A Pandemic, A Promise, and A Pivot
How the FTC Team Acted Fast to Support a White House Pledge to Refund over $240 Million in Veteran Copayments During the COVID-19 Crisis
EXECUTIVE SUMMARY
In a Rose Garden Address on April 6, 2020, the President announced a new Pandemic Relief Package to help American citizens through the rapidly escalating global COVID-19 crisis. Included in this sweeping relief package was a commitment to eliminate out of pocket costs for Veterans seeking healthcare for the duration of the crisis. The President’s promise: all copayments made by Veterans and their dependents seeking health services from April 6, 2020 through September 30, 2021 were to be waived or refunded in full to promote Veteran wellness and care during the pandemic.
To deliver on this promise, the Department of Veteran Affairs (VA) required rapid action and tasked the FTC team to set up, enable, and manage an automated workflow within the existing VHA IT environment to re-process more than 9 million bill/copayment refunds made by over 1.5 million Veterans and their dependents since April 6, 2020 – all within a 90-day window. Undaunted by the extensive scale, extremely condensed timeframe, and high-profile nature of this task, the FTC Team rose to the challenge, delivering customer success – and over $240 Million in copayment refunds to Veterans – ahead of schedule.
VETERANS AND THEIR DEPENDENTS SOUGHT HEALTH SERVICES AT THE START OF THE PANDEMIC
COPAYMENTS HAD TO BE IDENTIFIED, FLAGGED AND RE-PROCESSED IN THE EXISTING SYSTEM
IN REFUNDS HAD TO BE MAILED FROM MULTIPLE LOCATIONS
OUR TEAM HAD TO PIVOT FAST TO DELIVER A SOLUTION WITHIN A SHORT WINDOW
THE CHALLENGE
Leveraging the Veterans Health Administration (VHA) Consolidated Patient Account Center (CPAC) Information Technology Sustainment (ITS) contract, the VA tasked the FTC Team to set up, enable, and manage an automated workflow within the existing VHA IT environment to re-process more than 9 million bill/copayment refunds made by over 1.5 million Veterans and their dependents since April 6, 2020 – all within a 90-day window. Undaunted by the extensive scale, extremely condensed timeframe, and high-profile nature of this task, the FTC CPAC ITS Team quickly pivoted its existing IT sustainment roadmap to software development and realigned resources to build a new automated workflow that would enable the VHA system to:
Identify and flag eligible payments from within the VA VistA healthcare system
Process the refund check and credit the payment in the VA Financial Management System (FMS) system
Send the refund to the Veteran or dependent promptly and without error
Redirecting the existing system’s traditionally linear payment processing workflow was no small feat; to make this software development task even more complex, the system also had to process a significantly increased volume in rapid time. Whereas the system typically processed approximately 10,000 payments per week, it now needed to process several tens of thousands of payments per day – to prepare over $240 million in refund checks for distribution from multiple regional CPAC locations. The high visibility of this task meant expediency was of utmost importance. To meet the 90-day deadline and make the President’s promise a reality, the FTC Team had to condense 17 months of refund processing into less than three months’ time.
OUR SOLUTIONS
Applying an Agile framework to maximize efficiency, velocity, and transparency, the FTC Team was able to rapidly pivot and adjust. Strategic Program Increment (PI) planning and development forecasting allowed the FTC Team to effectively “press pause” on their current development roadmap and shift gears into rapid prototype development on behalf of the VA. Using a SAFe Agile framework, daily scrums with VA, VHA, and regional CPAC leadership to report progress, identify roadblocks, and present solutions, allowed the team to iterate and adjust quickly and effectively to stay on track with its expedited timeline. Within two weeks, the team had outlined the entire refund process and helped the VA build a comprehensive timeline for implementation, processing, and delivery of pandemic relief refunds.
When it came time for execution, it was estimated that the re-processing of the more than 9 million bill/copayment refunds would take approximately 21 days to complete. Thanks to the hard work of the FTC CPAC Development Team, FTC was able to deliver a product that allowed the VA to complete their bulk processing of refunds 7 days ahead of schedule. To date, thanks to the FTC Team’s fast pivot, the VA has successfully refunded over $240 Million in Veteran copayments – and canceled more than $880 Million copayments in full.
INSIGHTS
With a global pandemic affecting the lives, health, and livelihoods of American citizens at an unprecedented scale, affordable healthcare and wellness services have never been more urgently needed. While the promise to refund over 1.5 million copayments for Veterans seeking health services during the pandemic may at first have seemed daunting, thanks to the FTC Team’s expert planning, execution, and oversight, a promise made became a promise delivered. The team’s success was due to more than just an exceptional commitment to customer service; the fact that their efforts would result in a first-party payment that would immediately make a direct impact on Veterans and their dependents during a time of global crisis was a call to action that drove this team to go above and beyond in delivering excellence. “This phenomenal success pivoting to a whole new roadmap in a very brief span of time reflects incredible effort across our team,” commented FTC Director Adam Reagan. “Knowing that we were helping relieve a financial burden for Veterans and their families was all the motivation our team needed to get this task done – and fast!”
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