D2 Friday, 08.22.2014 The Daily Herald
Civilian doc networks to backstop VA primary care
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ore than two decades ago, when a shrinking military health care system saw patient demand exceed its capacity to deliver timely care, particularly for a burgeoning retiree population, the Department of Defense contracted with the private sector to provide alternative networks of civilian physicians to deliver managed care to military beneficiaries. The Department of Veterans Affairs is moving down a similar path of contracting for civilian provider networks. For the VA, however, the networks are to handle only an overflow of needed care, and not offer an alternative enrollment option to the VA’s integrated health care system. The networks also are helping to address an access-to-care crisis that, in recent months, shredded VA credibility and forced leadership changes. On Wednesday, less than a week after President Obama signed into law the Veterans Access, Choice and Accountability Act of 2014 to mandate that the VA offer more timely and convenient to veterans, the VA announced expansion of its new Patient-Centered Community Care contracts so they deliver primary care, too, to veterans when and where the VA cannot. The PC3 networks only started operating in January as a backstop to provide specialty care, mental health care, limited emergency care and also limited newborn care to infants of female veterans. With their new
TOM PHILPOTT MILITARY UPDATE responsibility to deliver primary care, these PC3 networks clearly have gained importance as tools the VA will routinely use over the next several years to restore timely access to care. These provider networks will be familiar to many veterans whose families relied on them for Tricare services while members were still served on active duty. The TriWest Healthcare Alliance, headquartered in Phoenix, Arizona, was support contractor for the Tricare West Region until two years ago. Now it will backstop VA care in 28 states and U.S. Pacific territories. HealthNet Federal Services of Arlington, Virginia, still manages patient care for Tricare North Region. It now will provide both primary and specialty backup care to veterans in the other 22 states when the VA decides it own facilities and staff can’t deliver timely or convenient care. The addition of primary care to PC3 contracts is “another example of how we are working to ensure veterans get the care they need, when they need it
and where they want to be seen,” said new VA Secretary Robert A. McDonald in a statement announcing the change. The press release also said the VA continues to review how PC3 “may be used to help implement the new law. It also emphasized, however, that all PC3 care to veterans will be “coordinated with their VA providers.” That’s a critical point for veteran service organizations. They favor the VA hiring more staff and building more VA clinics over any migration of health services into the private sector. The fear is that this could degrade the VA’s capacity over time to provide veterans, including those catastrophically injured in war, with full spectrum health care they will need for a lifetime. In a phone interview Wednesday, David McIntyre, president and chief executive officer of TriWest, was sensitive to this, emphasizing that PC3 networks will differ in a critical way from Tricare networks. Tricare providers offer beneficiaries a “stand alone, parallel plan” of enrollment to using military health care on base. By contrast, veterans who need occasional care through the PC3 networks will remain enrolled and have its care monitored by the VA health care system, McIntyre explained. “That’s the core of what the VA PC3 is. It’s not to serve as a threat, frankly, to the VA system. It’s really a wraparound network.” McIntyre also touted the value
IN UNIFORM To submit news and photos for this column, contact reporter Gale Fiege at 425-339-3427 or gfiege@heraldnet.com. Active Duty Air Force Airman Raymond Acuna graduated from basic military training at Joint Base San Antonio-Lackland, Texas. Acuna is the son of Angela Porr, of Lake Stevens, and is a 2013 graduate of Lake Stevens High School. Air Force Airman Joshua Sheard graduated from basic military training at Joint Base San Antonio-Lackland, Texas. He is a 2012 graduate of Lynnwood High School. Sheard is the son of Tammy Sheard, of Lynnwood, and Offie Sheard, of Fredericksburg, Va. Coast Guard Cadet Megan Nicole Rice, of Snohomish, is attending the Coast Guard Academy in New London, Connecticut. She is the daughter of Bruce and Melanie Rice and granddaughter of Terri English, of Mountlake Terrace, and Don Rice, of Seattle. She Megan Nicole graduated from SnohomRice ish High School in 2011 and attended North Seattle Community College. Rice will graduate as a commissioned officer in 2018. She recently completed in intensive seven-week “swab summer” training at the academy. In sea trials last week Rice’s company came in first place out of eight. Elliot N. Choe, an Army Reserve Officer Training Corps cadet at Pacific Lutheran University, has graduated from the leader development and assessment course at Fort Knox, Kentucky. Choe is the son of Wayne Choe, of Federal Way, and nephew of Edward Choe, of Lynnwood, and Peter Choe, of Olympia. John C. Bartkowski, an Army Reserve Officer Training Corps cadet at Central Washington University, has graduated from the leader development and assessment course at Fort Knox, Kentucky. Bartkowski is the son of Steve and Kathy Bartkowski, of Edmonds. He is a 2010 graduate of Meadowdale High School.
