Congressman Rubén Hinojosa (TX-15) brought together the Department of Veterans Affairs (VA), TriWest Healthcare Alliance, and local medical providers for a two-day event as part of his ongoing work to improve VA Community Care (VACC). VACC purchases health care for eligible veterans when a VA Medical Center, clinic, or other federal facility is not available to furnish that care. TriWest administers two VACC programs – Patient-Centered Community Care (PC3) and Veterans Choice Program (VCP) – on behalf of VA in 28 states including Texas.
On Monday, August 29th, Congressman Hinojosa hosted a Presentation and Work Session during which TriWest and VA offered educational information to local medical providers. Each provider had the opportunity to meet one-on-one with TriWest and VA representatives to address their questions regarding VACC programs, authorization, and billing.
On Tuesday, August 30th, many of the same individuals reunited at Valley Baptist Health System for a meeting which served as a midpoint progress report for the 90 day effort. Among the advances reported was a 20 percent increase in claims paid within 30 days since the initiation of the partnership. The group also reviewed key aspects of care coordination including authorization timelines, methods to submit claims and medical documentation, and communication of claim denials. Further, a number of opportunities for improvement for each party were identified.
This project originally began in May 2016 when Congressman Hinojosa hosted a Veterans Community Care Roundtable with VA, TriWest, and several Veteran Service Organization Post Commanders. At this roundtable, veterans expressed confusion and difficulties utilizing VACC and a clear need for enhanced coordination.