The company the U.S. Department of Veterans Affairs hired to oversee care from private providers insists it’s working out the kinks with the new program, even as demand skyrockets.

David McIntyre Jr., president and CEO of TriWest Healthcare Alliance, the company tasked with establishing contracts with outside providers in the 28-state region that includes Oregon, said TriWest went from receiving about 40,000 appointment requests per month in August 2015 to more than 100,000 per month today.

“This thing has shot off like a rocket, ” he said.

The VA in fall 2014 unveiled its new Veterans Choice Program, which allows veterans to get care in communities if they live far from VA facilities or have to wait longer than 30 days for appointments. But following the program’s launch, countless veterans nationwide complained it wasn’t working, citing breakdowns in communication between the VA, TriWest and private providers.

McIntyre visited St. Charles Bend in August 2015 promising to decrease the amount of time veterans had to wait between requesting appointments through Choice and scheduling them. Under Choice, that’s supposed to happen within five days of the initial call. McIntyre told the crowd in Bend he hoped to be there by November 2015, but that didn’t happen.

Veterans are waiting an average of 6.3 days to schedule appointments, he said. They are waiting an average of 19 days to see providers once those appointments are scheduled, he said.

“We’re chasing the demand curve,” he said, “but we are pretty close to being stabilized now.”

Here’s how the Choice Program works: Veterans call TriWest to determine their eligibility and enroll in the program (all veterans received Choice cards in the mail, but that doesn’t mean they’re all eligible). If a veteran is eligible for Choice because he or she lives more than 40 miles from the nearest VA facility that provides the service he or she needs, the veteran should call TriWest directly to schedule an appointment through the Choice Program.

If the VA tells a veteran he or she has to wait more than 30 days for an appointment, the VA will send TriWest that person’s name. In those cases, TriWest sends authorizations to both the veteran and the private provider, and veterans will usually receive a call from the provider to schedule an appointment, Daniel Herrigstad, a spokesman for the VA Portland Health Care System, wrote in an email.

That means the number of veterans enrolled in the Choice program is larger than the number of appointments requested. And since many of the problems appear to enter when veterans attempt to schedule appointments, enrollment figures are less important than the number of appointments requested.

“I don’t measure what we do based on how many people enroll,” McIntyre said. “There is a high enrollment, but the percentage of people actually using the card has continued to climb.”

In Central Oregon, 1,110 veterans used the Choice Program between July 2015 and January 2016, including 831 in Deschutes County, 187 in Crook County and 92 in Jefferson County.

Demand has shot up in the tri-county area since July. In Deschutes County, 318 veterans requested appointments in January — a more than threefold increase since last summer — 76 requested appointments in Crook County — just less than a threefold increase since last summer — and 51 requested appointments in Jefferson County — a nearly fourfold increase since last summer.

To meet the demand, TriWest has been working to expand the number and types of providers it contracts with, McIntyre said. TriWest now has Choice contracts with more than 160,000 providers. (That includes only states west of the Mississippi River. HealthNet is administering the Choice Program in states east of the Mississippi River.) Last summer, that number was about 90,000. In Central Oregon, 1,066 private providers had contracted to provide care through the Choice program as of January, up about 300 from last summer, McIntyre said.

But the program still has major hang-ups for some veterans. Bend resident 59-year-old James Darcy Jr., has a number of spinal issues, including what he said is a bone spur, three shot discs and a cyst. He’s in severe pain. Darcy said his doctor at the Bend VA outpatient clinic told him he could have X-rays done at St. Charles Bend through the Choice Program because the outpatient clinic doesn’t offer them. He called TriWest two Thursdays ago and was told he had been approved to get the X-rays at St. Charles. He went there Friday and waited, by his estimate, about three hours while staff members there tried to get approval from TriWest. He did the same last week, Monday and again Tuesday. He said he finally had the X-rays done on Tuesday afternoon.

He said, “It literally got to the point where I was so angry Monday that I was sitting there in tears.”

— Reporter: 541-383-0304,

tbannow@bendbulletin.com