White House officials looking into merging VA and Tricare health services

https://www.militarytimes.com/veterans/2017/11/17/white-house-officials-looking-into-merging-va-and-tricare-health-services/

White House officials looking into merging VA and Tricare health services

By: Leo Shane III ?  14 hours ago

WASHINGTON — Lawmakers and veterans advocates are demanding more details of a secret White House plan to merge parts of the Department of Veterans Affairs and the military’s Tricare health system in an effort to trim billions in federal medical bills. But VA Secretary David Shulkin insists there is no underhanded effort to sneak through major reforms, and that the work thus far amounts to brainstorming about ways to make veterans care more efficient.
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At issue is a proposal, first made public by the Associated Press Friday, that would combine aspects of the Veterans Health Administration and Tricare, the military’s health care program for troops, families and retirees. Specifics of the plans are unclear, but White House officials have discussed establishing a single purchased-care contract for the two different systems, sharing some military and VA facilities and linking the hiring of medical professionals in both systems. The moves could potentially save up to $2 billion annually, largely through cuts in the federal workforce. Actual program changes would not start before 2023.

Those details are spelled out in a series of White House memos that caught lawmakers and veterans groups unaware this week. Shulkin said his department has been involved in some conversations on the issue but did not draft the documents.
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The plan would intermix the medical needs of two different patient pools. The Tricare system currently serves about 9.4 million beneficiaries, including the primary health care needs for all active-duty troops and their families. The Department of Veterans Affairs system has roughly 9 million patients, too, but is largely focused on an older population dealing with service-connected illnesses. VA officials in recent months have talked about moving away from some primary care responsibilities in favor of increasing funds for more specialized services. Such moves would involve billions of dollars in upgrades and operational changes to the two massive health care systems, work that would have to be approved and funded by lawmakers.

Shulkin said any such decisions are years away, and the internal conversations on the issue thus far have been “beyond preliminary.” He said lawmakers and veterans groups have not been brought into the conversation yet because department officials are still gathering information and are not pursuing any specific recommendations.
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Memos on the topic show several meetings among White House staffers on the issue, and plans to make the idea a major topic of the December VA/DoD Health Executive Committee meeting.

Republicans on Capitol Hill said they have not been part of the conversation thus far.
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Veterans groups met with White House officials on Friday and expressed frustration that they have been left in the dark on the proposal.
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Earlier this year, White House officials were criticized for holding several meetings on veterans issues with health care executives and interested parties before meeting with veterans groups.

The new private meetings come as VA officials are working with lawmakers on potentially sweeping changes in how the department handles veterans medical appointments both inside and outside the federal system.
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Critics say the secret Tricare/VA meetings are an indication that their concerns about the Trump administration dismantling veterans health care services are well-founded.
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