Supporting Veterans’ Health: Community Care Referral and Authorization Program (CCRA)

Case Story

Context

Closer-to-Home Often Helps Veterans

The U.S. Department of Veterans Affairs (VA) aims to provide eligible Veterans the care they need at the right time, from the right provider, in the right place. The right place may mean care is provided by a provider of VA’s Community Care Network (CCN).

Community care benefits Veterans, often times by offering quicker access to quality care closer to their homes. The VA partnership with community care providers ensures Veterans receive the care they earned and deserve.

The Challenge

Healthcare Access Can Be Improved by Reducing Barriers

Prior to CCRA, referral processes were labor-intensive, creating months-long delays that impeded Veterans’ access to care. Administrative burdens, billing issues, and incomplete medical information limited providers’ ability to effectively participate in the program.

Our Innovative Solution

Digital Modernization Speeds Up Access to Care

The CCRA team led the integration of an easy-to-use web-based referral and authorization portal. The solution uses commercial-of-the-shelf technology to seamlessly create a data exchange of referral and appointment data between community providers, the Veteran’s Electronic Health Record, and more than 25 other VA enterprise systems.

A key component of CCRA, the portal generates referrals and authorizations for Veterans receiving care in the community. This secure, cloud-based solution—developed in partnership with InterSystems—operates on Amazon Web Services (AWS) GovCloud to integrate bi-directional exchange of appointment data between community providers, the Veteran’s Electronic Health Record (both VistA and Cerner), and other VA systems. As the first VA project to receive an Authorization to Operate (ATO) for cloud deployment, the CCRA system is rated at FISMA High and optimized regularly to be as responsive as possible to requested changes.

Additionally, the solution integrates with more than 25 other VA systems to allow faster financial and clinical processing. Workflow automation simplifies the referral process, standardizes it to align with industry standards and creates a unified platform for VA and community providers. Most importantly, it decreases the administrative burden on VA staff so they can focus on the patient. CCRA improves Veteran access to care by reducing turnaround time for appointments and streamlines care coordination. The solution is now an integral component of the VA Community Care information technology architecture.

Our Tangible Results

Veterans Receive the Care They Deserve When It’s Customized to Their Needs

By aligning referral processes with industry standards and accelerating the processing of clinical and financial records, this integration ultimately streamlined care coordination and provided a better customer experience (CX) for Veterans nationwide. Turnaround times for appointments were reduced from over 30 days to under one week–a 75% reduction.

The CCRA system has now processed over 25 million referrals, averaging over 650,000 referrals per month.

The success of this program has enabled further enhancements, such as an Emergency Care Reporting (ECR) portal that makes it easier to receive authorizations for emergency care provided with no referral.

The CCRA program has received numerous awards, including the FedHealthIT Innovation Award (2021), the WashingtonExec Pinnacle Award for Government TEAM Project of the Year (2021), and the Granicus Digital Government Changemaker Award (2023).

Cognosante is moving the customer mission forward by delivering exceptional customer experiences that lead to improved outcomes.

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