Working to improve health care access for rural veterans

Working to improve health care access for rural veterans
Working to improve health care access for rural veterans

Out of 9 million veterans enrolled in Veterans Affairs (VA) for health care, 3 million live in rural areas. For this reason, and many more, the Veterans Rural Health Advisory Committee (VRHAC) makes annual recommendations to the VA secretary on health care issues affecting rural veterans.

​For this reason, and many more, the Veterans Rural Health Advisory Committee (VRHAC) makes annual recommendations to the VA secretary on health care issues affecting rural veterans.

“We highly value the committee’s recommendations,” says Thomas Klobucar, VA Office of Rural Health acting director. “They’re very important since rural veterans rely on the VA for health care more than urban veterans — 56 percent of rural veterans are enrolled in the VA for health care, in contrast to 37 percent in urban areas.”

The most recent recommendations, contained in a letter from retired U.S. Navy Commander and VRHAC Chair Margaret Puccinelli to former VA Secretary Robert McDonald, include:

Improving the Veterans Choice Program

The Veterans Choice program provides VA coverage for civilian care in cases in which veterans have to wait more than 30+ days or travel more than 40+ miles for care at a VA facility.

The committee recommends that the VA:

  • Take legislative and regulatory steps to make the VA the primary payer for all care provided under the Choice program. “Under the current payer of last resort requirement in the Choice program, some rural veterans have to pay $3,000 to $5,000 deductibles for care that they would receive at no cost were they to obtain it at a VA facility,” Puccinelli says.
  • Continue developing communitybased outpatient clinics. The Choice program is not a replacement for these clinics. Veterans need both.

 

Addressing workforce issues 

Although nearly one-fourth of Americans live in rural areas, less than 12 percent of physicians practice there. “It’s a challenge to get the right number and mix of professionals in any health care setting, but it’s much more difficult in rural areas,” Puccinelli notes.

The committee recommends that the VA:

  • Evaluate the entire VA rural health system to identify geographic areas where additional health care providers — and particularly certain specialists — are needed.
  • Revamp and streamline recruiting efforts for rural health care providers.
  • Address salary discrepancies between rural and urban health professionals.

 

Increasing efficiency of care delivery using telehealth 

In recent years, the VA has enhanced veterans’ access to care through the use of telehealth technologies. However, many rural areas lack sufficient infrastructure to support the use of these technologies.

The committee recommends that the VA: 

  • Conduct a geospatial analysis overlaying data on where rural veterans live, what technologies are currently or soon will be available in those areas, and the predominant conditions requiring care in those areas.
  • Develop a comprehensive plan using that analysis to leverage telehealth technologies to more efficiently deliver health care where possible.
  • Partner with federal, state and local governments to increase investment in broadband services in rural areas.

 

Partnering to improve access for veterans 

“The committee is made up of wellinformed rural stakeholders, and we appreciate that they make important, concrete suggestions on large issues that are germane to health care for rural veterans,” Klobucar says. “The committee helps to sensitize the VA to issues affecting rural veterans and provides impetus for policies to address those issues.

“It’s a challenge to get the right number and mix of professionals in any health care setting, but it’s much more difficult in rural areas.” — Margaret Puccinelli, VRHAC chair 
 

Interested in serving on the advisory committee?

Nominations are being accepted for members to serve three-year terms on the VRHAC. Self-nominations are welcome. To learn about the requirements or how to submit a nomination, visit www.ruralhealth.va.gov and click “About us.”

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