S 506
Coordinating Care for Senior Veterans and Wounded Warriors Act
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Bill overview
The Coordinating Care for Senior Veterans and Wounded Warriors Act directs the Department of Veterans Affairs (VA) to run a three-year pilot program focused on improving care coordination for veterans who use both the VA healthcare system and Medicare. This program aims to enhance access to healthcare, improve patient outcomes, lower costs, and reduce duplication of services. The pilot will utilize case managers to personalize care plans and will draw on existing healthcare models to achieve these goals.
Key provisions
- Establishes a three-year pilot program for coordinated care.
- Assigns case managers to participating veterans to develop individualized care plans.
- Focuses on improving access, outcomes, quality, and cost of care.
- Utilizes existing value-based care models.
- Requires the VA to contract with private sector entities for assistance (unless impracticable).
- Tracks key metrics including veteran participation, reliance on VA and Medicare services, and patient satisfaction.
- Requires quarterly and annual reports to Congress on the pilot program's progress.
- Mandates a final report at the end of the pilot program with recommendations for continuation.
Who is affected
- Veterans
- Medicare recipients
- Department of Veterans Affairs
- Health care providers
- Private sector health care entities
Notable changes
- Creates a formal mechanism for coordinating care between the VA and Medicare systems.
Sponsors
Official sponsors from legislative records.
Primary sponsor
Cosponsor
Angus S., Jr. King
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119th CONGRESS — 1st Session
S. 506
IN THE SENATE OF THE UNITED STATES
A BILL
To require the Secretary of Veterans Affairs to carry out a pilot program to coordinate, navigate, and manage care and benefits for veterans enrolled in both the Medicare program and the system of annual patient enrollment of the Department of Veterans Affairs.
This Act may be cited as the Coordinating Care for Senior Veterans and Wounded Warriors Act
.
The Secretary, in consultation with the Secretary of Health and Human Services, shall carry out a pilot program (in this section referred to as the pilot program
) to coordinate, navigate, and manage care and benefits for covered veterans.
To improve outcomes of care received by covered veterans.
To improve quality of care received by covered veterans.
To lower costs of care received by covered veterans.
To eliminate gaps in care and duplication of services and expenses for covered veterans.
To improve care coordination for covered veterans, including coordination of patient information and medical records between providers.
The Secretary shall carry out the pilot program in not less than three but not more than five Veterans Integrated Service Networks with a large number of covered veterans and varying degrees of urbanization, including—
In designing the pilot program, the Secretary shall, to the extent practicable, use existing models, including value-based care models, used by commercial health care programs to improve access, health outcomes, quality, and customer experience and lower per capita costs.
If the Secretary determines that contracting with private sector entities under paragraph (1) is not practicable, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives—
a description of the steps the Secretary has taken to contract with a private sector entity;
a justification for why the Secretary has determined that contracting with a private sector entity is not practicable; and
a plan for how the Secretary will carry out the pilot program without contracting with a private sector entity, including through the use of employees of the Department of Veterans Affairs or other government agencies, nonprofit organizations, or other entities.
The number of veterans participating in the pilot program, disaggregated by Veterans Integrated Service Network.
Reliance on health care services administered by the Secretary.
Reliance on health care services administered under the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).
Quality of care, including patient outcomes.
Cost of care.
Access to care, including under the designated access standards developed by the Secretary under section 1703B of title 38, United States Code.
Patient satisfaction.
Provider satisfaction.
Care coordination, including timely information sharing and medical documentation return.
whether care received by a covered veteran is related to a service-connected disability (as defined in section 101 of title 38, United States Code);
the priority group under section 1705(a) of title 38, United States Code, through which each covered veteran was enrolled in the system of annual patient enrollment of the Department of Veterans Affairs under such section;
the type of care and services provided to covered veterans; and
the demographics of covered veterans participating in the pilot program, including age.
One of the reports required under subparagraph (A) shall contain a description of the final design of the pilot program.
Not later than one year after the submission of the final report under paragraph (1), and not less frequently than annually thereafter during the duration of the pilot program, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the results of the pilot program.
Not later than 180 days before the termination of the pilot program, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a final report on the pilot program, which shall include the recommendation of the Secretary for whether the pilot program should be extended or made permanent.
In this section:
The term covered veteran means a veteran who is enrolled in both the Medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) and the system of annual patient enrollment of the Department of Veterans Affairs under section 1705(a) of title 38, United States Code.
The term Secretary means the Secretary of Veterans Affairs.