The Department of Veterans Affairs (VA) — or the Tesla of home care, according to some — recently made changes to its health care plan to put veterans at the center of their own care and reduce network fragmentation.
The VA Mission Act makes it easier for veterans to visit non-VA medical facilities and creates a provider network built by private insurers.
While many believe the new plan is good for veterans, it’s also good for home-based care providers. The changes will make it easier and more efficient for private home-based care companies to partner with the VA — an attractive referral and payer source that spent more than $721 million on homemaker and home health aide services in 2015, according to the Congressional Research Service.
“For agencies, the changes will mean a reduced administrative burden and more streamlined referral and payment systems,” Tatjana Christian, a VA spokeswoman, told Home Health Care News via email. “While it is very early in the consolidated community care structure, home- and community-based agencies have offered positive comments on VA’s approach.”
Currently, more than 8,000 home and community-based care providers participate in at least one of the VA’s programs. Omaha, Nebraska-based home care franchise Right at Home is one such provider.
Right at Home has more than 500 franchises total, with locations in the U.S. and seven other countries.
The provider, who has signed agreements with network contractors and local veteran medical centers, says the new plans could mean more — and better — business from the VA going forward.
“We’re hoping that we’ll see some improvements in efficiencies — and perhaps we could even see some improvements in reimbursement rates across the country as the department kind of hits the reset button on the homemaker/home health benefit,” Doug Robertson, health care regulation and compliance manager at Right at Home’s parent company, RiseMark Brands, told HHCN.
Previously, home- and community-based care providers interested in contracting with the VA could do so through a variety of different programs. This new network consolidates those programs, “providing more choices and robust care coordination for veterans,” according to a fact sheet.
The new program uses a single set of eligibility criteria, rules and processes, leading to less complexity and fewer errors for veterans and community providers, Christian said.
“VA believes that private providers will find the standardization and reduced administrative burden attractive and that more providers will be interested in joining the VA’s program,” she said.
Optum Public Sector Solutions, part of UnitedHealth Group, was awarded the contract to administer the new networks in the eastern and central U.S. As part of the network, Right at Home will provide home care to veterans there.
Meanwhile, the contract for the western United States was awarded to TriWest Healthcare Alliance earlier this month.