Colorado senators pressure VA to improve veteran health care

Visitors stroll through a long, glass-walled corridor that connects a dozen buildings at the new Rocky Mountain Regional VA Medical Center in Aurora, Colo., after a ribbon-cutting ceremony at the hospital July 21, 2018. (Dan Elliott/AP)

WASHINGTON -- Colorado’s U.S. senators are demanding that the U.S. Department of Veterans Affairs take action to reduce wait times at the agency’s health care facilities in the state after Congress held a hearing on medical treatment for veterans.

Senators Cory Gardner, a Republican, and Michael Bennet, a Democrat, asked in a letter for a report on how the VA will more quickly assist veterans at the agency’s Eastern Colorado Health Care System (ECHCS) facilities, which includes the new Rocky Mountain Regional VA Medical Center in Aurora.

“The troubling November 2018 [wait time] numbers demonstrate that the VA needs to prioritize solutions for Colorado veterans,” the senators wrote to Secretary of Veterans Affairs Robert Wilkie.

Wilkie spent part of the afternoon Wednesday being grilled by a joint committee of the House and Senate veterans affairs committees.

The lawmakers wanted an update on his progress in implementing the MISSION Act, which is a program Congress approved in June to give veterans greater access to private sector health care.

Rather than being restricted to treatment only at Veterans Administration facilities, the MISSION Act expands authority for private healthcare facilities to be reimbursed for serving veterans.

The MISSION Act was a response to complaints by veterans of long wait times and inadequate care at Veterans Administration hospitals. Witnesses told Congress in previous hearings that some veterans died as they waited for treatment of serious illnesses and injuries.

Part of the blame fell on VA medical facilities in Colorado.

“As MISSION is implemented, we request a report on how the VA intends to use existing authorities, as well as the new flexibility and tools provided in the MISSION Act, to expeditiously fix issues with wait times across ECHCS,” Gardner and Bennet said in their letter.

The MISSION Act gave the VA a year to develop new rules for veterans to receive government-funded health care. Lawmakers at the hearing Wednesday asked Wilkie for clarification on what they could expect from the VA’s regulations.

Several of them expressed concern the VA would broaden veteran access to private care too much, possibly dramatically driving up costs reimbursed by taxpayers. About 30 percent of veterans are treated by private physicians now, the Veterans Administration reports.

“The Mission Act, we passed it with the best of intentions, but it could be a train wreck, too,” Senate Veterans’ Affairs Committee ranking member Jon Tester, D-Montana, told Wilkie during the hearing. “It is in your lap."

Wilkie said the MISSION Act program could increase patients’ access to outside doctors’ treatment but still keep the Veterans Administration as the “central node” of veteran health care.

He pledged to keep Congress informed of his actions.

Colorado U.S. Rep. Mike Coffman, R-Aurora, is a member of the House Veterans Affairs Committee. He said that in Colorado some private health care providers dropped out of programs that serve veterans after becoming frustrated over negotiations with the VA about their reimbursement.

He said some doctors were asking, “Why don’t we just simply use Medicare rates?” instead of negotiating each contract separately with the VA.

Medicare, the national health insurance program for Americans at least 65 year old, reimburses doctors and hospitals under standardized rates.

Wilkie said the TriWest Healthcare Alliance, which manages VA health benefits in Colorado and surrounding states, is creating a network of private doctors that uses standardized reimbursement rates. “They are getting Medicare rates,” Wilkie said.

Coffman also asked about a suicide rate among veterans that is running twice the national average, according to VA statistics. He asked whether prescription medications might be contributing to the problem.

“I do have a concern that we are over-prescribing some of our veterans in mental health,” Coffman said.

Wilkie acknowledged painkillers like opioids might be contributing to the suicide problem.

“VA has taken the lead in creating alternative therapies, alternative prescriptions for those in great pain,” he said. The alternatives include Tai Chi and acupuncture.

“We have been able to reduce the amount of opioid prescriptions by 41 percent in just the last two years,” Wilkie said.

But he cautioned the VA patients are unlike most other patients. “We help the people who come from a dangerous profession,” he said.

Other parts of the MISSION Act require the VA to organize a commission to determine which of its facilities should be repaired or closed and where new ones should be built. The law also offers scholarships and other financial incentives for more health care providers to work at VA facilities.

President Donald Trump made expanded access to private health care for veterans one of his campaign promises.

A Veterans Affairs spokesperson told Colorado Politics the quality of its health care has made significant progress, sometimes surpassing private medical treatment.

“All VA health care facilities now provide same-day urgent primary and mental health care services for veterans who need them,” said Susan Carter, the VA’s media relations director. “Under President Trump, VA began posting wait times online for every one of our medical centers and clinics across the country and we update them on a weekly basis. No other health system in the country has done anything like that and no one is as transparent as we are.”

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