A new Department of Veterans Affairs program referred to as Patient-Centered Community Care (PCCC) www.nonvacare.va.gov/PC3/index.asp provides eligible veterans access to healthcare through a comprehensive network of community-based care when the care must be supplemented outside of the Veterans Health Administration (VHA) system.
Now, VA Medical Centers have the ability to purchase non-VA medical care for veterans through contracted medical providers when they can’t readily provide the needed care due to geographic inaccessibility or limited capacity.
The VA has modified PCCC contracts to enable eligible veterans to have access to primary care, along with inpatient specialty care, outpatient specialty care, mental health care, limited emergency care, and limited newborn care for female veterans following the birth of a child.
To initiate the PCCC program, VHA contracted with Health Net Federal Services LLC www.hnfs.com and TriWest Healthcare Alliance www.triwest.com to develop a network of providers to deliver the care needed.
Health Net is working on the claims process through Emdeon www.emdeon.com to make it easier for providers by offering Electronic Data Interchange (EDI). The plan is establish EDI to communicate not only claims but also eligibility and other information.
TriWest Health Care Alliance manages health benefits under the TRICARE program in the 21 state Western Region. To do business with TriWest, competitive bidding is emphasized but all small business vendors are encouraged to register with the Central Contractor Registration System (CCR) www.uscontractorregistration.com.
The addition of PCCC enables the VA to ensure that all types of care can be purchased through existing contracts and to ensure that appointments can be scheduled within 5 days so that veterans can be seen within 30 days.
Care is expanding to help even more veterans since Tenet Healthcare Corporation www.tenethealth.com and TriWest have signed an agreement to expand access to healthcare services for veterans in Arizona, California, Missouri, Tennessee, and Texas.
As a result of the agreement, veterans will now have access to 41 hospitals, 19 urgent care centers, 7 freestanding emergency departments, 18 ambulatory surgery centers, 85 diagnostic imaging centers, and nearly 600 employed physicians.