It is no secret that the Department of Veterans Affairs (VA) has faced tremendous challenges providing our nation’s veterans with access to the timely, quality care they deserve.
In its continued efforts to improve services to veterans, the VA will contract with healthcare organizations to manage its Community Care Network – establishing and maintaining a network of high-quality providers that will provide veterans with timely access to care in their communities. The VA released an RFP for bidders just last month (December 2016).
It’s not just the consolidation and streamlining of healthcare services that will improve the quality and access of care for veterans and their families; it’s also the requirement for accreditation. Before we get into that, here’s some background on the VA’s community programs.
Despite the VA’s national network of facilities and providers, it is not always possible for the VA to meet all the healthcare needs of every veteran within the VA’s system. To ensure these needs do not go unmet, the VA allows veterans to seek care at a provider in their community. Generally, veterans are eligible for the VA’s Community Care Program if they require healthcare services that are not available at their local VA medical center or if there is an issue accessing a service at their local VA medical center in a timely manner.
While the VA has been operating community programs for decades, the program was recently modified by Congress to address current access issues by the Veterans Access, Choice, and Accountability Act of 2014 and the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. In fact, more veterans are now accessing care in the community and outside of VA facilities than ever before. According to the VA’s website, in fiscal year 2016, more than 25.5 million appointments were scheduled across all VA Community Care Programs.
Given the expansion and myriad of community care programs, the VA submitted a report to Congress outlining their Plan to Consolidate Community Care Programs in 2015. The VA indicates in its report that the consolidation of its community programs will “clarify eligibility requirements, build on existing infrastructure to develop a high-performing network, streamline processes, and implement a continuum of care coordination services.”
This effort is also in line with the VA’s enterprise-wide transformation initiative, called MyVA, which seeks to modernize the VA’s culture, processes, and capabilities by putting the needs of veterans and their families first.
The VA’s recently released RFP represents the VA’s commitment to consolidate its community programs and streamline services for veterans and their families. The program divides the nation into four regions and successful Community Care Network bidders will be responsible for managing a network of high-quality providers in one or more regions to provide veterans with timely access to care in their community.
One of the tenets of the VA’s Community Care Network is the need for bidders to establish and maintain a network of high-quality providers. To ensure the quality of services provided to veterans, the VA requires successful Community Care Network bidders to hold accreditation from a national accrediting organization. The VA requires that the accreditation cover the bidder’s network of providers and its credentialing process. Should a bidder seek to provide case management and disease management services, these areas must also be accredited.
Accreditation from URAC and other national organizations is an indication of an organization’s commitment to meet industry leading, quality best practices. The VA’s use of accreditation in its oversight of the Community Care Network is an indication that the VA is committed to ensuring that veterans have access to the highest quality care in the community.
URAC-accredited organizations not only comply with requirements of the VA’s RFP but they are also the best positioned to deliver quality care to veterans. URAC's unique approach to accreditation ensures that organizations are meeting national best practices without dictating the manner in which they are achieved. This allows for innovation that is sustainable within one’s community. Given that each community is unique and may require a different set of providers to meet veterans’ needs, URAC accredited organizations are distinctly prepared to deliver quality care in a manner that matches local needs – a critical element successful CCN bidders must meet.
Visit URAC’s VA Community Care Network Resources page to download free information and register for a free webinar