Taking Care of the Nation’s Heroes

team’s relentless efforts to live out the company’s motto of “Whatever it Takes!®” as a collaborator and constant innovator, and staying true to the mission of supporting the government in delivering on the health care needs of heroes and their families, has uniquely prepared the company to be a partner to the Department of Defense (DoD) and now VA, and has contributed to TriWest’s success.

“We and our network of local, high-quality health care providers and facilities have been honored to deliver on the care needs of our nation’s heroes, giving the federal delivery system needed elasticity, while also making sure that providers receive timely and accurate payment for the care they have rendered,” explains Dave.

“TriWest is honored to support the unique health care needs of our nation’s Veterans, offering timely access to high quality care and excellent customer service through the Department of Veterans Affairs (VA) Community Care Network.” Every day, TriWest works with VA to ensure community-based health care is available to Veterans – when VA determines it is needed. To date, TriWest’s network of more than 700,000 community health care providers has delivered more than 33 million appointments to the nation’s heroes to give VA the elasticity needed to meet health care needs.

Overall, TriWest’s work makes a difference in providing needed elasticity to access health care services for the nation’s heroes and their families. “Since 2013, our work has been alongside VA and is largely in response to the wait list crisis that lit off in April 2014 shortly after we had been awarded our first VA contract,” explains Dave. “When the backlog of care was discovered that April at the Phoenix VA Medical Center, our quick execution and partnering with VA helped clear the backlog in Phoenix by August. We worked diligently to have those Veteran patients seen in the community so the care critical to their health was provided.”

Ensuring VA has the elasticity it needs to deliver timely access to care for Veterans starts with developing a customized network sized in a manner that enhances VA capacity and capabilities. TriWest initiated a process with VA to assess demand and determine the distribution and supply of network needed in the community to support that demand. TriWest calls it the “Demand Capacity Assessment Process.”

“We meet one on one with each medical center to assess how many medical professionals of each specialty would be needed in addition to the supply of medical providers working at the VA facility to meet the needs of Veterans in each geographic area,” adds Dave. “We take the output of this data-driven process and tailor our network of providers on a market-by-market basis to meet demand.”

The collaboration between VA and TriWest and the commitment of TriWest’s network of community providers to serve Veterans’ needs in support of VA have delivered exemplary results. “Our business model has always focused on custom VA solutions to issues, and therefore it is essential that we collaborate with VA to collect feedback on systems and processes to help streamline workflows and improve efficiency,” says Dave. “Today, we continue to collaborate with VA on requirements for an upgraded portal to meet VA’s needs for this next generation of VA community care contracts.” TriWest developed the ability for VA to access TriWest’s systems/operations through an innovative “pane of glass” view within a secure portal. This close working relationship helps advance the collaboration between the two organizations so that coordination of care for Veterans is as seamless as possible.

TriWest is the only company of its kind whose sole mission is to serve the Veteran and military communities and is owned by an alliance of non-profit health plans and two university hospital systems. As TriWest has demonstrated and continues to demonstrate, the company’s collaboration with VA is a full-scale effort with the second largest Department in the federal government. “We have assisted VA by rapidly helping the Department solve a crisis that began in 2014, and getting VA back on the road to a full scale re-setting for this generation’s customers (Veterans) and the next,” explains Dave. “Innovation is inherent in our daily operational culture and operations.”