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Community Health Centers Could Provide Better Outsourced Primary Care for Veterans

  • Richard E. Rieselbach
  • Ted Epperly
  • Greg Nycz
  • Peter Shin
Perspective

Abstract

The “VA Mission Act of 2018” will expand the current “Choice Program” legislation of 2014, which has enabled outsourcing of VA care to private physicians. As the ranks of Veteran patients swell, Congress intended that the Mission Act will help relieve the VHA’s significant access problems. We contend that this new legislation will have negative consequences for veterans by diverting support from our VA system of 1300 hospitals and clinics. We recommend modification of this legislation, promoting much greater utilization of Community Health Centers (CHCs) for veterans outsourced primary care. In support of this proposal, we describe (1) features of the “VA Mission Act” relevant to outsourcing, (2) the challenges of the present “Choice Program” and likely future obstacles with the new legislation, and (3) the advantages of expanding CHC VA outsourced primary care. This policy would focus more on providing specialized care for veterans in the VA system, while coordinating with CHCs for the necessary expanded outsourced, holistic primary care. We conclude that failure to develop an incremental, cost-effective alternative as described herein represents a potential threat to adequate future support of our VA hospital system, and thus outstanding care for our veterans.

KEY WORDS

veterans outsourced care community health centers primary care access VAH care system 

Notes

Acknowledgements

We gratefully acknowledge the efforts of Ms. Grace Compton in preparation of this manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

References

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Copyright information

© Society of General Internal Medicine 2018

Authors and Affiliations

  • Richard E. Rieselbach
    • 1
  • Ted Epperly
    • 2
    • 3
  • Greg Nycz
    • 4
  • Peter Shin
    • 5
    • 6
  1. 1.University of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.Family Medicine Residency of IdahoBoiseUSA
  3. 3.University of Washington School of MedicineSeattleUSA
  4. 4.Family Health Center of MarshfieldMarshfieldUSA
  5. 5.Health Policy and ManagementGeorge Washington UniversityWashingtonUSA
  6. 6.Geiger Gibson Program in Community HealthRCHN Community Health FoundationNew YorkUSA

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