Wait times still lengthy for VA patients

More than a year after the federal Veteran Choice program was rushed into existence to serve veterans facing long waits to see a doctor, Montana vets say their access to health care is even further out of reach.

In response, state and Veterans Affairs officials are working to address recurring problems and regain some of the ground lost to the new program.

Rich Hayes of Columbia Falls said he has waited seven months to see a specialist to be evaluated for a hip replacement.

“There’s a crack somewhere they’re sweeping me through,” Hayes said. “I served my country in Vietnam and I suffered for it many years. I need help and I’m told I can get it, but I get nothing. And somehow, it’s gotten even harder.”

Hayes is one of an undocumented number of people using Veterans Choice, a $10 billion program Congress approved in 2014 in an attempt to ease bottlenecked VA health-care agencies.

The program was intended to streamline veterans’ access to care by having private companies schedule their appointments. People can opt into it if they can’t get an appointment through the VA within 30 days or live more than 40 miles from a VA clinic.

Veterans Choice was created after Congressional investigators discovered a VA hospital in Phoenix, Arizona, falsified records to hide lengthy waiting times. At least 40 veterans died during the time they waited to see a doctor, according to the investigation.

At the same time, VA data showed new patients in Montana were waiting an average of 69 days for an appointment with a primary care doctor at the Fort Harrison clinic.

Congress gave Veterans Choice 90 days to get off the ground. The VA asked private companies to bid on two contracts to administer it. Only two responded.

Montana veterans were swept under the care of Health Net, a company based in California that received the contract for a large part of the country.

A YEAR and a half into Veterans Choice, there’s national recognition it hasn’t worked.

Veterans say their wait time has grown and the program is inconsistent. On the other end, providers have faced delays for reimbursement of care.

John Ginnity, director of the VA Montana Health Care System, said Congress’ timeline for the program was too short.

“As congress and the VA sat across from each other, there was an urgency to help veterans,” Ginnity said. “The intent was right, but of course everything looks better in hindsight.”

VA documents posted in March stated Montana’s average wait time for an established patient to see a primary care physician is roughly 11 days. That estimate doesn’t include patients working through Veterans Choice, said Mike Garcia, the public affairs officer for the Montana VA agency.

Health Net hasn’t maintained a database of its veterans, so there’s no known documentation of how many people it’s serving or a patient’s average wait time.

Garcia said Health Net averages 4,200 Montana consults on any given day, meaning it’s either trying to schedule an appointment, or has scheduled one that hasn’t happened yet.

The state VA agency handles between 500 and 750 consultations each day.

In response to a Daily Inter Lake request for an interview, Health Net sent a press release stating the company is working closely with Congress, the VA and providers to improve its service. According to the release, the company receives roughly 320,000 calls a month tied to Veterans Choice.

DURING an April 14 Kalispell veteran town hall meeting hosted by the Montana VA, dozens of veterans testified they have waited months to be scheduled for an appointment.

John Roberts of Kalispell said he waited five months to see a doctor for his trigger finger.

“Veterans Choice lies to you,” Roberts said. “They’ll say the paperwork is in the mail, or you’re scheduled in two weeks.”

Roberts said he’d contact his provider and learn nothing had been set up. He said when he had an appointment, he had to wait another six weeks for surgery.

In another case, Roberts said he was told by Health Net his prescription glasses were in the mail. A month later he discovered they were never ordered.

Darci Sanborn of Dermatology Associates in Kalispell said her office was considering opting out of serving veterans through Veterans Choice.

She said when she can get through Health Net’s phone lines, she has talked with people who can’t help.

“Referrals come in under the wrong doctor, the wrong dates of service. I’ve sent in requests asking for further referral to a patient with melanoma of the skin,” she said. “I’m not getting responses.”

GINNITY said the VA Montana Health Care System met with Health Net this month to discuss recurring issues. He said the company agreed to track its average wait times, reveal how many providers they have and embed several employees in the state.

Montana is also one of five locations in the nation working on a Congress-initiated pilot program to put more power back in the hands of the VA.

The program, which unrolled this month with support from Sen. Jon Tester, D-Mont., allows veterans to go back to the VA for services if Health Net doesn’t schedule an appointment within seven days. But the VA can only schedule appointments through provider agreements. As of April 19, the VA had secured 78 agreements.

At the town hall meeting, Ginnity told veterans the VA can’t get out of its contract with Health Net until $10 billion is spent or three years have wrapped up.

“We’ve been holding them accountable and taking back a little bit of the time,” he said. “For a long time, the VA has been a bureaucracy, but it needs to act with a more local focus. That’s part of the hope with these provider agreements and the direction everyone is looking in now.”

Reporter Katheryn Houghton may be reached at 758-4436 or by email at khoughton@dailyinterlake.com.