The Department of Veterans Affairs saw an increase in patients receiving health care through its network of private providers at the start of fiscal 2020, a "significant uptake" the department is now reviewing, according to VA Secretary Denis McDonough.
Speaking at a White House press briefing on the American Rescue Plan bill, which contains more than $17 billion of additional funding for the VA, McDonough said that in the first quarter of fiscal 2020 -- before the pandemic canceled many in-person medical visits at the VA and in the community -- more veterans received care from department's private network physicians than previously observed.
The uptick followed an expansion in community care in 2019 as a result of the Mission Act, a law signed by President Donald Trump in 2018 to improve health services for veterans.
Under the Mission Act, the eligibility rules for veterans to receive care from a non-VA doctor were changed to include those who have to wait more than 20 days or drive more than 30 minutes for a primary or mental health appointment at a VA facility.
For specialty care, the new rules allow veterans to see a non-VA network private provider if they have to wait longer than 28 days or drive more than 60 minutes to a VA clinic or medical center.
Under the Choice Act, legislation passed in 2014 by the Obama administration to offer private health services to more veterans following a scandal over wait times at VA facilities, non-VA care was available to veterans who had to drive more than 40 miles to a VA facility or wait longer than 30 days for an appointment.
According to estimates, the changes brought by the Mission Act made more than 1.5 million veterans eligible for community care services.
When introduced, critics likened the expansion to privatization and expressed concern that it would draw money away from VA health facilities.
During his confirmation hearing, McDonough said that community network care would continue to be part of VA health services, but "at the same time, we have to ensure that this integrated health model continues to draw on the success and excellence that is obvious in VA's workforce."
On Thursday, McDonough said the VA is reviewing the data and is in discussions with Senate Veterans Affairs Committee members about the balance, pledging to ensure that the VA pays network providers on time and maintains "vibrant networks."
But, he added, the department has a backlog of facilities maintenance and operates many buildings that are more than 50 years old and require recapitalization.
"We have to ... make sure that these institutions ... are brought up to speed -- things like new air control systems, zero pressure rooms," McDonough said.
The VA will use part of the $17 billion in funding from the American Rescue Plan legislation to pay for these upgrades, he said.
The funding also will go to provide medical care for veterans who deferred health services under COVID-19, reduce the disability claims backlog, help homeless veterans, and manage a retraining program for veterans unemployed as a result of the pandemic.
The Senate is expected to vote on the bill this week.