Kenai vets get Choice in care — New VA program expands health care options for veterans

By Jenny Neyman

Redoubt Reporter

Representatives from the Veterans Administration in Alaska had good news to share at a town hall meeting Thursday evening at Kenai Peninsula College — veterans on the Kenai Peninsula eligible for VA health care now have more options to receive timely, localized care, and even have a free way to get to that care.

The meeting was to explain the changes that came with the Veterans Access, Choice and Accountability Act of 2014.

The Choice program offers just that. In the past, veterans eligible for VA benefits generally had to receive their care directly from a VA facility, which could mean a lot of traveling and waiting in areas where VA facilities are limited or understaffed to meet demand. With the Choice program, eligible veterans who live more than 40 miles from a VA facility, or if the VA isn’t able to provide care within 30 days, can obtain care in the private sector, with the VA pitching in to cover the bill, as much as it would if a VA clinic was providing the care.

Susan Yeager, director of the Alaska VA Healthcare System, said that the purpose of the program is to give the VA time to increase its capacity to meet patient needs, and in the meantime, give vets better care.

“When this bill was passed, for Choice Act, the idea was that it was a three-year pilot, allowing the VA to build up their staff, so that at the end of three years the VA has enough staff so that veterans can get the care they need, when they need it, at a VA,” she said.

Alaska is one of three states, Hawaii and New Hampshire being the other two, where all vets eligible for VA health benefits can utilize the Choice program. To do so, a vet would call the number on their Choice card and request to see a private-practice provider. The VA’s vendor for the program, Tricare, is currently creating a network of preferred providers in the state. But even if a provider isn’t part of the arranged network, Tricare can contact that provider and try to negotiate a rate at which the VA will compensate for services.

Initially, it was difficult to get private providers to be willing to work with Tricare, because the reimbursement rate was not very competitive, Yeager said. The rate was recently increased, and more providers are joining the network.

“I think we’re going to see more access opening up in Alaska,” she said.

The program is especially well suited here, where access to care is a big challenge. The VA has a shared agreement to use the U.S. Air Force Hospital 673rd at JBER in Anchorage, but doesn’t have its own hospital in the state. And Anchorage is a long way away from most communities.

The VA operates regional, community-based outpatient clinics, including the one in Kenai, which is rated to serve the 2,589 eligible vets on the Kenai that have enrolled for VA services. But even Kenai, and VA services in Homer, can make for a long trip for patients. And in rural areas of the state, accessing a VA clinic can mean a plane or boat ride.

“It’s a big challenge, I think, up here, more than other VAs I’ve seen in the Lower 48, because of our distances and lack of roads. And that’s expensive, too,” Yeager said.

Accordingly, the VA in Alaska has already been partnering with other providers to get vets the care they need, since VA-provided services are relatively few and far between.

“Traditionally, we’ve spent over $100 million to buy health care for vets, to coordinate care from clinics and for specialty care, and sometimes primary care, in the private sector. That’s been a back and forth up here for some time,” Yeager said.

Some vets are eligible for a travel benefit from the VA to cover the costs of getting to and from services, but most are not.

Another wrinkle is a policy set in 2011 dictating that vets in Alaska receive VA care close to home whenever possible, rather than being sent off to Seattle, which was previously the practice.

“Our budget for purchasing care has doubled since then, and that’s good because that means we’re buying care in Alaska for veterans to stay in Alaska,” Yeager said. “… Getting well is not just about the physical part. What moral support are you getting, what’s the spiritual part? (We believe in care) close to home. So the person’s still in their community with their family support. It’s extremely important for someone to get well and stay well.”

And for the next three years, it will be even easier for vets on the Kenai Peninsula to access care. Forest Powell, with the Alaska Office of Veterans Affairs, announced that the state got a $750,000, three-year grant from the VA to cover the costs of ground transportation in rural areas, including the Kenai Peninsula.

“You, as a veteran, get free transportation from here to the VA and return back, free,” he said.

Alaska Cab is the vendor on the Kenai. Any vet eligible for VA health care benefits can simply call Alaska Cab and get a free ride to a doctor’s appointment, a pharmacy, the hospital or the clinic in Kenai. Just show proof of veteran status and call in advance to reserve a cab. The grant provides $50,000 for three years — $150,000 in all, just to the peninsula.

Powell said that he’s excited about the program, as a way the state can support its veterans.

“I’m a combat vet, I’ve been in the field, I’ve done eight tours over there in the desert, and my dad’s a Vietnam vet. My grandfather’s a WWII veteran. … So I understand. It’s very important to me to take care of you, the veteran,” he said.

Linda L. Boyle, associate director for Patient/Nursing Services for the Alaska VA Healthcare System, said she’s pleased with this move toward partnerships in providing VA care. It’s indicative of a larger, philosophical move toward treating patients as partners, too, she said.

“It’s not, ‘What’s the matter with me?’ It’s, ‘What matters to me?’ If I know what matters to you and understand what your goals are for yourself and for your life then I can look at how I can assist you with those things, versus just coming up with a medical diagnosis and saying, ‘You should do this, this, this and this.’ Rather than finding out, ‘What does matter to me as an individual?’ I’m excited that we’re moving that direction.”

For more information on these changes and VA care in general, call the Kenai veterans clinic at 395-4100.

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