Veterans calendar Fleet Reserve Association Branch 170: Branch meetings are held at 5 p.m. second Wednesdays, 6802 Beverly Blvd., Everett. 425-353-2600. The Military Order of the Purple Heart, Chapter 12: 7 p.m. fourth Tuesdays, Lynnwood Elks Club, 6620 196th St. SW. Call Keith Reyes, 844-4MOPH12. Disabled American Veterans, Martin T. Sofie Sunshine Chapter 13: 11:30 a.m. second Thursdays, Lynnwood Elks, 6620 196th St. SW. Call Gil, 425-742-1600. Coast Guard Auxiliary: 7 p.m. second Tuesdays, Port of Everett Conference Center, 404 14th St. Marie Porterfield, 425-629-3241, 509-949-6715 or Marie. Porterfield64@gmail.com. Fleet Reserve Association and Ladies Fleet Reserve Association Unit and Branch 18: Lunch noon, meeting 1 p.m. second Saturdays, 23003 56th Ave. W., Mountlake Terrace. 425-771-2774. Veterans: A group of veterans of wars in foreign lands (not associated with VFW) meets at 1 p.m., second Wednesdays, Carl Gipson Senior Center, 3025 Lombard, Everett. Call 425-257-8780.
American Legion Legion Post 76: Arlington Post 76 and auxiliary
meetings, 7 p.m. second Tuesdays. SAL meetings 6 p.m. first Thursdays. All meetings are downstairs at 115 N. Olympic Ave., Arlington. Call 360-435-2492. Legion Post 58: Arthur Kincaid Post meets 7 p.m. third Tuesdays, Odd Fellows Building, 610 Lewis St., Monroe. Call Bob at 360-863-3544 or go to www.americanlegion monroe.org. Legion Post 66: 6 p.m. third Mondays, 117 Sixth Ave. S., Edmonds. Call Les, 206-546-6831. Legion Post 234: 7 p.m. second Mondays, Legion Hall, 22909 56th Ave. W., Mountlake Terrace. Call Frank Martinez, 425-697-4102. Legion Post 37: 7 p.m. third Thursdays, Lynnwood Elks Club, 6620 196th St. SW. 425-585-0279. Legion Post 92: Stanwood offers prime rib dinner, 4:30 p.m., third Fridays. Legion and auxiliary meeting, 7 p.m., second Mondays, 26921 88th Ave. NW, Stanwood. Service office, 360-629-8021, open 9 a.m. to 3:30 p.m. Tuesdays, Wednesdays and Thursdays to help veterans. Legion Post 96: 7 p.m. second Tuesdays, Legion Hall, 1201 First St., Snohomish. Call 360-568-5340. Legion Post 6: 6 p.m. second Thursdays, the Fleet Reserve Association Club, 6802 Beverly Blvd., Everett. Call Marvin at 425-923-8172. Legion Post 181: 7 p.m. second and fourth Thursdays, Lake Stevens Community Center, 1812 124th Ave. NE. Call Tom at 425-314-5865, Tony at 360-631-3242, or Vern at 425-343-9637; email info@post181.org; or go to www.post181.org.
