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November 21, 2017

Shulkin wants to further integrate private providers into VA health system

Daily Briefing

Veterans Affairs (VA) Secretary David Shulkin said he wants to expand the role of private-sector health care providers in the VA health care system.

According to the Wall Street Journal, Shulkin during an interview said he would like to shift the VA health system to make it compete with private health care providers and give veterans greater choice in where they receive their care. He said, "The direction I'm taking this is to give veterans more choice in their care and be the decision maker for their care, which I fundamentally believe is a concept that has to be implemented."

But Shulkin said he aims to ensure the VA health system is of such high quality that veterans choose VA health care providers over private-sector providers. Still, Shulkin said VA should focus on providing services to veterans that are unique to them—such as treating brain injuries and other war wounds—while outsourcing services that can be more economically provided by others, such as audiology and podiatry services. "We're trying to let the VA understand … for them to remain strong, they have to be veteran-centric," Shulkin said, adding, "They have to treat their veterans like customers, and they have to have quality of services and access to services that is equal to or better than the private sector."

Shulkin said until veterans have total transparency into their health care options and are able to make informed decisions about their care, VA must continue helping veterans coordinate their care. In addition, Shulkin said further integrating the VA health system with private providers could be difficult because of the costs associated with such a shift. According to the Journal, the Congressional Budget Office has estimated that shifting veterans' health care to private providers could cost tens of billions of dollars.

Stakeholders mixed

Stakeholders have expressed mixed views on expanding the role of private providers in the VA health system.

For instance, supports of further privatization say it would give veterans more power to coordinate their care. Proponents also say such a shift could increase veterans' access to care.

However, some lawmakers and veterans organizations say VA's current health system ensures veterans see providers who have been properly vetted by VA (Kesling/Nicholas, Wall Street Journal, 11/20).

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