Post-acute care organizations should always be looking for new opportunities to expand their services and increase revenue. Veterans are a prime example of an often underserved yet highly profitable market segment.
Post-acute care organizations should always be looking for new opportunities to expand their services and increase revenue. Veterans are a prime example of an often underserved yet highly profitable market segment.
The VA provides a wide range of healthcare services and benefits to eligible Veterans, these include home care services. For home care agencies seeking to expand their payer lines and reach a growing market, partnering with the VA can prove to be a wise move.
In this article, we’ll explore two programs offered by the Department of Veterans Affairs: the VA Community Care Network (CCN) and the Aid and Attendance (A&A) benefit. These programs are designed to ensure exceptional care for veterans and are also fantastic opportunities for diversification and growth for home care agencies.
The Benefits of Getting Started With the VA
Before we dive into the different programs, here are some reasons why an ever-growing number of home care agencies have started to care for Veterans:
Access to a large client pool: With more than 9 million Veterans over the age of 65 enrolled in the VA healthcare system, home care agencies can tap into a vast pool of potential clients.
Increased revenue potential: The VA offers competitive reimbursement rates to providers, which can increase the revenue potential for home care agencies.
Diversify payer lines: By becoming a provider for the VA, home care agencies can diversify their payer lines and reduce their dependence on private pay clients.
Improved reputation and credibility: Partnering with the VA can help enhance a home care agency’s reputation and credibility as a provider of high-quality care.
Opportunity for growth and expansion: As the Veteran population continues to age and require more healthcare services, there is a significant opportunity for home care agencies to grow and expand their services by working with the VA.
What Is the VA Community Care Network?
The VA Community Care Network is a vast network of healthcare providers, including home care agencies, who work with the Department of Veterans Affairs to offer services to eligible Veterans who are unable to receive the necessary care directly from the VA.
For home care services such as Homemaker/Home Health Aide (HHA), or Respite care, the VA authorizes community providers to offer these services to eligible Veterans and pays the agency directly for the services rendered. This arrangement allows home care agencies to provide high-quality care to Veterans and receive reliable payment for their services.
Through the CCN, home care agencies can expand their census, increase revenue, and help ensure that Veterans receive the care they need.
CCN: Eligibility, Rates, and Hours for Home Care.
To receive home care services, Veterans must first enroll in the VA Health Care system and then undergo an evaluation by the VA to determine their eligibility for home care services. In general, veterans may be eligible if they are part of the VA Health Care system and experience challenges with Activities of Daily Living (ADLs).
The number of hours of care provided to a Veteran is solely based on their need and not their financial situation. Typically, Veterans receive between 6 to 16 hours of care per week, but there is no maximum limit. In some situations, the VA may even approve 24-hour care if the Veteran needs it.
The reimbursement rates for home care services are set annually by the VA and vary by location. In 2023, the rates range from $28.80 to $82.00 per hour, making the CCN one of the highest-paying payer lines. Reimbursements are paid directly to the agency for the care provided.
Click here to look up your local VA Rates.
CCN Key Players: The VA, Optum, & TriWest
When considering the Community Care Network, there are three key players involved: the VA, along with the Third-Party Administrators (TPAs) Optum and TriWest. The TPAs oversee enrollment, credentialing, and manage all invoices and billing. On the other hand, the VA and local VA Medical Centers are responsible for case management and referrals.
By entrusting the TPAs with tasks such as credentialing and billing, the VA has effectively streamlined the program’s administrative processes, removing a significant operational burden from local VA Medical Centers. This allows the VA Medical Centers to focus solely on coordinating care for Veterans.
How Home Care Agencies Join The CCN
To join the VA Community Care Network (CCN), home care agencies need to enroll directly with Optum or Triwest. The VA has divided the country into six regions, and the enrollment process varies based on the region. Agencies located in regions 1, 2, or 3 need to join the CCN through Optum, while those in regions 4 and 5 should go through TriWest.
To begin the enrollment process with Optum or TriWest, visit the “Join CCN” section of the Community Care Network website. There, you will discover specific contact numbers for your region as well as links to the TPAs’ websites. The enrollment process usually takes 6-12 months, depending on your region and the level of local provider saturation.
Once enrolled, your agency will be included in the VA’s system and become eligible to receive referrals from the VA. However, it’s important to note that enrollment alone does not guarantee a steady stream of referrals. Nevertheless, with dedication, patience, and an active approach to referral marketing, you have the potential to achieve remarkable results.
What Is the Aid & Attendance Pension Benefit?
The Aid and Attendance program is a pension benefit extended by the VA to eligible wartime Veterans, as well as their spouses and surviving spouses.
The A&A benefit aims to improve access to care for eligible Veterans who require help with their Activities of Daily Living (ADLs) but cannot receive the necessary care at a VA medical facility.
A&A Eligibility
Eligibility requirements for the Aid and Attendance program are divided into four criteria, namely military service, health needs, monthly income, and total assets.
Click here for a user-friendly tool that helps Veterans determine their eligibility.
Veterans are required to complete an application for benefits, along with attaching the necessary supporting documents. The application should then be submitted by mail or fax to the VA Pension Management Center. While some companies can assist veterans with this often-arduous process, it is crucial for veterans to remain vigilant and cautious of potential predatory institutions.
The A&A pension varies for each eligible veteran and can range from $1,432 – $2,229 per month (as of writing in 2023). The exact amount will ultimately be determined by the VA based on the aforementioned criteria. Veterans can then use these funds to buy care from local agencies at a rate determined by the agency, or at a rate negotiated on their behalf.
Aid & Attendance for Home Care Agencies
Home care agencies often struggle to find clients and thus accepting A&A clients helps them to expand their reach. To start offering Aid and Attendance (A&A) services, home care agencies should ensure compliance with regulations, familiarize themselves with eligibility criteria and documentation requirements, and establish partnerships with local VA offices or Veteran service organizations.
Stacking VA Benefits
A&A and CCN benefits are often stackable, enabling veterans to receive an increased number of care hours, while also raising billable hours for agencies.
Even within the CCN program, different service types, such as Respite or Homemaker/HHA, may be authorized at the same time. For instance, a client authorized for respite care may also be able to qualify for Homemaker services, leading to various potential combinations of benefits.
Key Takeaways
Home care agencies have a unique opportunity to improve the lives of Veterans and their families while expanding their services and revenue by partnering with the Department of Veterans Affairs.
By participating in VA programs like the Community Care Network and Aid & Attendance benefit, agencies can access a larger client pool and diversify their payer lines.
Paradigm Senior Services offers assistance to home care agencies in navigating the challenges of working with the VA, such as getting enrolled, automating billing, managing VA authorizations, and assisting with auditing and collection of outstanding VA-related accounts receivable.
About Greg Bean
Greg began his career in healthcare at the young age of 17 as a Hospital Corpsman in the United States Navy. After the Navy, he spent the next 12 years as a paramedic and critical care nurse. Greg has spent the last 25 years working in both skilled and private duty home care, including opening two private duty companies. Greg’s positions include stints as a Director, Regional Director, and National Director of Operations for home care and community-based operations, such as Bayada, PSA, Butterfly Effect, and Visiting Angels. Greg currently lives in Central Pennsylvania and is the Vice President of Business Development for Paradigm Senior Services.
