The Tennessee Valley Healthcare System (TVHS) began a new contract with Optum Public Sector Solutions, Inc., this week that will give Veterans access to more health care providers in their community.
The new network serves as the direct link between TVHS and local health care providers. VA also created an industry-standard contract vehicle for TVHS to purchase care. Optum will manage the network and process claims for payment to local providers on behalf of TVHS.
"We are confident this will greatly improve care coordination for Veterans in our area and improve the timeliness of payments to our local community providers," said Jennifer Vedral-Baron, TVHS health system director.
TriWest Health Care Alliance currently manages the TVHS community care network (CCN) and will fully transition responsibility to Optum on July 16, 2020. Veterans will continue to receive care from their community providers during the transition. TVHS community providers contracted by TriWest will not be automatically enrolled in CCN, so they will be required to sign up with Optum to continue providing services to Veterans under CCN.
"A large number of the providers our Veterans are seeing are already enrolled in the new network," said Shannon Bales, TVHS community care program manager. "For most of our Veterans this will be completely seamless, and in any case, there is no action required of our Veterans," he said.
VA's new CCN consist of six regions. Region 3 includes Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, Puerto Rico, South Carolina, Tennessee, and the U.S. Virgin Islands.
TVHS is an integrated tertiary health care system comprised of two hospitals, the Alvin C. York Campus in Murfreesboro and the Nashville Campus, as well as more than a dozen community-based outpatient clinics located in Tennessee and Kentucky. TVHS provides ambulatory care, primary care, and secondary care in acute medicine and surgery, specialized tertiary care, transplant services, spinal cord injury outpatient care, and a full range of extended care and mental health services.