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Code · STATUTE-COMPILATIONS · Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act · Sec. 107

Sec. 107. STRATEGIC PLAN ON VALUE-BASED HEALTH CARE SYSTEM FOR VETERANS HEALTH ADMINISTRATION; PILOT PROGRAM

1,610 words·~7 min read·/statute-compilations/comps-18103/sec-107

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## SEC. 107 STRATEGIC PLAN ON VALUE-BASED HEALTH CARE SYSTEM FOR VETERANS HEALTH ADMINISTRATION; PILOT PROGRAM **[**[38 U.S.C. 1701 note](/us/usc/t38/s1701)**]** ###
(a)Establishment of Working Group ####
(1)In general Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall— #####
(A)establish a working group on value-based care; and #####
(B)submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate the strategic plan developed by the working group pursuant to subsection (b). ####
(2)Membership #####
(A)Required members The working group shall include, at a minimum, the following members: ######
(i)The Under Secretary for Health of the Department of Veterans Affairs. ######
(ii)The Director of the Office of Mental Health and Suicide Prevention of the Department of Veterans Affairs (or any successor office). ######
(iii)The Director of the Office of Integrated Veteran Care of the Department (or any successor office). ######
(iv)The Director of the Office of Rural Health of the Department (or any successor office). ######
(v)The Director of the Office of Connected Care of the Department (or any successor office). ######
(vi)The Assistant Secretary for the Office of Information Technology (or any successor office). ######
(vii)The Chief Officer of the Office of Healthcare Innovation and Learning of the Office of Discovery, Education, and Affiliate Networks of the Veterans Health Administration (or any successor office). ######
(viii)An individual designated by the Secretary from the Center for Innovation for Care and Payment of the Department under section 1703E of title 38, United States Code. ######
(ix)An individual designated by the Administrator of the Centers for Medicare & Medicaid Services from the Center for Medicare and Medicaid Innovation. ######
(x)An individual designated by the Secretary of Health and Human Services from the Federal Office of Rural Health Policy of the Health Resources and Services Administration. ######
(xi)The Chief of Human Capital Management for the Veterans Health Administration. ######
(xii)An individual designated by the Secretary of Defense that is a representative of the Defense Health Agency. ######
(xiii)An individual selected by the Secretary of Veterans Affairs from the special medical advisory group established under section 7312 of title 38, United States Code. #####
(B)Optional members The Secretary of Veterans Affairs may appoint any of the following individuals as members of the working group: ######
(i)An individual representing the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine. ######
(ii)Three individuals representing a private health care system that has made the transition to value-based care. ######
(iii)Three individuals representing an organization recognized by the Secretary of Veterans Affairs under section 5902 of title 38, United States Code. ####
(3)Public availability All meetings deliberations, and products of the working group shall be made publicly available throughout the duration of the working group, including to individuals representing organizations recognized by the Secretary of Veterans Affairs under section 5902 of title 38, United States Code. ####
(4)Exemption from faca Chapter 10 of title 5, United States Code, shall not apply to the working group established under paragraph (1). ###
(b)Development of Strategic Plan The working group shall develop a strategic plan to implement value-based care into the Veterans Health Administration that includes the following: ####
(1)An identification of the state of the Veterans Health Administration as of the date of the enactment of this Act, including an assessment of the current model of health care delivery used by the Veterans Health Administration in medical facilities of the Department of Veterans Affairs. ####
(2)An assessment of the capacity needs of the Veterans Health Administration during the five-year period beginning on the date of the enactment of this Act. ####
(3)An analysis of the leadership of the Veterans Health Administration, including an assessment of leadership acumen and ability to implement a clear, shared vision and effective change management and care coordination. ####
(4)An identification of goals for the future of the Veterans Health Administration. ####
(5)An identification and classification of the current capabilities, capacity, and gaps in access and quality of the health care system of the Department of Veterans Affairs. ####
(6)An analysis of value-based care models, including— #####
(A)a selection of potential models that would best work for the Veterans Health Administration; #####
(B)the capacity and capabilities of each such model; and #####
(C)a thorough justification of the selection of each selected model, including a summary of the ability of such model to improve the metrics described under paragraph (9). ####
(7)A definition of what quality means with respect to— #####
(A)access to health care under the laws administered by the Secretary of Veterans Affairs; and #####