Veterans of Foreign Wars Gold Bar Martin-Osterholtz VFW Post 9417: 6 p.m. first Thursdays. Auxiliary hosts a pancake breakfast from 8 to 10 a.m. July 26 at 301 Third St., Gold Bar. Suggested donation is $5. Call “Sarge” Watkins at 425-931-1638. Ladies Auxiliary: 3 p.m. first Thursdays. Call Arden King at 360-793-2786. Oak Harbor’s Whitehead-Muzzall VFW Post 7392: 360-675-4048 or go to vfwpost7392.org. Sultan VFW Post 2554 and Ladies Auxiliary: 7 p.m., second Thursdays, United Methodist Church, 211 Birch Ave., Sultan. Call 425-870-0235. Arlington Boyer-Daniel VFW Post 1561: 7 p.m. first Tuesdays. For meeting location, call 425232-8453, 360-435-6677 or go to vfw1561.org. Monroe VFW Post 7511: 7 p.m., second Thursdays, IOOF Hall, 610 Lewis St., Monroe. Call Ken, 425-315-3509. Edmonds VFW Post 8870 and Ladies Auxiliary: Lunch at 11:45 a.m., meeting at 12:30 p.m. second Fridays, Edmonds Senior Center, 220 Railroad Ave., Edmonds. Fred at 206-940-7502, email quartermaster@vfw8870.org or go to www. vfw8870.org. Snohomish Gay Jones VFW Post 921 and Auxiliary: 1 p.m. second Saturdays, Boys & Girls Club, 402 Second St., Snohomish. Call 425-3977111. Everett Old Guard VFW Post 2100: 6:30 p.m. fourth Thursdays, 2711 Oaks Ave., Everett. Ladies Auxiliary 2100: 6:30 p.m. second Monday. Call 425-337-1559 or go to www.vfwpost2100.org. Post 2100 will host a rummage sale 10 a.m. to 5 p.m. Aug. 22, 23 and 24 in the lower hall of the post. Donations for the fundraiser will be accepted at the post each afternoon until the end of the sale. Lynnwood VFW Post 1040: 7 p.m., first Thursdays, Alderwood Youth Club, 19619 24th Ave. W., Lynnwood. Call Martin, 425-774-7416, or Frank, 425-697-4102. Lynnwood VFW Post 1040 Ladies Auxiliary meets from 7 to 8 p.m. at the same location. Contact Myra Rintamaki, 206-235-0348 for more information.
to the VA of having consolidated networks of providers ready to serve as a “relief valve” when veterans can’t get timely, convenient care from inside the VA. He noted that discovery of thousands of veterans awaiting care through the Phoenix VA Health Care System “lit off the furnace” of the crisis over veterans facing long wait times for care. Yet last month, McIntyre said, civilian providers working under the TriWest PC3 network provided specialty care to about 3,000 veterans in the Phoenix area, as part of an aggressive VA effort to end patient backlogs. “Today,” he said, “every veteran who cannot be seen in the (Phoenix) VA on the specialty side gets care within standards downtown. … The backlog in specialty care has been worked off and 4,400 providers in Maricopa County surrounding the (Phoenix) VA medical center are that safety net.” Starting this month, under newly modified contracts, TriWest and HealthNet will begin to backstop the VA on primary care appointments at select locations. By December, primary care will be available in “all of the areas in which we operate,” McIntyre said. PC3 contracts also were changed to aligned networks to tighter “drive times” for care access set in the new law. McIntyre and Thomas Carrato, president of HealthNet Federal Services, testified before the House Veterans Affairs Committee in June and each of them
