NH hospital clarifies contract expansion for veteran care

July 16, 2009 04:48 AM

By Margot Sanger-Katz
The Concord Monitor

CONCORD, N.H. — Administrators from the Veterans Administration and Concord Hospital have clarified the details of a contract expansion announced earlier this week.

The change will mean that more veterans who require hospital stays will be given the choice to stay in New Hampshire for their care. But veterans will still need to travel out of state for some specialized care.

Concord Hospital has had a contract with the VA since the fall. Under the old contract, patients with medical needs who required hospitalization could be transferred from the VA Medical Center in Manchester to Concord. But not every patient was given that option — some were instead transferred to VA hospitals out of state, even if their conditions did not require specialized surgery.

The new contract allows two major changes:

- Concord Hospital will be allowed to perform more medical and surgical procedures for veterans.

- And all veterans with health conditions Concord Hospital is allowed to treat will have the choice to go there if they prefer a local hospital to one of the VA facilities.

“Now, everybody who has an urgent condition can stay locally,” said Dr. Marc Levinson, the medical director at the Manchester VA center.

The new treatments Concord Hospital can offer include some elective abdominal surgeries and may grow to include some cancer treatments. Patients will also be allowed to come back to Concord Hospital for follow-up care after they leave the hospital, said CFO Bruce Burns.

Complex, specialized elective surgeries, including joint replacements or open heart surgeries, will still be offered only at VA hospitals. As always, veterans with life-threatening medical emergencies will be taken by ambulance to the nearest appropriate hospital.

Both the hospital and the VA estimate that Concord Hospital will treat about 600 veterans a year under the new contract. That’s about two-thirds of the approximately 900 New Hampshire veterans who need hospital-based care in the state each year, Levinson said.

Levinson estimated that the new contract will net Concord Hospital about $6 million to $7 million, roughly double what they would have earned under the previous contract.

Concord Hospital won the contract under a competitive bidding process. It entered its bid last summer and learned it had won the contract in September. Burns said Concord Hospital is happy with the rate of reimbursement.

“We hope to build a long-term relationship with them to provide services,” he said. “We see it as a start of a relationship that will hopefully last longer.”

Political figures have long clamored for a full-service veterans hospital in the state, but Levinson said those numbers aren’t enough to make a hospital practical.

Instead, he said, the contract expansion could become a test case for how the VA serves patients who live far from VA facilities. New Hampshire is one of a small number of states without its own full- service center, but veterans living in larger states elsewhere may actually have longer distances to travel if they need hospital- based care.

“This is a model of care that may be of interest to VAs around the country,” he said.