While the U.S. Department of Veterans Affairs (VA) seeks to address and remedy the systemic scheduling problems and other procedural violations recently brought to light at VA hospitals, health care providers are reminded of the opportunities available to them to fulfill the health care needs of veterans under the Patient-Centered Community Care, or PC3, program.
A relatively unknown VA program, PC3 allows hospitals and other providers to contract with HealthNet and TriWest (depending upon the provider's geographic location) to provide services to local veterans when their local VA hospital is unable to do so, whether because of a lack of available specialists, prolonged wait times, geographic inaccessibility or other factors.
PC3 contracts cover the following services:
- Inpatient specialty care
- Outpatient specialty care (including skilled home health and home infusion therapy services)
- Mental health care
- Limited emergency care
- Limited newborn care for enrolled female veterans following the birth of a child
Services by a non-VA-contracted provider are authorized by local non-VA Care Coordination staff, who also assist with appointment coordination. Reimbursement rates are typically 92 to 97.5 percent of Medicare.
During FY 2013, the VA purchased non-VA medical care for more than one million veterans at a cost of $4.81 billion. Non-VA expenditures for outpatient and ancillary care exceeded $1.4 billion, and non-VA expenditures for inpatient and ancillary care exceeded $1.3 billion.
For more information on the PC3 program, click here.
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