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VA sends patients to UPMC hospitals for timely care

| Wednesday, Aug. 27, 2014, 11:52 p.m.
Trib Total Media
The main entrance of UPMC Presbyterian in Oakland.

Hundreds of veterans in Western Pennsylvania are getting medical care at UPMC hospitals as the Department of Veterans Affairs tries to erase backlogs of patients waiting for attention.

The VA, criticized for lengthy appointment wait times and scheduling flaws, said it gave veterans the option of scheduling visits with UPMC or other private providers. Officials said they want to make sure veterans don't wait more than 30 days for appointments.

UPMC, the region's largest hospital system, received about 290 referrals from the VA after setting up special 24-hour phone lines for veterans last month, said John Innocenti, president of UPMC Presbyterian Shadyside. Pittsburgh VA treated about 67,000 patients last year.

“The goal is to be a loyal partner and provide backup to the VA and try to reduce the backlog of patients they have,” Innocenti said on Wednesday.

President Obama this month signed a $16.3 billion law that intends to address long waits affecting tens of thousands of veterans.

The VA began taking steps in spring to ease delays nationwide, making nearly 912,000 total referrals to non-VA care providers during roughly two months this summer. That was up from 721,000 referrals during the same period last year.

In Western Pennsylvania, U.S. Reps. Tim Murphy and Mike Doyle revealed May 29 that nearly 700 veterans waited for up to a year or more for care from the VA Pittsburgh Healthcare System. The VA Pittsburgh director at the time, Terry Gerigk Wolf, disclosed the once-secret wait list to the congressmen and said superiors instructed her not to talk about it.

VA officials later acknowledged the queue of veterans who applied for care, some of whom waited from 2012 until May for appointments. Murphy and Doyle demanded that the VA contact every veteran on the list within 48 hours to schedule appointments. VA officials have said they attempted to contact every veteran.

Pittsburgh VA spokesman Mark Ray said most veterans referred to UPMC and other providers did not appear on that particular list, which remains under federal investigation. Ray said veterans referred outside the VA system faced delays of more than 30 days for noncritical specialty care.

He said the temporary fix will continue until all patients have appointments within 30 days, or at times they request.

“Once we reduce the backlog, we can see: Do we need more people (staffing) particular clinics?” Ray said.

He cited capacity problems as one factor triggering delays.

“Furthermore, we believe, as an institution, we were not as sensitive to timeliness of appointments as we should have been,” Ray said in a statement. “We regret this and wish to apologize to veterans for any delays they perceive.”

Innocenti said UPMC long has collaborated with the neighboring VA. He estimated that roughly 200 VA patients were admitted to UPMC Presby in the fiscal year that ended June 30 who had nothing to do with the backlog. The VA and UPMC negotiated a fee schedule that applies to the influx of patients.

Referrals to other providers should not affect out-of-pocket expenses for veterans who are responsible for co-pays, according to the VA.

Innocenti said UPMC stepped up to help with the backlog after getting a phone call in late July from Dr. Ali Sonel, chief of staff for the Pittsburgh VA, which operates medical campuses in Oakland and O'Hara.

Veterans going to UPMC hospitals receive a range of services, from orthopedic surgeries to mammograms and MRIs, Innocenti said. It wasn't clear which other hospitals have accepted Pittsburgh VA referrals. Allegheny Health Network officials said they offered to help but have received no referrals.

Paul Kennedy, western vice commander for the Pennsylvania American Legion, sees nothing wrong with the outsourcing — as long as veterans get good treatment.

“Let's be honest, VA probably has some of the best care,” Kennedy said. “I would hope there's somebody in the VA who's monitoring to make sure (veterans) are getting the care they should be getting.”

Ray said, “A lot of effort here goes into ensuring that veterans receiving non-VA care get the quality of care they expect and deserve.”

Veterans eligible for outside referrals can still opt for care within the VA system, he said.

Partnerships between the VA and academic medical centers are not new. More than a third of resident physicians receive medical training at VA facilities, according to the Association of American Medical Colleges. The Washington-based group said it told VA officials that 161 of its member medical schools, teaching hospitals and their physicians have the capacity to help the VA.

In 2012, more than 1.2 million VA patients went to non-VA providers, the group said.

Innocenti could not estimate how many patients UPMC might accept but said the health system can accommodate patients because not all seek the same type of treatment at once and they utilize different locations.

“It's not like we have 290 orthopedic surgeries,” he said. “It really has gone seamlessly.”

About 40 percent of the 290 patients referred to UPMC completed treatment, and 40 percent are scheduled for treatments.

UPMC established a hotline for patients requiring physical or occupational therapy, he said.

Patient records will go back to the VA when the course of treatment is completed, Innocenti said.

Luis Fábregas is Trib Total Media's medical editor. Reach him at 412-320-7998 or lfabregas@tribweb.com. Adam Smeltz is a staff writer. Reach him at 412-380-5676 or asmeltz@tribweb.com.

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