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Community Care

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Patient-Centered Community Care (PC3)

icon PC3 with heart and medical crossPatient-Centered Community Care (PC3) is a nationwide network of community providers that provides eligible Veterans access to primary care, inpatient/outpatient specialty care, mental health care, limited emergency care, and limited newborn care for enrolled female Veterans following the birth of a child.

In instances where you require primary and specialty care that is not readily available through your VA Health Care Facility (HCF), your HCF may use a Patient-Centered Community Care (PC3) contract to purchase your care. Your HCF’s clinical and Non-VA care teams coordinate to determine if the care is available at your HCF, a nearby HCF or another health care partner. If not, they will look to the PC3 contract to buy the care. If you need care, you should always start with your VA health care provider at your local facility.

To locate a facility near you, please visit the VA Facility Locator page.


Availability

Contracts are currently awarded to Health Net Federal Services and TriWest Healthcare Alliance in the following regions:

Health Net Federal Services
  • Region 1: VISNs 1, 2, 3 and 4
  • Region 2: VISNs 5, 6, 7 and 8
  • Region 4: VISNs 10, 11, 12, 19 and 23
TriWest Healthcare Alliance
  • Region 3: VISNs 9, 15, 16 and 17
  • Region 5A: VISNs 18 and 20 (excluding Alaska), VISN 21 (excluding Hawaii and Pacific Islands), and VISN 22
  • Region 5B: VISN 21 – Hawaii and Pacific Islands
    (The Philippines are not covered by PC3 contracts)
  • Region 6: VISN 20 – Alaska
Graphic of a map of the United States and territories showing the Field-Based Implementation Team National Regions

Click on the map to view a larger illustration and a regional breakdown by VISN.

UPDATE: The Department of Veterans Affairs (VA) contract with Health Net Federal Services (HNFS) is ending on September 30, 2018.

HNFS is the third party administrator for the eastern region of the Veterans Choice Program (VCP) and Patient-Centered Community Care (PC3) network. When the contract with HNFS ends, VA will take over all activity previously performed by HNFS. The end of the VA contract with HNFS does not affect the VA contract with TriWest Healthcare Alliance, which administers the western region of the VCP and the PC3 network.

VA will work with Veterans, community providers, and VA staff to transition care coordination from HNFS to your local VA medical facility as seamlessly as possible. No immediate action is needed on your part. However, if you are requesting care in the community, please contact your local VA medical facility to coordinate all care after September 30, 2018. If you are unaware of whom you should contact, visit the VA Facility Locator to find your local facility. Please view the annoucement below for more information.

Health Net Federal Services Contract Close OutFacility and Service Locator

Process for Receiving Care Under PC3

If your VA provider has authorized health care for you through a PC3 contract, you should receive a flyer from your HCF for your respective contractor at the time of referral. You can reference them below:

Veterans Receiving Care from a Health Net ProviderVeterans Receiving Care from a TriWest Provider

Illustration showing the six-step process for receiving primary or specialty healthcare from a PC3 provider


STEP 1: An eligible Veteran visits their VA primary care provider and requires primary or specialty health care that is not readily available at the local VA Medical Center (VAMC).

STEP 2: The Non-VA Medical Care Office authorizes the Veteran for care through PC3 if care is not available through another VAMC, sharing agreement, Academic Affiliate or pilot.

STEP 3: The Veteran is contacted by a regional contractor within five days of authorization to set up an appointment. (The contractor should ensure that the Veteran’s commute is within the standard.) VA sends the medical information to the community care provider.

STEP 4: The Veteran sees the local PC3 provider within 30 days of appointment scheduling.

STEP 5: The Veteran’s records are returned to the VAMC within 14 days for an outpatient visit or within 30 days for an inpatient visit.

STEP 6: VA continues to provide and coordinate patient care. Veterans may be surveyed about their health care experience to give patient feedback which helps ensure PC3 meets Veterans’ needs.

Contract Benefits

PC3 sets contractual requirements* that benefit Veterans and the VA Medical Centers. These contracts:

  • Ensure quality as providers and facilities meet quality standards
  • Provide efficiency as providers help the VA Medical Centers (VAMC) manage high volumes of one type of care. Contractors set appointments and authorizations do not require additional contracting review
  • Convenient for Veterans who can be seen quickly and within required commute times
  • Decrease improper payments as payment rates are defined by the contract and contractors perform an additional level of review to ensure services performed match the authorization and were billed correctly to VA
  • Support care coordination by providing medical documentation back to the VAMC in a timely manner
  • Standardize processes by providing national contract administration and oversight from the VHA Office of Community Care, and integrating into the Community Care Coordination processes
  • Support reimbursement as appointment information provided by the contractor allows for review of third party payer precertification

Contract requirements were developed by VHA clinical, policy, administration and acquisition subject matter experts. The requirements also reflect input from Congress, Veterans Service Organizations and industry.

Contact

We value your feedback, please email us at PCCC.Info@va.gov

Resources

If you are a community provider interested in joining the Health Net or TriWest network, we thank you for your interest. For more information, please visit: