A major change is coming in the way Alaska veterans get medical care. Congressional leaders announced Monday that TriWest, the subcontractor acting as an intermediary between veterans and medical providers, will no longer be responsible for booking appointments.
Veterans in Alaska have criticized the appointment process as a major bottle-neck in accessing critical care. Many see the change as a small potential improvement within a larger web of problems connected to the 2014 Choice Act.
Retired Army sergeant Zack Sherman tried to make an appointment through the VA for help with worsening health issues connected to post-traumatic stress that began with his deployments in Iraq.
“I called in October,” Sherman said by phone from Fairbanks, where he lives. “‘I’m in a lot of pain and I’m really depressed and I’m having anxiety issues and I’m non-functional, and I need your assistance.'”
Weeks later, he was sent to a local clinic. The experience was demoralizing. According to Sherman, it wasn’t a good practice, and at the end he was left without a real diagnosis, just referrals for more tests elsewhere. When he tried to arrange those follow-ups the real nightmare began.
“I had to call TriWest, then TriWest had to say ‘well we don’t have the authorization,'” Sherman recounted, launching into a lengthy explanation of the ordeal.
Until about a year ago, the VA was the entity that handled follow-up appointments like this. They knew nearby providers and understood the circumstances local veterans were working with. Now, Sherman found himself calling TriWest and driving back and forth for referrals in order to finally get an X-Ray at an imaging clinic.
“Then I had to call a month later to say ‘why has no one called me about my x-rays?’ to have them say ‘oh well we didn’t see anything, so we didn’t bother calling you.'”
It was frustrating, time-consuming, and there were mistakes. Sherman would be routed to a TriWest call center in Hawaii, where employees would direct him to medical options hundreds of miles away from him in Anchorage, or book appointments with doctors who didn’t accept VA coverage.
Sherman didn’t mince words describing TriWest’s record with appointments.
“I think that ‘a s**tshow’ may be a complement to them,” said the former infantryman, employing a common synonym for ‘a very bad mess.’
The news that starting next month the VA will once again handle booking medical appointments for vets might seem relatively minor, but for those working closely on the problem it’s seen as significant.
“I think it’s a major change actually,” said Verdie Bowen, director of the state’s Department of Military and Veterans Affairs, which connects veterans in Alaska with VA resources.
According to Bowen, one of the problems over the last year has been that TriWest didn’t have staff in Alaska, which meant the company had difficulty understanding and responding to the nuances of the state’s healthcare system.
That’s improved since the company moved six staffers to the state earlier this year. And now that local VA employees are the ones booking appointments, Bowen thinks the process will be more effective.
“It’ll make it easier for the veteran to stay within the healthcare network that they want to be in, that’s number one,” Bowen said. “Number two: it’ll help that if the veteran does not want to go to that doctor or that service they’ll be able to talk to someone one on one and be able to fix those issues up front.”
TriWest isn’t going away: they’ll still handle billing medical providers, which Bowen said the company does faster than the VA. He twice described the new arrangement as “the best of both worlds.”
It’s unclear what the change means for tax-dollars paid to TriWest. The company is compensated based steps leading to completed appointments by vets. It featured prominently in a recent investigation by National Public Radio into larger problems ushered in by the 2014 Choice Act passed by Congress.
TriWest declined a request for an interview, but Vice President of Communications Elaine Labedz wrote in an email, “When pieces to the process are eliminated or revised, payment is appropriately re-calibrated.”
The VA did not respond to a request for comment on how the restructuring of responsibilities would be implemented locally.
Sherman isn’t very optimistic. In the last two-and-a-half years he’s lost six friends that he served with to suicide. He expects changes to the appointments process will be an improvement for vets in need of care care, but is a modest adjustment within a confusing bureaucratic process.
“I’m pretty high functioning and have a good support network,” Sherman said. “If I didn’t, I probably wouldn’t be here.”
The Alaska VA resumes control of appointments starting July 10th.
Zachariah Hughes reports on city & state politics, arts & culture, drugs, and military affairs in Anchorage and South Central Alaska.
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