(B)delivery of such health care. ####
(8)A definition of what value means with respect to care furnished by the Veterans Health Administration, ####
(9)A system for measuring value within the Veterans Health Administration that includes metrics for— #####
(A)outcomes; #####
(B)safety; #####
(C)service; #####
(D)access; #####
(E)productivity; #####
(F)capacity; and #####
(G)total cost of patient care. ####
(10)With respect to the system described in subparagraph (H), an analysis of variable value with respect to patient outcomes across different health care types and specialties. ####
(11)An assessment of— #####
(A)previous or ongoing assessments of the current information technology infrastructure of the Veterans Health Administration, including— ######
(i)such assessments conducted pursuant to the Electronic Health Record Modernization program of the Department of Veterans Affairs; and ######
(ii)any other ongoing information technology modernization programs of such Department and any unimplemented relevant recommendations from such assessments; #####
(B)the information technology infrastructure of the Veterans Health Administration in effect as of the date of the enactment of this Act; #####
(C)the value-driven framework of the Department, in effect as of the date of the enactment of this Act, for evaluating health care innovations, and how improvements in such framework could be used to encourage innovation; and #####
(D)workforce challenges and needs of the Veterans Health Administration based on— ######
(i)reviews of workforce assessment data available as of the date of the enactment of this Act; and ######
(ii)the findings of— ######
(I)the report required by section 301(d) of the Veterans Access, Choice, and Accountability Act of 2014 (Public Law 113-146); ######
(II)the reports required by section 505 of the John S. McCain III, Daniel K. Akaka and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (Public Law 115-182); ######
(III)the report required by section 301 of the VA Choice and Quality Employment Act of 2017 (Public Law 115-46); and ######
(IV)any comprehensive health care inspection conducted by the Inspector General of the Department of Veterans Affairs as of the date of the enactment of this Act. ####
(12)Any recommendations of the working group with respect to improving the information technology infrastructure described in clause
(i)of subparagraph (J). ####
(13)An analysis of how the value-driven framework described in clause
(iii)of such subparagraph could be used to improve the model of care delivery by the Department. ####
(14)A description of how a value-based care system would apply to primary care, inpatient and outpatient mental health care, and inpatient and outpatient substance use treatment, spinal cord injury disorder care, and polytrauma care furnished by the Veterans Health Administration. ####
(15)With respect to legislative or administrative action necessary to incorporate value-based care models into the Veterans Health Administration, a description of the estimated timelines, effect on workforce, and costs. ###
(c)Pilot Program ####
(1)In general Not later than 180 days after the submission of the strategic plan pursuant to subsection (b), the Secretary of Veterans Affairs, acting through the Center for Innovation for Care and Payment established under section 1703E of title 38, United States Code, shall commence a three-year pilot program under which the Secretary shall implement the elements of such strategic plan relating to the delivery, by the Veterans Health Administration, of primary care, inpatient and outpatient mental health treatment, inpatient and outpatient substance abuse treatment, spinal cord injury disorder care, and polytrauma care. ####
(2)Locations The Secretary shall carry out such pilot program in four Veterans Integrated Service Networks that are geographically dispersed and shall include the following: #####
(A)A Veterans Integrated Service Network that predominately serves veterans in rural and highly rural areas. #####
(B)A Veterans Integrated Service Network that predominately serves veterans in urban areas. #####
(C)A Veterans Integrated Service Network that has a high rate of suicide among veterans. #####
(D)A Veterans Integrated Service Network that has a high rate of substance use disorder among veterans. #####
(E)A Veterans Integrated Service Network that has access or productivity challenges. ####
(3)Reports to congress #####
(A)Annual report Not later than one year after the commencement of the pilot program, and annually thereafter during the duration of the pilot program, the Secretary shall submit to Congress a report on the pilot program. #####
(B)Final report Not later than 90 days before the conclusion of the pilot program, the Secretary shall submit to Congress a final report on the pilot program that includes— ######
(i)lessons learned during the administration of such pilot program; and ######
(ii)specific health outcomes in veteran patient care compared to the Veterans Health Administration system of care in effect as of the date of the enactment of this Act.
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Sec. 107
STRATEGIC PLAN ON VALUE-BASED HEALTH CARE SYSTEM FOR VETERANS HEALTH ADMINISTRATION; PILOT PROGRAM
U.S.C.§ 1701
Pub. L.Public Law 113-146
Pub. L.Public Law 115-182
Pub. L.Public Law 115-46
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