suggested expanding PC3 contracts into primary care. At the time Carrato said that while PC3 contractors continue to build out specialty care networks, they have met resistance in some locations from civilian providers who are reluctant to join a network while they have separate contracts with individual VA facilities also to provide backup care. “The communication is a lot better but that’s an issue that continues to linger,” Carrato told lawmakers. McIntyre, in our interview, suggested VA increasingly sees the advantages of using networks of providers for backup care rather than the VA cutting local deals. These include discounts off VA payment rates, prompt provider reimbursements and PC3 networks having responsibility for patient record transfer back into the VA system after every episode of civilian care. VA officials still must decide how to use a “Veterans Choice Card” that the new law requires be issued to veterans as a guarantee of timely access to care. McIntyre wouldn’t speculate on how it would be used. He did suggest, however, that PC3 contracts will result in fewer veterans having to find their own doctors out of frustration that the VA or its partner networks can’t deliver on timely, convenient care. Send comments to Military Update, P.O. Box 231111, Centreville, VA, 20120, email milupdate@aol.com or twitter: Tom Philpott @Military_Update
VITAL STATISTICS MARRIAGE LICENSES Gephart, Matthew Ryan and Gephart, Jamie Elizabeth Tecorral, Valeriano Antonio and Marshall, Rebecca Guinn Phan, Philip Duc and Le, Nam-Phuong Thi Gieseking, Bjorn Aaron and Kachele, Brianna Renee Neves, Kathleen Nicole and Long, Brian Peter Gordon, Sherri Ann and Root, Michael Lee Johnson, Benjamin Scott and Peterson, Markie Re Rockcastle, Lisa Elizabeth and Campos, Robert Larson, William Jeffrey and Usitalo, Sheryl Renee Noste, Joan Elinor and Kelley, Gail Diane Navas, Perez Daniel and Galaz, Chavez Pholett Adilene Meyer, Isaac Nolan and Moynihan, Kelly Maureen Tingley, Cary Vincent and Rhodes, Milissa Louise Cameron, Christopher Paul Jr and Olney, Katie Brianne Wise, Nikaelah Noelle and Zepeda, Luis Miguel Luebke, Katherine Amanda and Nelsen, Corey Michael Wang, Timothy Tsekit and Salerno, Angela Marie Yarin, Eduard Grigoryevich and Serova, Yelena Vasilyevna Jarosky, Brittany Marie and Nelson, Curtis Ross Carlson, Mark James and Alexander, Brenda Faye Beard, Branden Richard and Mohoric, Stephanie Kloss, Michael Brian and Roark, Jamie Rain Keene, Erica Rose and Mehl, Zane Michael Kielty, Martha Meiko and Thompson, Erik Walter Do, Renny Frank and Phong, Anh Cong Barkley, Paul Fredric Sr and Couch, Norah May McKinney, Bobbie Jo and Meissner, Saundra Ann Pulkrabek, Michael Jay and McClelland, Robin Kay Gasperetti, Stephen Joseph and Clark, Megan Elizabeth Chweya, Eric Lubusy and Nyale, Winnie Sidi Warburton, Cory Richard and Trautmann, Kailey Jean Danae Rios, Rodriguez Ramiro and Parra, Tellez Beatriz Gabriela Byron, Ashlee Lillian and Smith, Timothy Daniel Guyot, Michael James and Wesson, Jamie Lee Arnold, Kaylie Lynn and Fairbanks, Robert William Hudson, Joel Thomas and Collet, Jennifer Amber Sipma, Jennifer Lynn and Voigt, Jeffrey David Loera, Davi Miguel and Plymale, Diana Lynn Ramsey, Ryan Lee and Boughton, Wendy June Nordensson, Jonathan Ray and Schiessl, Lauren Marie Lebreton, Carrie Marie and Duprey-Ford, Joshua Glenn Sikorskiy, Oleg Victorovitch and Barbina, Victoriya Anatolivya Flolid, Derek John and