MinuteClinic-VA Partnership Could Reduce Wait Times for Veterans Seeking Care

Access to care remains an issue for many US veterans, but a new initiative between the Department of Veterans Affairs (VA) Palo Alto Health Care System and MinuteClinic could expand access to care in Northern California.

More than 60,000 veterans who are enrolled in the VA Palo Alto system can now be referred to MinuteClinic, the walk-in medical clinic of CVS Health, for acute health services.

"We are pleased to announce this new initiative with the VA Palo Alto Health Care System," Andrew Sussman, MD, executive vice president and associate chief medical officer of CVS Health and president of MinuteClinic, said in a statement. "Through this arrangement, MinuteClinic and the VA Palo Alto will join forces to provide Veterans in Northern California with additional options for high quality clinical services. We're committed to providing top-notch care to the area's Veterans and this relationship will allow us to do so in locations and at times that are convenient for the VA's patients."

Now, veterans who call the VA Palo Alto’s Nurse Helpling can be referred to 1 of the 14 are MinuteClinics for treatment of common illnesses. Veterans written a prescription at a MInuteClinic will also be able to fill it at a CVS Pharmacy. The VA Palo Alto system and MinuteClinic will use an interconnected electronic medical record system and with patient consent MinuteClinic locations will be able to send patient visit summaries to the patient’s primary care physician at the VA.

"This program reaffirms our commitment to access through innovation and flexible healthcare delivery," said Stephen Ezeji-Okoye, MD, deputy chief of staff at the VA Palo Alto Health Care System. "The diverse geography of our veteran population requires us to think about access as providing the right care at the right place at the right time—as defined by the veteran.”

Access issues first came to light in the summer of 2014, when long wait times for veterans seeking care at VA clinics across the country were being reported. The outcome was that Congress passed the Veterans Access, Choice and Accountability Act of 2014, also known as Veterans Choice. The $10 billion program would let veterans who lived more than 40 miles away form a VA facility or who were going to have to wait longer than 30 days for an appointment with a VA provider see a non-VA doctor.

While the idea sounds simple, the execution has left a lot to be desired. NPR has reported that wait times have actually gotten worse. As a result, the VA is opposing a bill sponsored by Senator John McCain (R-AZ) that would expand the Veterans Choice program by making it permanent and allowing any veteran using VA health services to use the program, reported Military Times.

A March 2016 report from the Government Accountability Office (GAO) on access to primary care for newly enrolled veterans actually called into question the reliability of wait-time data used for oversight. For example, the GAO report found that the VA calculated wait times starting from the date the veteran wanted to be seen, not the date that the veteran initially requested the VA contact him or her to schedule an appointment. Not knowing how long veterans wait before being contacted by schedulers makes it difficult to identify and remedy scheduling issues that arise before the veteran is even contacted.

The GAO report reviewed records for a sample of 120 veterans across 6 VA medical centers and found that the average number of days veterans waited between their initial request and the date they were seen by a primary care provider varied widely from 22 days to 71 days. While more than half of the 120 veterans were able to see a provider in less than 30 days, wait times varied widely even within the same medical center.