CVS MinuteClinics: A Cure For Long Wait Times At Veterans Affairs?

Struggling with long wait times, the Veterans Affairs Health Care System is trying something new: a partnership with the CVS Pharmacy chain services to more than 65,000 veterans.

The experiment begins today at the VAs operations in Palo Alto, California.

Veterans can visit 14 MinuteClinics operated by CVS in the San Francisco Bay area and Sacramento, where staff will treat them for conditions such as respiratory infections, order lab tests and prescribe medications, which can be filled at CVS pharmacies.

The care will be free for veterans, and the VA will reimburse CVS for the treatment and medications. Whether the partnership will spread to other VA locales isnt yet clear.

The collaboration comes amid renewed scrutiny of the nation’s troubled VA health system, which hastried without much successto improve long wait times for veterans needing health care.

Despite a $10 billion Veterans Choice program allowing veterans to receive care outside the closed VA system, vets nationwide wait for an appointment even longer than they did before the program started in 2014, according to a .

The MinuteClinic partnership is not part of the Veterans Choice program.

SANTA CLARITA, CA/USA - MARCH 1, 2015: CVS/pharmacy store front and sign. CVS Pharmacy is the second largest pharmacy chain in the United States.

The concern has always been, how do we make sure veterans get the care they need in a timely way and in a way that works for the veteran? said Dr. Stephen Ezeji-Okoye, the Palo Alto VAs deputy chief of staff. The deal indicates that the VA is willing to try outside partnerships to meet veterans needs, he said. We want to have not just timely access but geographic access to care.

Sarah Russell, the Palo Alto VAs chief medical informatics officer, came up with the idea, said Ezeji-Okoye.

The VA will integrate MinuteClinics patient records with its own electronic health records to provide consistency of care, Ezeji-Okoye said.

The Palo Alto VA fares better than some other facilities nationwide in providing timely care to veterans, , and Ezeji-Okoye said most patients with urgent care needs are seen quickly.

But the system was so busy in the past year that of appointments at its network of hospitals and clinics — which stretch south from Sonora to Monterey — could not be scheduled within 30 or fewer days, which is considered an acceptable timeframe, . That includes appointments that would require urgent care.

More than 5,000 appointments system-wide were scheduled more than 30 days out, but each hospital and clinics performance varied widely. At a Fremont clinic, less than 2 percent of appointment requests could not be scheduled within 30 days. At the VAs rural Modesto clinic, by contrast, more than 17 percent of requests were not be scheduled within 30 days.

Once the MinuteClinic operation is well underway, Ezeji-Okoye anticipates that between 10 and 15 veterans — from among the estimated 150 who call the Palo Alto VAs advice nurse hotline daily — will be treated at the retail clinics on any given day.

About 95,000 veterans are eligible to use the Palo Alto system, one of the VAs largest in the Western United States. About 65,000 use it every year.

The $330,000 pilot project will be evaluated after one year. CVS MinuteClinic president, Dr. Andrew Sussman, hopes it can be rolled out nationally if it succeeds. CVS is by far the biggest player in retail pharmacy clinics, operating 1,135 of them in 35 states.

Wed love to have that opportunity to expand after we go through this phase, Sussman said. Were well suited to help because of our large footprint and ability to see people on a quick basis.

It is unclear, however, what the VAs nationwide plans are. The Veterans Health Administration office did not respond to Kaiser Health News request for comment.

Blake Schindler, a retired Army major who lives in Santa Clara near one of the participating MinuteClinics, was intrigued, but cautious about the MinuteClinics. He counts himself lucky because unlike some other veterans, he has access to the U.S. militarys TRICARE health insurance program for active and some retired service members.

It could make a big difference, but how much access are the veterans going to have? That was the big problem with the Veterans Choice program; it didnt end up the way it was supposed to, said Schindler, 58.

Im always hopeful when I hear about these things; I keep an open mind until I have experience with it, he added.

Interested veterans served by the VA Palo Alto can call its advice nurse line at 800-455-0057.

This story was produced by , which publishes , a service of the .

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Health IndustryPublic HealthVeterans' HealthCalifornia

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