Mr. Robert M. Walton

Director

Rio Grande Valley VA Town Hall Meeting

This Is Your VA

- Where We Were

- Where We Are

- Accelerating Care Initiatives

- How Are We Doing?

- How Can We Do Better?

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VCB – Counties We Serve

Veteran Population, Enrollees, and

Uniques

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• The Valley Coastal Bend is comprised of 20 counties in deep South Texas and encompasses the Laredo, McAllen, Harlingen, and Corpus Christi Outpatient Clinic service areas.

VA Texas Valley Coastal Bend

Health Care System

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Harlingen VA Outpatient Clinic McAllen VA Outpatient Clinic

Corpus Christi VA Outpatient Clinic Laredo VA Outpatient Clinic

VA Health Care Center at Harlingen Corpus Christi VA Specialty Clinic

Active Patients: 10,595 (August 2014)

Harlingen VA Outpatient Clinic

McAllen VA Outpatient Clinic

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Active Patients: 11,177 (August 2014)

• New Services include Optometry, Prosthetics, and Physical Therapy

VA Health Care Center (HCC) at

Harlingen

This facility was activated on January 18, 2011

Laredo VA Outpatient Clinic

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Active Patients: 2,720 (August 2014)

Corpus Christi VA Outpatient Clinic and Specialty Clinic

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Active Patients: 10,814 (August 2014)

Current Services in VATVCBHCS

Active Services

Primary Care Pathology and Laboratory Mental Health Prosthetics Amputee Clinic Dermatology Minor Procedures Rheumatology Infectious Disease Pulmonary Orthopedics Neurology Gastroenterology Urology Dental Physical Therapy

Oncology Optometry Ophthalmology Podiatry Physical Medicine & Rehabilitation Geriatrics and Extended Care Home and Community Based Care Cardiology ENT Audiology Nutrition Social Work Women’s health Pharmacy Radiology/MRI/CT Services Telemedicine

Rio Grande Valley Inpatient

Contracts

Fiscal Year Vendor

Authorized

BDOC ADC

Unique

Patients Payment Amount

FY11 South Texas Health System 7,123 20 797 $14,323,198

FY11 Valley Baptist Health System 4,838 13 644 $10,099,086

Total 11,961 33 1,441 $24,422,284

FY12 South Texas Health System 6,964 19 935

$13,876,800.46

FY12 Valley Baptist Health System 5,267 14 761 $11,424,363.69

Total 12,231 33 1,696 $25,301,164.15

FY13 South Texas Health System 7,501 21 1,276 $11,789,598.30

FY13 Valley Baptist Health System 4,949 14 994 $9,098,690.51

Total 12,450 35 2,270 $20,888,288.81

FY14 thru June South Texas Health System 6,213 23 1,071 $8,165,838.51

FY14 thru June Valley Baptist Health System 4,847 18 915 $7,648,258.38

FY14 thru June Total 11,078 41 1,986 $15,814,096.89

Note: Numbers are based on paid claims from VSSC – Non-VA Care Cube thru 07/01/14. Unpaid or pending claims are not included in

the data counts. From Strategic Analysis Service – ADUSH for Policy & Planning.

Number of Rio Grande Valley Market

Veterans Seeking Care at the

San Antonio VA

SOURCE: VSSC Enrollment Cube

Date Pulled: 9/4/14

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

2010 2011 2012 2013 2014

Cameron Co

Hidalgo Co

Jim Hogg Co

Starr Co

Willacy Co

Zapata Co

VCB Total

Year Cameron

Co

Hidalgo

Co

Jim Hogg

Co

Starr

Co

Willacy

Co

Zapata

Co

VCB

Total

2010 1,304 2,689 42 123 78 58 4,294

2011 934 1,838 21 91 64 27 2,975

2012 248 419 11 17 12 15 722

2013 114 212 2 8 6 3 345

2014

YTD 105 158 3 4 4 3 277

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Rio Grande Valley Market Veterans

Seeking Care at the San Antonio VA

Non-VA Care (Fee) Update

FY-14 (Thru August)

Total Fee Authorizations for the entire VATVCBHCS:

• FY10 for VCB:

• 19,936 Authorizations

• FY11 for VCB:

• 29,762 Authorizations

• FY 12 for VCB:

• 26,579 Authorizations

• FY13 for VCB:

• 24,938 Authorizations

• FY14 for VCB (Thru July):

• 34,921 Authorizations

Source: VSSC Non-VA Medical

Care Program Performance 14

Non-VA Claims Processing Update

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0

10

20

30

40

50

60

70

80

90% of Claims over 30 days

Site Oct 2010 Oct 2011 Oct 2012 Oct 2013 2014 YTD

Harlingen 184 295 340 409 426

Corpus Christi 82 92 108 140 152

McAllen 70 80 91 100 116

Laredo 20 25 27 35 45

VCB Totals 356 492 566 684 739

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VCB Staffing Growth

VCB Staffing Growth

0

100

200

300

400

500

600

700

800

10/1/10 10/1/11 10/1/12 10/1/13 2014 YTD

Laredo

McAllen

Corpus

Harlingen

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VA National Audit Findings

• The National Access Audit results show that as of May 15, 2014, wait times

were:

