“Where it makes sense to outsource, believe me, we’re going to move in that direction,” Gibson said at a hearing before the House Veterans Committee.
VA officials had a delicate balancing act before them: To convince lawmakers skeptical that they are moving to privatize the country’s largest health-care system that they are not — and others skeptical that they have the management skills to achieve the consolidation they want.
“We cannot provide every [medical] service in every location to every single veteran,” said Baligh Yehia, VA’s assistant deputy undersecretary for Health for Community Care. “This doesn’t mean we’re outsourcing VA or dismantling VA. We want a complementary system. VA will still provide foundational services.”
The New Veterans Choice Program would combine seven of the agency’s existing private health-care arrangements into a single system with the goal of eliminating gaps in care. The proposed overhaul for veterans who can go to private doctors if they live too far from a VA hospital or need a specialist is the agency’s latest effort to recover from a scandal over patient wait times. VA is struggling to serve an influx of veterans returning from the wars in Iraq and Afghanistan and an aging Vietnam-era population needing more care.
Lawmakers in both parties were concerned about the costs of the overhaul, which VA projects will reach $1.2 billion to $2.4 billion in each of the first three years. Officials said much of that spending will result from a surge in demand, since veterans will have better access and shorter waits for appointments to see outside doctors.
But the agency says it needs $421 million in new money from Congress in fiscal 2016 to redesign its internal computer systems to improve how VA shares veterans’ medical records with private doctors and authorizes referrals.
“As we all know, VA does not have a great track record when it comes to implementation [of new programs],” said Rep. Mark Takano (D-Calif.), referring to failing information technology projects. “I’d like an IT structure that actually works. I do not want to see a repeat of these failures.”
Rep. Tim Walz (D-Minn.) called the plan “the silver lining out of Phoenix,” a reference to last year’s scandal in which whistleblowers revealed that employees were manipulating wait times to hide long delays for patient appointments. Walz predicted that the changes to the system of private care will turn into “VA 2050.”
VA has had trouble determining whether its network of private doctors is even meeting veterans’ needs. “They all are in silos,” Yehia said. “We can’t assess supply and demand, and whether we have the right population of doctors in the right areas.”