Many (202 YR 2009) of the VA’s CBOCs are not staffed by VA employees but are employees of Healthcare Management Organization (HMO) type providers under contract with the VA. This may be more desirable in terms of efficiency and lower costs for taxpayers. For example, Humana purchased Valor Healthcare in 2012 to get into the business of veteran outpatient health care.
The ability to rapidly deploy a Veteran-centric facility while providing the absolute highest quality of care is a Humana’s Government Business hallmark. From the time of contract award, we can have a clinic opened, staffed and seeing patients within 90 days.
CBOCs (833 in FY 2010) are also closer to where many rural and urban veterans reside, a good thing. They can be VA-owned and staffed, VA-leased and staffed, or contracted and staffed by private contractors under contract.
In 2009, the break down was:
The above charts come from a Congressional Research Report. Are corporate cultures better than VA-culture in terms of quality care? Just depends.

Story by Mark Brunswick. HIBBING, MINN. – The 6-inch scar running down the middle of Lonnie Lee’s chest is one sign that all might not be well at the Veterans Affairs clinic here. Lee (65) is a Navy veteran of the Vietnam War.
For example, if you want to seen by a privately-contracted PCP in Puget Sound, “Valor HealthCare” operates three and Sterling Medical operates one.
Sterling Medical is hated by veterans at the Hibbing VA Clinic in Northern MN according to a story in the Star Tribune! And Minneapolis (VISN 23) does not disclosure on its website that Hibbing or any others are run by Sterling or any other clinics are managed by HMO. So it comes down to asking questions and doing some research about these clinics. Some non-VA clinics’ staff will be better than VA-owned or leased, others worse. But whoever is managing the clinics should be disclosed by every VA Health Care Network.
Have been to the local hospital twice in one month for Radiologic procedures and had no problems and they were not running 30+ minutes behind. They offered me travel pay for driving 15 minutes and I told them it was not worth the time. Travel time to Denver is usually 1 hour plus to the parking of that hospital. Saved time, money, hassle and gas. Works for me!
Good to know. Did you have any paper work or did the hospital handle everything? Do you know which firm has the contract? This is the way to reduce wait times across the country for basic services that can be done locally and cheaply.
VA sent me the paperwork and requested that I schedule my own appointment times which would be convenient for me. No mention of a firm with a contract. The hospital submitted the bill to the VA for direct payment. So far so good. I believe that the VA may move further forward with this program and that will work well for many of us. One problem I foresee is when you have worked with the same folks over a period of time and need a nexus letter is the VA going to balk? I cannot foresee a civilian doctor listening to the VA not to provide the nexus for us.
I agree with you because the VA tells us that these appointment are temporary. They’ll want to bring you back into the VA fold as soon as possible (wait backlog resolved). But I think those living over 40-miles from a VA clinic or medical center may be safe for a while. The provider treating you should be able to follow-up with you until an issue is resolved I hope.
Another thing that shows how dumb Congress is because demand is up for new enrollees requesting their first primary care visit at the VA. These younger (and older) uninsured veterans are not allowed to buy an Obamacare (ACA) insurance policy AND be in the direct-benefit VA health plan. So younger vets enrolled. Congress does not want vets to be dual-eligible for their VA benefit AND get an insurance plan that might result in a tax subsidy. Yet vets are told that VA is a benefit program, it is not insurance. They are two different categories of programs. The VHA resembles a bad HMO at times. But getting a consult to see a specialist is far faster with an good HMO. So veterans should be allowed to buy into Obamacare if they are self-employed, or their employer doesn’t offer health insurance. And they should be allowed to go to the VA for services as well. Dual-eligibility is cheaper for the taxpayers to foot the bill and results in the best care. Vets deserve a choice.