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Veterans Choice health-care program growing in popularity in eastern Oklahoma

Tulsa World - 9/3/2017

MUSKOGEE - Okmulgee County veteran Jack Flanagin says the Veterans Choice program has been "a godsend."

But it hasn't always been that way.

Implemented in 2014, Veterans Choice was supposed to shorten waiting times for Veterans Health Administration services and increase access for veterans in areas with limited or no VHA facilities. It allows veterans on a waiting list for 30 days or more or who live at least 40 miles from a VA clinic or hospital to be routed to a private provider.

That part worked well for Flanagin. It allowed him, after what he says was a dozen years of waiting for a heart procedure at the VA hospital in Oklahoma City, to have it done at the Oklahoma Heart Institute in Tulsa.

Veterans Choice also made it possible for him to see a Tulsa urologist.

What didn't work so well was the paper pushing.

Because of billing mix-ups and misunderstandings, Flanagin wound up with a "$42,000 rock" on his credit that took two years and 2nd District Congressman Markwayne Mullin's office to lift.

"I called them (his creditors) monthly to say I was working on it," Flanagin said. "I am not a mooch."

News reports and an inspector general's report suggest that Flanagin's experience was not unusual. Veterans Choice did help some veterans get better care faster.

But there also were numerous billing foul-ups, and sometimes wait times were actually longer for Veterans Choice because providers were slow to accept it.

Aside from that, some people suspected - or, alternately, hoped - Veterans Choice would be a pathway to full privatization of veterans health care. Some veterans groups were leery of the program because they feared it would divert money from the existing network of VA hospitals and clinics.

So with Veterans Choice nearly out of cash in mid-summer, some seemed content to let it die, at least in its current form.

But in Mullin's field office, the phone began ringing as soon as word got out that the new Veterans Choice program might be allowed to lapse.

"Whenever the rumors were just beginning to be whispered around, our phones started blowing up," said Jake Marlin, a veterans caseworker for Mullin.

"Our veterans here (in Muskogee) came right in to tell us in person," said William Barnes, who also handles veterans issues for Mullin.

Whether delivered in person or over the phone, the message was the same - don't take away Veterans Choice.

Ultimately, Congress and President Donald Trump agreed. Last month, Trump signed legislation putting another $2.1 billion into the program, plus an additional $1.8 billion into the traditional VHA system.

Veterans affairs is a big part of most congressional offices' constituent services. The 2nd District is no different. Barnes, Marlin and colleague Jason Self averaged around 400 cases the past two years and have nearly that many closed and ongoing cases combined this year.

With that many veterans - and both a VA hospital and a major regional benefits center in his district - Mullin has been involved in quite a bit of veterans legislation, including the Veterans Choice and several other VA bills signed by Trump recently.

Veterans Choice seemed promising for the 2nd District and for other Oklahomans who rely on the Eastern Oklahoma VA Health Care System, based in Muskogee, for care.

The Jack Montgomery Medical Center in Muskogee has trouble recruiting and retaining specialists in certain areas, such as rheumatology, urology, sleep studies and ophthalmology. Veterans Choice allowed patients to be routed to private specialists within driving distance.

In at least one case, Marlin said, that meant a veteran and his wife had to travel only to Tulsa instead of to Houston.

But it took a while to gather the private providers into a network and work out administrative kinks, said Mark Morgan, director of the Jack Montgomery Medical Center.

"It has been quite a lot of work, but it is a good idea," he said.

The Muskogee hospital is the hub for the Eastern Oklahoma VA Health Care System, which includes clinics in Tulsa, Vinita and Hartshorne. A contract VA clinic recently opened in Idabel, and the Veterans Health Care System of the Ozarks, based in Fayetteville, Arkansas, operates a clinic in Jay.

Morgan said the focus now for the Eastern Oklahoma system is to continue adding specialists to the provider network and to encourage the VA to further streamline administration of the program.

"I see the VA and private sector relationships continuing to improve," he said. "I don't see this sliding back."

That's encouraging news for veterans such as Flanagin.

"It took a while and the will of some people to make this Choice program work," Flanagin said. "It is so much better.

"I'd be very sad about losing the Choice card."


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