Consolidated Patient Account Center (CPAC)
VA’s Authority to Bill High Deductible Health Plans
In April 2013, VA Office of General Counsel (OCG) confirmed that VA may bill and accept reimbursement from high deductible health plans (HDHPs) for medical care and services provided to Veterans for non-service connected conditions. An HDHP is a health plan with an annual deductible of at least $1,250 for an individual or $2,500 for a family. An HDHP may provide coverage for preventive medical care or services without the deductible having been met by a covered individual.
OGC also confirmed that VA may accept reimbursement from employer-sponsored health reimbursement arrangements (HRAs) – also referred to as health reimbursement accounts – for care and services provided for non-service connected conditions.
Finally, the opinion clarified that Veterans may use their health savings accounts (HSAs), often linked to HDHP plans, to pay their VA first party copayments.
Veterans benefit in several ways from VA’s efforts to collect funds from private insurers for these increasingly common types of health insurance plans. Read VA’s new fact sheet on VA health insurance billing for more information.
CPAC Featured on VA News
VA News — a weekly video news program providing timely news and information about the Department of Veterans Affairs — recently featured a piece about the completion of national CPAC implementation.
Click here to see the piece. (The CPAC story starts at time code 10:47.)
National CPAC Implementation Completed
On September 24, 2012, the last VA Medical Center (VAMC) transitioned into the CPAC model, marking the official completion of national CPAC implementation. This significant milestone was achieved through an excellent collaboration between the Chief Business Office (CBO) and field leadership. Most critically, the deployment was completed one year ahead of the schedule mandated in public law and under budget.
Over the past four years, seven state-of-the-art business centers located in both commercial locations as well as on VA medical center grounds opened to provide the best setup for operations based on industry best practice. Additionally, over 3,500 high quality staff members were hired to perform core revenue cycle functions including insurance verification, billing, utilization review, and accounts receivable follow-up. These staff received training and education on business tools to ensure VA not only meets but exceeds collection targets. Finally, internal controls and quality assurance programs were set up to ensure the integrity of the work produced over the long term.
The results of the CPAC model are evidenced not only by the $30 million collections improvement in FY 12 versus the prior year but also with regard to improved performance metrics. Specifically, days to bill improved 4.0 days (from 42.4 days in FY 10 to 38.4 days and accounts receivable over 90 days improved by 5.5 percent (from 27.7 percent in FY 10 to 22.2 percent).
Through the implementation of CPAC, CBO is using industry-proven business processes to provide world-class revenue cycle management. Like the agency’s ongoing commitment to continually improve clinical care, a commitment to excellence in revenue practices strengthens our nation’s ability to meet Veterans’ healthcare needs.
Secretary of Veterans Affairs Visits Central Plains CPAC
Secretary of Veterans Affairs Eric K. Shinseki visited the Central Plains Consolidated Patient Account Center (CPCPAC) on June 12, 2012, while in Leavenworth, Kansas, to announce that the department would add approximately 1,600 mental health clinicians as well as nearly 300 support staff to its existing workforce. Secretary Shinseki was given a tour of the new center by the CPCPAC Director David Isaacks. While inside, he walked around various departments, shaking hands with and meeting CPAC staff.
CBO Celebrates Openings of Three New CPAC Facilities
In the fall of 2011, CBO celebrated the openings of the North Central, West, and North East CPAC facilities.
North Central CPAC: The North Central CPAC (NCCPAC) held a ribbon cutting ceremony September 13, 2011 to officially open its newly renovated center in Middleton, Wisconsin. Occupying more than 44,000 square feet, the NCCPAC provides revenue activities for 19 VA treatment locations within Veterans Integrated Service Networks (VISNs) 10, 11, and 12.
West CPAC: The West CPAC (WCPAC) held a ribbon cutting ceremony November 8, 2011 to officially open its newly renovated center in Las Vegas, Nevada. The WCPAC comprises 50,828 square feet and provides revenue activities for 26 VA treatment locations within VISN 18, 20, 21, and 22. Once fully staffed, the WCPAC will employ a total of approximately 520 staff to include facility-based CPAC staff that will be located at each of the serviced VA medical centers within the western region.
North East CPAC: The North East CPAC (NECPAC) held a ribbon cutting ceremony November 16, 2011 to officially open its 65,000 square foot center in Lebanon, Pennsylvania on the campus of the Lebanon VA Medical Center (VAMC). The NECPAC provides revenue services to VISNs 1, 2, 3 and 4. Once fully staffed, this center will employ approximately 630 employees including individuals based in Lebanon as well as in each VAMC serviced across their region.
