| UNION, SENATORS
QUESTION VALUE OF CONTRACTED VA CARE
According to the AFGE, contract care
requires that the VA give up a certain degree of control to
for-profit outside entities.
NOTE from Larry Scott, VA
Watchdog dot Org ... Does contracted VA care really offer more
to veterans ... and, is it a better value? A hearing of the
Senate Committee on Veterans' Affairs tried to address that issue.
Some Senators had questions.
From an article in the Military Times:
A Senate committee reviewing
the increased use of contracted health care for veterans
disability exams and treatment is growing increasingly skeptical
that this is a cheaper or higher-quality alternative to using
Veterans Affairs Department health care workers.
Complete article is here ...
http://www.armytimes.com/news/2009/09/milita
ry_contractors_VA_healthcare_093009w/
And, the American Federation of
Government Employees (AFGE), the union which represents many VA
employees, issued the following press release:
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For-Profit Health Care Contracts
Jeopardizing the Strength of the VA,
Union Says
(WASHINGTON)
–
The American Federation of Government Employees today told
Congress that the Department of Veterans Affairs’ over-reliance on
private for-profit health care providers is straining medical
center budgets and jeopardizing veterans’ health care. AFGE
represents 180,000 employees on the frontlines of the Department
of Veterans Affairs (VA).
 Health
care contracts are one of the many tools available to the VA to
increase access for rural veterans and to address other gaps in
care. However, “the VA often fails to adequately consider the
risks of contract care, as compared to other options,” said Mary
A. Curtis, a psychiatric clinic nurse specialist and 1st
vice-president of AFGE Local 1273 at the Boise VA Medical Center,
who delivered the testimony before the Senate Committee on
Veterans’ Affairs.
According to the union, contract
care requires that the VA give up a certain degree of control to
for-profit outside entities. The use of these for-profit providers
leaves the VA less able to control costs, quality of care,
provider qualifications, and medical privacy or to ensure that
care is timely. In the long term, this may compromise the VA’s
capacity to provide veterans with a full range of services, as
well as its exemplary research and medical education programs.
Congress clearly recognized these
privatization risks when it enacted legislation that authorizes
contract care in very limited circumstances, when care is not
available from the VA. Unfortunately, medical center directors
seeking short term fixes for patient wait lists and staff
shortages often ignore these criteria and opt for fee basis care
and other costly contract care arrangements without adequately
considering alternatives that would better serve the veteran and
the VA health care system. As a result, in many cases, the VA ends
up spending more on for-profit contract care than it would cost to
more fully staff the VA health care workforce.
In its study of the VA’s Fee
Program (VA OIG Report No. 08-02901-185), the VA Office of the
Inspector General found that VA medical centers have made large
numbers of improper payments for fee care. These findings mirror
concerns previously voiced by AFGE, including a strong
recommendation that the VA strengthen controls over its for-profit
contract program to reduce payment, justification, and
authorization errors.
During her testimony, Curtis also
criticized the VA’s continued expansion of the pilot for-profit
contract program, Project HERO. Through a contract with health
care giant HUMANA, the VA launched Project HERO as a pilot program
in 2007. The program essentially injects an additional private
contract layer in the contact care process through the use of
for-profit care coordinators, who manage the referral of veterans
to health care providers outside the VA. The idea of contractors
managing other contractors is ludicrous on its face. “These
contractors provide little or no value added to the VA health care
system. In some cases, veterans end up traveling even further to
HERO providers and the VA ends up paying more to Humana than it
would if it had contracted directly with providers without an
intermediary,” said Curtis.
In Curtis’ testimony, AFGE called
on the VA to comply with a new directive from the Office of
Management of Budget that directs federal agencies to end their
overreliance on contractors, conduct an inventory of current
contracts and “insource” or bring back in-house work that is more
appropriately handled by the government. AFGE also recommended the
use of joint labor-management training on the VA’s for-profit
contract care program to enable front line health care employees
to monitor decisions to contract out care. Finally, AFGE requested
that Congress withhold funding for the fourth and fifth option
years of Project HERO and prevent further expansion of the pilot,
pending an investigation of its actual costs, its impact on health
care quality can access, and its effect on the VA’s own capacity
to provide veterans with the services they need.
The American Federation of
Government Employees is the nation’s largest federal employee
union, representing 600,000 workers in the federal government and
the government of the
District of Columbia.
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TOPICS:
veterans, veterans' benefits, VA, Department of Veterans' Affairs,
contracted care |
