Thousands of West Texas veterans may soon find that “aging in place” now comes with a mandatory road trip—because the VA just slashed reimbursement rates for rural home health care providers by a casual 43% across 247 Texas counties. This new rate structure kicked in this month and is part of a statewide “standardization” effort, which is bureaucratic code for pretending Spur is basically Houston.
Local providers say the math doesn’t work when your nurse has to drive 40–60 miles just to knock on a veteran’s door. Under the new system, the VA pays one flat statewide rate and only starts the clock once the caregiver arrives—meaning the gas, time, and wear-and-tear it takes to actually get there is now a fun little donation from already-struggling agencies.
Providers warn this will reduce services, push agencies to stop accepting VA patients, and—ironically—send more veterans into hospitals or nursing facilities. You know, the places that cost dramatically more than home care. As one Lubbock provider put it, one day in the hospital costs more than two months of in-home services, but apparently spreadsheets don’t do irony.
The VA says its home health programs were never meant to provide long-term care and suggests veterans talk to social workers about alternatives. Meanwhile, advocates point out this move undercuts the whole point of the 2018 VA Mission Act, which was supposed to expand community-based care, not quietly price it out of existence in rural America.
So the VA’s big solution for rural veterans is… less care, more driving, and a polite suggestion to call someone else. But hey, at least the rates are “consistent,” right?