Bower, Lindsay Katherine Landon, Randy Gene and Landon, Ivee Renae Wilder, Samantha Nicole and Nelson, Derek Steven Wills, Evan Jason and Kida, Mina Dosen, Kelsey J and Taylor, Justin Harrison Purcell, David Lewis and Gamman, Laurel Louise Salmon, Jessica Marie and Lesher, Todd Michael Ramos-Chavez, Jose Antonio and RamosSt Clair, Brynn Bettina Douglass, William Alexander and Christenson, Tanya Andrea Van, Vleet Darian Sky and Carson, Jacob Michael Toteva, Elena Milkova and Martinez, Aceves Jose Eduardo Gabriel, Jacob Daniel Ekblad and Croyle, Heather Michelle Isherwood, Jenna Wanda Dawn and Cooper, Michael Neal Jr
Worthen, Richard Gordon and Holmes, Alicelee Jo Peterson, Kalani Ua Lohe Ke Akua and Puff, Chloe Alexandra Hathaway, Cassandra Elizabeth and Delahunty, Corey Allen Perrault, Allison Joy and Garton, Jeremy William Berg, Angela Mastrallo and Wickstrom, Derek Russell Fesyuk, David Anatoly and Datskaya, Ulyana Vasiliyevna Ovena, Manuel Christian and Meyer, Michelle Patricia Pryor, Robert Breen and Earp, Kayce Lee Hughes, Beverly Dot and Sauer, Darin James Martin, Richard Lee and Dillan, Roberta Marie Rippee-Butler, Bailey Jordan and Bertram, Patrick Johnathen Ottmar, Michael David and Brantley, Heather Lynn Watson, Loni Diena and Mowbray, Dana Ray Tveit, Oliver Douglas and Crismon, Tezra Lee Allen, Aubrey Lee and Helgeson, Brenan Dale Eyster, Grayson Kelley and Malakhovskaya, Irina Vladimirovna Pilat, Vasiliy Ivanovich and Sklyarova, Snezhana Yevgeniy Jackson, Kendra Lorrie and Hardman, Todd James Sherbourne, Bruce Alan and Campbell, Thelma Andersen, Jeffrey Steven and Deonarine, Nazima Azmi Maddalena, Jennifer Elizabeth and Saucedo, Benjamin Edwards Mugge, Jeffrey Phillip and Webster, Ayla Louise Lemon, David Loren and Smith, Erin Marie Guthrie, Clifton James and Thompson, Susan Ashley Henderson, Jason David and Henderson, Katelyn Elaine Bartenbach, Joel William Ii and Scott, Melissa Rose Valley Derrick, Alyssa Kaylee and Owen, Evin Nathaniel Hendrickson, Michael Thomas and Henson, Jermaine Katura Allen, Melvin Gerald and Costanzo, Mary Martha Johnson, Krista Leanne and Lilly, Mickey Patrick Griffin, Nakwisi Leon and Setal, Eunice Abigail Hagen, Michelle Lynn and Spies, Jeffrey Lloyd Kask, Heidi Korinne and Haley, Tyler Robert Muresan, Constantin and Bernadette, Bulungu Mutombo Pierre, Everett Arthur and Pearson, Lydia Anne Nielsen, Vernon Hans Jr and Hale, Lauren Ann Jessen, Steven and Fu, Lily Kallow, Lamin B J and Oates, Tkayah Carmel Palmer, Kenneth Fredrick and Jorgenson, Eula Kaye Mansour, Waleed Abdellatief and Foster, Raejeanna Victoria Arnett, Raymond Lee and Davis, Sharon Elaine Moore, James Fred and Boone, Sherry Kemethia Tucker, Kendra Mae and Odom, Daniel Robert Smith, Richard Joseph and Krueger, Megan Elizabeth Everson, Lisa Marie and Dexter, Alexander Christopher Tshivuadi, Emmanuel Dieudonne and Medsker, Tarah Michelle Gustafson, James Douglas and Swint, Ginger Leigh Cravens, Charles Eric and McCloud, Majkin Lindsey Young, Debra Mae and Hendricks, Roger Scott Gaulding, David Emmett Lee and McConville, Jennifer Lynn Libbing, Jessi Kalina Scott and Wiley, Michael Mason Zaneski, Morgan Ann and Farrow, Cole Alan Cady, Jamie Leigh and Black, Joshua Michael Medley, Kelli Lynn and Chhetri, Basant Lake, Tobias Jonathan and Morris, Tiffany Rose
