility) 5 Provide timely, accurate, and easy-to-understand eligibility information to Veterans, community providers, and VA staff VA Medical Centers What we want to hear from Veterans: “With the New VCP I understand when and where I am eligible for care.” Emergency Treatment Veterans Community Care Provider

Working Draft – Internal VA Use Only Access to Community Care (Referrals & Authorizations) 6 Deliver timely access to care through appointment scheduling and health information exchange What we want to hear from Veterans: “I was easily and quickly referred to a community provider for my care.” Veteran requests care Veteran receives care from Community Provider

Working Draft – Internal VA Use Only Care Coordination 7 Deliver personalized Veteran-centric care coordination supported by an industry standard health information exchange What we want to hear from Veterans: “I knew what to expect and I had everything I needed from my doctor.” Community Providers VA Providers Veterans Clinical Information

Working Draft – Internal VA Use Only Community Care Network 8 Implement a high performing network and management systems that provide access to seamless, high quality care options inside and outside the VA, to better meet the needs and preferences of the Veterans we serve What we want to hear from Veterans: “I now have many options when seeking community care and I feel confident that there will always be a provider when and where I need one.” Utilize VA’s network of VA and Non-VA providers Provide access to high-quality care

Working Draft – Internal VA Use Only Provider Payment (Claims) 9 Support accurate and timely payment of community providers Provider Claim Auto Processing Check What we want to hear from Veterans: “I am billed accurately within a reasonable time of my visit. I know my financial responsibility and understand how to pay my bills.”

Working Draft – Internal VA Use Only Congressional Partnership 10 The proposed changes will improve the Veteran and community provider experience for Community Care. But VA cannot move to the future state of Community Care without Congressional action. Proposed Legislative Changes Immediate Improvements to the Veterans Choice Program Process and Organizational Structure Improvements Improving VA’s Partnerships with Community Providers to Increase Access to Care (Provider Agreements) Improving Access to Community Care through Choice Fund Flexibility Increasing Accuracy of Funding by Recording Community Care Obligations at Payment Improving Veterans Access to Community Care by Establishing the New VCP Increasing Access and Transparency by Requesting Budget Authority for a Community Care Account Streamlining Community Care Funding Improving Veterans Experience by Consolidating Existing Programs Improving Veterans Access to Emergency Treatment and Urgent Care Improving Care Coordination for Veterans through Exchange of Certain Medical Records Aligning with Best Practices on Collection of Health Insurance Information Formalizing VA’s Prompt Payment Standard to Promote Timely Payments to Providers Establishing a Single Program for Community Care Immediate Improvements to the Veterans Choice Program

Working Draft – Internal VA Use Only What Can American Legion Do to Help? 11 Contact Congress Provide support for the plan Educate Veterans on the program Support outreach Provide actionable feedback Understand things will take time

Working Draft – Internal VA Use Only Closing Remarks Thank you for your dedicated support. We look forward to continued collaboration in the future. 12