Coordinating Care for Senior Veterans and Wounded Warriors Act
S. 506, the Coordinating Care for Senior Veterans and Wounded Warriors Act, would require the Department of Veterans Affairs (VA), in cooperation with the Department of Health and Human Services (HHS), to run a three-year pilot program to better coordinate care and benefits for veterans who are enrolled in both Medicare and VA’s annual enrollment system. Each participating veteran would get a dedicated case manager who develops a personalized needs assessment and care coordination plan and helps them access services across VA, VA’s community care programs, and Medicare providers. The pilot aims to improve access, outcomes, quality, and satisfaction while reducing duplicative services and costs, and it could involve private sector contractors or, if contracting isn’t practicable, a plan to proceed using VA or other entities. The VA would track a set of metrics (participation, service reliance, quality, costs, access, satisfaction, and care coordination) and report findings regularly to Congress, with a final recommendation on whether to extend or make the program permanent.
Key Points
- 1Establishes a three-year pilot program within the VA (Center for Innovation for Care and Payment) to coordinate care for “covered veterans” who are enrolled in both Medicare and VA’s annual enrollment system.
- 2Each participating veteran gets a case manager who creates an individualized needs assessment and a care coordination plan, and helps navigate services across VA and Medicare.
- 3Requires use of existing models (including value-based care) and, where feasible, contracting with private sector entities to design, implement, and manage the pilot; if private contracting isn’t practicable, requires a detailed plan and justification for proceeding without private entities.
- 4Mandates comprehensive metrics (participation, VA and Medicare service use, quality, cost, access, patient and provider satisfaction, and care coordination) and reporting on demographics, service types, and service-related disability status.
- 5Includes detailed reporting requirements: quarterly updates during the first two years, a final design report, annual results reports, and a final report with a recommendation on extending or permanency no later than 180 days before termination.