• New Patient Primary Care average wait time was 85.22 days

• New Patient Specialty Care average wait time was 145.18 days

• New Patient Mental Health average wait time was 55.4 days

• Established Patient Primary Care average wait time was 12.45 days

• Established Patient Specialty Care average wait time was 1.22 days

• Established Patient Mental Health average wait time 1.77 days

• We had 853 Veterans who had been waiting for 90 days or longer for a

Specialty Appointment: 87 for Audiology, 56 for Ophthalmology, 484 for

Optometry, 66 for Podiatry, 42 for Poly-trauma, and 118 for Physical Therapy

• We had 215 Veterans who had been waiting for 90 days or longer for a Primary

Care Appointment

• There were inconsistencies throughout VATVCBHCS in the determination and

use of the “Desired Date” for established patients

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VCB Response to Findings

• In response to the Accelerated Access to Care Initiative, on May 23 we

began calling all these Veterans and offered the opportunity to move

their appointment up, send to Non-VA Care, or keep the scheduled

appointment.

• We administered additional training for all scheduling staff.

• New Scheduling Review Process.

• Added Mid Level Provider and their teams to McAllen (MOPC),

Harlingen (HOPC),Corpus Christi (CCOPC), and Laredo (LOPC)

Outpatient clinics to assist with walk-in patients.

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VCB Response to Findings

• We are adding one Primary Care Team (Physician, RN, LVN, MSA) to each

McAllen (MOPC) and Harlingen Outpatient Clinic (HOPC).

• One Audiologist to each HOPC and Corpus Christi Naval Air Station

(CCNAS).

• Optometrist and Ophthalmologist to Corpus Christi Specialty Clinic (CCSC).

• Two Eye Techs, one at CCSC and one at Harlingen Health Care Center

(HCC).

• Neurologist, Respiratory Therapist, and Nurse Practitioner for Poly-Trauma

and sleep clinics at HCC

• We have 20 Recruitments for vacant Mental Health positions, and we will be

adding a Professional Counselor and a Behavioral Health Physician

Assistant for CCOPC, and a Psychologist for MOPC.

• We are adding a Nurse and a Management Analyst to assist with scheduling

reviews to ensure that appropriate scheduling practices are being followed.

• We are adding additional RN & MSA to the Non-VA Care staff to improve the

timeliness of processing and coordination of acre

VATVCBHCS Wait Times Update

(Does not count Non-VA Care Appointments)

VATVCBHCS 16-May 1-Jun 15-Jun 1-Jul 15-July 1- Aug 15-Aug 1-Sep Appointments

Scheduled 16,789 18,709 19,728 19,735 19,023

18,674 18,335 18,719 New Pt Ave W/T

PC 85.22 63.54 55.72 50.04 49.35 51.73 49.27 47.93 New Pt Ave W/T

SC 145.18 114.01 91.02 81.7 77.51 68.83 62.46 54.21 New Pt Ave W/T

MH 55.4 23.63 22.42 27.33 30.27 27.27 24.47 29.35 Est Pt Ave W/T

PC 12.45 14.34 15.04 15.74 16.60 19.25 21.77 23.75 Est Pt Ave

W/TSC 1.22 1.21 1.67 4.23 6.37 7.86 9.6 10.18

Est Pt Ave W/T MH 1.77 2.49 3.59 4.63 5.93 8.55 10.12 11.09

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• The contracts include:

– Inpatient Specialty care

– Outpatient Care

– Including Skilled Home Health

and Home Infusion Therapy

– Mental Health Care

– Limited Emergency Care

– Limited Newborn Care for enrolled

Female Veterans after delivery

• The contracts do not include:

– Dental Care

– Nursing Home Care

– Long Term Acute Care

Hospitals (LTAC)

– Homemaker and Home

Health Aide Services

– Chronic Dialysis Treatments

– Compensation and Pension

Examinations

What is PC3 (TriWest) Contract?

• VHA has awarded national contracts for surgical and medical specialty

providers under a VHA program called Patient-Centered Community Care

(PC3). The PC3 contractor for Valley Coastal Bend is TriWest. As TriWest

continues to build a larger and more diverse provider network, VCB will

send more Veterans to PC3 contracts instead of using the traditional fee

“voucher”.

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Self Check-in Kiosks are here

- Successfully deployed 38 kiosks at 7 VCB

sites.

- Week of August 4th – Harlingen & McAllen

- Week of August 26th - Corpus Christi &

Laredo

- From August 4, 2014 through September 3,

2014, we had:

- Number of Kiosk Successful Check-In; 1,597

How do I Stay up to date with the New Health Care System?

Stay connected: www.texasvalley.va.gov

Like us: www.facebook.com/VCBHCS

Follow Us: www.twitter.com/VCBHCS

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This Is Your VA

- What are we doing?

- How can we do better?