Fowler, Nicholes Edward and Moore, Mackenzie Ray
DISSOLUTIONS
Royce Glenn and Debra Glenn Richard Ortloff and Patti Ortloff Karen Townsend and Christopher Townsend Cassey Frisk and Jason Frisk Jennifer Hendrix and Brian Hendrix Shirley Nolton and Kevin Nolton Frank Simorjay and Holly Simorjay Brian Wick and Mariah Wick Jennifer Lowe and Sean Lowe Michael Goens and Tammy Goens Alanna St George-Lewis and John Joseph Lewis Melissa Bennett and Jeremy Bennett Martin Strand and Sharon Strand Kristin Dewitte and Daniel Dewitte Salvador Sanchez and Leticia Chavez Patricia Whitcomb and Trevor Whitcomb Susan Lorenzana and Mario Lorenzana Rosalie Heinrich and Richard Heinrich Rolana Wahlgren and Kevin Wahlgren Debra Anderson and Shelley Stanton Kaaren Sidoine and Abdurraouf Gseaa Meya Sanyang and Pa Sanyang Shari Trail and Steven Trail Michele Spaulding-Burns and Mathew Burns Sandra Moyers and Vernon Moyers Megan Grandez Quintana and Diego Grandez Quintana Tresia Hammonds and Eric Hammonds Susan Schneider and Frank Schneider Lea Tyo and Gerald Tyo Balbir Mann and Davinder Mann Rebekah Knapp and Randall Knapp Brenna Duarte and Aldaberto Duarte Hernandez Waleed Mansour and Winona FraserMansour Shellie Trudell and Cora-Jean Potter Douglas Hinds and Paula Hinds Chelsea Ackerman and Brandon Ackerman Jeremy Mcconnell and Rebecca Rickett
DEATHS
Adams, Nicholas, 21, Lynnwood, Aug. 2 Ami, Remedios, 63, Bothell, Aug. 10 Bulger, Paul, 67, Everett, Aug. 4 Bynum, Andrew, 34, Everett, Aug. 7 Carver, James, 79, Mountlake Terrace, Aug. 11 Champagne, Lena, 101, Mountlake Terrace, Aug. 7 Church, Julie, 54, Everett, Aug. 5 Contraro, Frances, 63, Tulalip, Aug. 10 Crain, Ruth, 85, Snohomish, Aug. 10 Dargoo, Mary, 89, Marysville, Aug. 6 DeLisle, Mary, 88, Lynnwood, Aug. 6 Dinger-Dickson, Cordice, 97, Arlington, Aug. 5 Doe, Betty, 88, Snohomish, Aug. 7 Egorova, Alexandra, 89, Lynnwood, Aug. 6 Flogo, Rolanda, 73, Mukilteo, Aug. 12 Fredericksen, Roy, 78, Edmonds, Aug. 5 Gilbert, Rodger, 70, Snohomish, Aug. 9 Graham, Fredrick aka: Fred, 73, Edmonds, Aug. 6 Halligan, Marcia, 66, Langley, Aug. 10 Hebert, Dorothy, 91, Marysville, Aug. 7 Hill, Deborah, 55, Stanwood, Aug. 7 Holden, James, 41, Edmonds, Aug. 13 Howell, Alica, 91, Monroe, Aug. 8 Hunter, Clydetta, 90, Arlington, Aug. 9 Huxley, Jane, 62, Snohomish, Aug. 2 James, Richard, 85, Edmonds, Aug. 11 Johnson, Kathleen, 55, Lynnwood, Aug. 3 Kahle, Donna, 66, Edmonds, Aug. 6 Keene, Eugene, 101, Stanwood, Aug. 9 Kwon, Choe, 49, Bothell, Aug. 13 Lafferty, Francis, 80, Snohomish, Aug. 11 Landburg, Dora, 87, Mountlake Terrace, Aug. 10 Lemke, David, 77, Snohomish, Aug. 10 Ligenza, Nancy, 74, Marysville, Aug. 10 Lowery, Helen, 88, Everett, Aug. 9 Matthews, Jean, 84, Sammamish, Aug. 10 McCrory, Francis, 87, Lynnwood, Aug. 10 McLauchlin, Mary, 81, Sequim, Aug. 7 Mead, Morris, 71, Edmonds, July 31 Minor, Edward, 89, Edmonds, Aug. 11 Nelson, Mildred, 73, Darrington, Aug. 7 Nesbitt, Nancy, 71, Everett, Aug. 8 Norvell, Donald, 80, Stanwood, Aug. 3 Nugent Horton, Mildred, 79, Lynnwood, Aug. 2 O’Neil, Ethel, 89, Everett, Aug. 12 Ogard, Elizabeth, 91, Marysville, Aug. 9 Oshie, Carol, 72, Everett, Aug. 11 Oswalt, Christine, 63, Greenbank, Aug. 12 Parrish, Mary, 88, Kirkland, Aug. 13 Partlo, Susan, 66, Everett, Aug. 6 Paulsen, Robert, 54, Arlington, Aug. 10 Wright, Byron, 53, Arlington, Feb. 19