Patient-Centered Community Care (PC3)
Patient-Centered Community Care is a Veterans Health Administration (VHA) nationwide program that utilizes health care contracts to provide 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 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 Directory page.
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:
- For Veterans Receiving Care from a Health Net Provider
- For Veterans Receiving Care from a TriWest Provider
Contracts have been 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, 20 (excluding Alaska), 21 (excluding Hawaii and Pacific Islands) and 22
- Region 5B: VISN 21 – Hawaii and Pacific Islands
(The Philippines are not covered by PC3 contracts)
- Region 6: VISN 20 – Alaska
You can also learn more about PC3 on the current contractor websites:
Process for Receiving Care Under PC3
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 non-VA 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.
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 Non-VA 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.