Sponsors (7)
The bill seeks to improve care coordination for veterans dually enrolled in VA and Medicare through pilots, private-sector care models, and data-driven oversight, trading faster, potentially more efficient access for some veterans against privacy risks, uneven rollout, possible higher costs, and added strain on VA resources.
Veterans enrolled in both VA and Medicare will receive a dedicated case manager who creates individualized care plans, improving access to and navigation of VA and Medicare services.
Veterans in underserved and rural areas will gain improved coordinated-care access through a pilot rolled out across multiple VISNs, targeting gaps in regions with limited services.
Taxpayers and veterans may see lower per-capita costs and better outcomes because the pilot leverages existing commercial/value-based care models and private-sector care-management practices.
Taxpayers and veterans could face higher costs or reduced VA control over care if contracting with private-sector vendors increases program costs or shifts care toward profit-driven providers.
Veterans and health systems face privacy and data-security risks from integrating VA and Medicare data across multiple providers unless information-sharing is strictly safeguarded.
Veterans in non-selected regions may experience delayed access to benefits and uneven care during the three-year pilot limited to a subset of VISNs.
Based on analysis of 2 sections of legislative text.
Requires VA, with HHS consultation, to run a 3–5 VISN pilot assigning case managers to coordinate care and benefits for covered veterans using commercial/value‑based models and private contractors when practicable.
Introduced January 23, 2025 by Juan Ciscomani · Last progress January 23, 2025
Requires the Department of Veterans Affairs, working with HHS, to run a pilot program in 3–5 Veterans Integrated Service Networks that assigns each participating veteran a VA case manager who builds individualized needs assessments and care coordination plans. The pilot must improve access to VA and non‑VA care (including Medicare providers), reduce gaps and duplication, improve outcomes and patient experience, and leverage commercial/value‑based models and private‑sector contractors where practicable. The pilot must be run in VISNs chosen for large veteran populations and diverse urban/rural and medically underserved settings. If the VA decides contracting with private entities is impracticable, the Secretary must notify and report to congressional veterans committees explaining the reasons and an alternative plan to operate the pilot without contractors.