CPAC Executive Director Appointed
The Chief Business Office (CBO) is pleased to announce that Mr. Tony Bennett has been appointed as the CPAC Executive Director effective Sept. 25, 2011. Mr. Bennett comes to us most recently as the Medical Center Director at the James E. Van Zandt VA Medical Center in Altoona, PA. Prior to that assignment, Mr. Bennett served as the Chief Operating Officer at the Tennessee Valley Healthcare System (TVHS) from May 2003 to April 2008 and before that he served at the Ralph H. Johnson VA Medical Center, Charleston, South Carolina, as the Chief Financial Officer from 1991 and the Business Office Service Line Director from 1998. Mr. Bennett served as the Chief Financial Officer at the VAMC, Louisville, Kentucky from 1989 to 1991 and at the VAMC Fayetteville, North Carolina from 1985 to 1989. Mr. Bennett served in several financial positions at the VAMC Albuquerque, New Mexico, VAMC Chillicothe, Ohio, and the VAMC Tuscaloosa, Alabama.
Mr. Bennett began his VA career in 1977 as a medical clerk at the VAMC Mountain Home, Tennessee. He is an Air Force Veteran, serving on active duty from March 1974 to September 1977. Mr. Bennett earned a B.S. Degree in Business Administration with a major in accounting from Steed College in 1981 and completed several graduate level courses at Campbell University, Fayetteville, North Carolina. Mr. Bennett is a graduate of VA’s Healthcare Leadership Institute Program and is a Fellow of the American College of Healthcare Executives. Mr. Bennett will be working out of the Mid-South CPAC in Smyrna, Tennessee. The Chief Business Office and CPAC Program Management Office welcomes Mr. Bennett to his new role, and we look forward to his leadership.
Opening of Central Plains CPAC Celebrated
(August 31, 2011) The Central Plains Consolidated Patient Account Center (CPCPAC) held a ribbon cutting ceremony, Wednesday, August 31, 2011 to officially open the newly renovated facility in Leavenworth, Kansas on the Dwight D. Eisenhower VA campus. The ribbon cutting ceremony represents a cooperative effort as we aim to improve care and services provided to our nation’s Veterans by ensuring the most efficient practices are in place. This newly renovated state-of-the-art facility occupies 66,054 square feet to allow for optimal workflow and communications between co-workers. The Central Plains CPAC provides revenue activities for 24 VA treatment locations within Veterans Integrated Service Networks (VISN) 15, 19, and 23. Once fully staffed, the CPCPAC will employ approximately 520 staff, including the 120 facility-based CPAC staff who will be located at each of the serviced VA medical centers within the Central Plains region (Missouri, Kansas, Illinois, North Dakota, South Dakota, Minnesota, Iowa, Nebraska, Montana, Wyoming, Utah, and Colorado).
CPAC Implementation Reaches Halfway Point
(May 1, 2011) Implementation of the Consolidated Patient Account Center (CPAC) program has nearly reached the halfway point with more than 63 out of 153 VA medical centers now being served by a regional CPAC for revenue operations.
CPAC began when the Mid-Atlantic CPAC was established in 2006 with a pilot program to service Veterans Service Integrated Network (VISN) 6. After the pilot demonstrated that standardized business practices and centralized operations could improve revenue operations, Congress authorized the expansion of CPAC throughout the Veterans Health Administration.
The CPAC business model calls for the establishment of seven regional account centers throughout the United States. The first to be fully operational (in fiscal year 2009) was the Mid-Atlantic Consolidated Patient Account Center (MACPAC), headquartered in Asheville, NC. The Mid-South (MSCPAC) and North Central CPACs (NCCPAC) became fully operational in FY 2010. And the Florida Caribbean CPAC (FCCPAC) completed transition in January 2011.
The three remaining regional CPACs will be fully implemented by the end of FY 2012. The North East CPAC (NECPAC) will serve VISNs 1, 2, 3, and 4 while the Central Plains CPAC (CPCPAC) will support VISNs 15, 19, and 23. The West CPAC (WCPAC) will handle revenue operations for VISNs 18, 20, 21, and 22.
According to Stephanie Mardon, Deputy Chief Business Officer for Revenue Operations, “Reaching the halfway point is a significant milestone for the CPAC program. An undertaking of this size and complexity is a challenge but we’ve learned a great deal from our experience and will apply those lessons to the implementation of the final three CPACs.”