What can we expect from the Department of Veterans Affairs in the next five years?
At EnableComp, we are frequently asked that question, and this year has been no exception. One certainty as we look to the future: The VA and the Veterans Health Administration (VHA) will not be sitting still. They are perpetually on the move in their ongoing quest for improvement.
Meanwhile, many Veterans are awaiting the fulfillment of a promise made nearly 160 years ago — a promise that is, in fact, the source of the VA motto (updated in 2023 to be more gender-inclusive): “To fulfill President Lincoln’s promise to care for those who have served in our nation’s military and for their families, caregivers, and survivors.” But the cold reality is that, even with the best of intentions, the VA can’t do it alone. That’s where you come in.
In 2023, we saw unprecedented change, most notably relating to the MISSION Act, which opened the floodgates for Veterans to seek care from providers outside the VA network. For Community Care Network providers and others, this represents a golden opportunity to care for a valuable but vulnerable (and vocal) population.
The VA’s 2022–2028 Strategic Plan offers a glimpse into what’s on the horizon.
Guiding Principles of the Strategic Plan
Only about 3% of the U.S. population is enrolled in the VA healthcare program. But that’s 9 million people who have faithfully served our country and deserve the best healthcare they can get. As a result, those who provide care for these Veterans do so with high expectations on them.
The VA’s hefty Strategic Plan — guided by the fundamental principles of access, advocacy, outcomes, and excellence — establishes four strategic goals to achieve by 2028:
- Consistent communication with customers and partners to assess and maximize performance, evaluate needs, and build long-term relationships and trust
- The delivery of timely, accessible and high-quality benefits, care, and services
- Building and maintaining trust with Veterans and their families, caregivers, and survivors
- Excellence in all business operations to improve experiences, satisfaction rates, accountability, and security for Veterans
To accomplish these worthy goals, the VA plan places a heavy emphasis on partnerships. Improved healthcare access for Veterans, regardless of who is providing the care, is central to the picture. “The MISSION Act is driving the evolution of VHA’s role as a healthcare payor in addition to health care provider for millions of Veterans nationwide,” the plan acknowledges.
Reducing suicide and homelessness among Veterans is a major focus, along with efforts to combat unemployment, economic insecurity, and opioid addiction. Expanded access to mental health services facilitates treatment of conditions including PTSD, traumatic brain injury, depression, and substance-abuse disorder.
Veterans living in rural areas are a high priority — with a specific focus on providing maternity, obstetrics, gynecology, and mental health services for female Veterans.
Diversity, equity, and inclusion initiatives seek to improve trust among underserved demographics such as women, Veterans of color, and LGBTQ+ Veterans. Other special emphasis groups are racial, ethnic, religious, and/or cultural minorities, including American Indian and Alaska Native Veterans; those with physical or intellectual disabilities; and homeless Veterans.
Better technology is a thread running through all these efforts. Telehealth and connected care are essential to improve access; the VA’s Office of Rural Health is working with other federal agencies to expand broadband capacity in rural areas. The VA is also pushing the use of emerging technologies including 3D printing, genomics, robotics, artificial intelligence, personalized medicine, and virtual and augmented reality.
All the while, the VA remains under intense scrutiny.
The View From Capitol Hill
Congress continues to look through a microscope at the VA and how it spends its $260 billion-plus budget. The VA network, a hodgepodge of old and modern facilities, requires continual upkeep. The agency has been historically slow to adopt technologies that will improve care delivery by streamlining information sharing and other processes. Now, anything from minor alterations or modifications to a complete overhaul could be in the works.
Two 2023 bills targeting care delivery and timing were working their way through Congress at this writing.
The Veterans Health Care Freedom Act would improve eligible Veterans’ ability to access hospital care, medical services, and extended care services through the “covered care system,” which includes the VA health system, community care providers, and entities that have entered limited Veterans Care Agreements (VCAs). The VA opposes this bill, which would rewrite its code for what can be considered a covered care system and what treatments a Veteran can receive.
The Making Community Care Work for Veterans Act of 2023 would require the VA to ensure that covered Veterans making appointments through the Community Care Network have access to that care within 48 hours for urgent care and within seven days for non-urgent care. The VA opposes this change from the current requirement of 72 hours for urgent and 28 days for non-urgent care.
A third bill, the RELIEVE ACT, has significant support, including from the VA. It would allow a Veteran to be reimbursed for emergency treatment received at a non-VA facility within the first 60 days of their enrollment in the VA network. This would be an exception to the requirement that the Veteran must have received VA care within the 24 months before the receipt of emergency care.
New VA Disability Rates
In other Veterans Affairs news, the new VA disability rates for 2024, which took effect December 1, 2023, reflect an increase of 3.2% based on the Social Security Administration’s latest cost-of-living adjustment (COLA).
Opportunity Comes With Challenges Attached
So what does all this mean for you? While working with the VA to care for Veterans can be a great opportunity, certain challenges are inherent. You’ve probably confronted at least some of these:
- Complex filing requirements
- Unforgiving deadlines
- Frequent claim denials and rejections
- Burdensome documentation
- Regulations that vary from state to state
- Constantly changing rules
Your limited resources most likely don’t allow for the small army needed to successfully navigate this rocky terrain. As a result, VA claims end up on the back burner while your claims and revenue cycle teams prioritize Medicare and commercial — the lower-hanging fruit. But even if VA claims constitute only 1% of your revenue picture, that can add up to a sizable amount of money in an industry of shrinking profit margins. Unless you want to leave that money on the table, you need someone to handle your VA claims and ensure that you get paid.
That’s where we come in. When it comes to dealing with the VA, EnableComp is your “department down the hall.” We have the training, technology, legal expertise, and knowledge to find solutions for you and the Veterans in your care. From patient eligibility and authorizations to notifications, referrals, filing, coding, and appeals, we know and understand the VA. Just as important: The VA knows — and respects — us. That’s how we get things done.
Are you prepared for whatever happens at the VA? Schedule a consultation and set your mind at ease.
