Key Takeaways
- •The VA released RFPs for its "NextGen" community care contracts and a national dental contract, aiming for innovation, competition, and accountability in veteran healthcare delivery.
- •Michael Topping outlined NextGen's five pillars: quality, value-based payments, utilization management, and program integrity, projecting $54-100 billion in savings over the contract life.
- •Sen. Blumenthal (Democratic-CT) pressed Michael Topping on the 530% increase in community care funding versus 200% for direct care, questioning the disparity and current lack of quality data.
- •Republicans emphasized expanding veteran choice and simplifying community care access, while Democrats stressed protecting direct VA care and increasing oversight of community care spending and quality.
- •NextGen contracts are expected to be awarded in January 2027, with a one-year implementation period, as the VA builds internal program management for oversight and accountability.
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Hearing Analysis
Overview
On February 11, 2026, the Senate Veterans' Affairs Committee held a hearing to examine the future of the Department of Veterans Affairs (VA) community care system, specifically focusing on the "NextGen" Community Care Network (CCN) contract procurement. Chairman Jerry Moran (R-KS) and Ranking Member Richard Blumenthal (D-CT) presided over the session, which addressed the transition of the VA’s community care infrastructure into a more modern, accountable, and sustainable system. The hearing followed the December 2025 release of a Request for Proposals (RFP) for the NextGen contract, a 10-year, trillion-dollar initiative intended to succeed the current Third-Party Administrator (TPA) model.
Key Testimony
The primary witness, Michael Topping, VA Assistant Secretary and Chief Financial Officer, detailed the "NextGen" framework. He described it as a multiple-award Indefinite Delivery, Indefinite Quantity (IDIQ) contract designed to increase competition by allowing both national and regional health plans to bid. Topping outlined five pillars of the new system: quality, value, alternative payments, utilization management, and program integrity. He emphasized that for the first time, the VA would implement industry-standard quality measures and value-based payment models, such as episode-based payments for joint replacements. Topping projected that these reforms would generate between $54 billion and $100 billion in savings over the life of the contract by reducing unnecessary hospitalizations and improving fraud detection.
Julie Kroviak, Principal Deputy Assistant Inspector General for the VA Office of Inspector General (OIG), provided a more cautious perspective. She highlighted persistent challenges in the current community care program, including $4 billion in improper payments identified since 2021. Kroviak noted that current TPAs often fail to return medical records to the VA promptly and that the OIG has historically struggled to obtain documents from community providers without subpoenas. She urged the VA to ensure the NextGen contracts include explicit requirements for data sharing and adherence to VA opioid safety guidelines. Alicia Skolrud, Executive Director of Integrated External Networks for the VA, added that the new contracts would also include a separate national dental community care contract to address specific niche needs in veteran dental health.
Overview
Partisan dynamics were evident throughout the hearing. Republican members, including Chairman Moran and Sen. Dan Sullivan (R-AK), focused on the importance of veteran choice and the removal of bureaucratic barriers. Chairman Moran expressed concern over reports that VA staff sometimes manipulate clinical dates to discourage veterans from seeking community care, a violation of the MISSION Act of 2018. Sen. Sullivan and Sen. Tim Sheehy (R-MT) emphasized the unique needs of "frontier" and rural states, where community care is often the only viable option. They pushed for regional flexibility in the NextGen contracts to ensure that high-cost, remote areas like Alaska and Montana are not left without bidders.
Notable Exchanges
Conversely, Democratic members expressed significant concern regarding the rapid growth of community care spending. Ranking Member Blumenthal noted a "staggering" 530 percent increase in community care funding since 2019, compared to a 200 percent increase for VA direct care. He and Sen. Tammy Duckworth (D-IL) questioned whether the shift toward community care was effectively a "blank check" that could lead to the privatization of the VA and the erosion of direct care staffing. Sen. Duckworth pointed out that while the VA claims veterans prefer community care, the department currently lacks the data to benchmark the quality of community care against VA direct care—a gap Topping admitted exists but claimed NextGen would fix.
Overview
Notable exchanges occurred regarding the "zero-day record" issue. Sen. Sheehy criticized the lack of a seamless medical record transfer between the Department of Defense (DOD) and the VA, noting that veterans often have to undergo redundant physical exams upon separation. Topping confirmed that Secretary Collins and Secretary Hegseth are personally engaged in resolving this to ensure records transfer on "day zero." Another significant moment involved Chairman Moran recounting an "unacceptable anomaly" where a veteran in Kansas was forced to travel an hour to a VA facility for his final two cancer treatments after receiving the first 15 in his local community, simply because he lived 59 minutes away rather than the 60-minute threshold. Topping assured the committee that NextGen’s utilization management would focus on "episodes of care" to prevent such disruptions.
Key Testimony
The committee also discussed the ACCESS Act, a bipartisan bill aimed at expanding community care access for mental health and addiction services. Topping stated that the VA supports the goals of the ACCESS Act and that the NextGen contract vehicle is being built to be compatible with the legislation’s requirements.
In terms of next steps, Topping testified that the NextGen contracts are expected to be awarded in January 2027, followed by a one-year implementation period. The VA committed to providing the committee with a detailed 10-year investment plan for direct care facilities to balance the growth in community care. Chairman Moran closed the hearing by requesting that the VA be more responsive to previous information requests, particularly a letter sent by him and Ranking Member Blumenthal regarding the Secretary’s vision for VHA modernization. Organizations mentioned during the hearing included the Agency for Healthcare Research and Quality (AHRQ), the Government Accountability Office (GAO), and various Tribal Health Organizations.
Transcript
Good afternoon, everyone. Thank you for your presence. Welcome to our this week's hearing. Two weeks ago, we had the opportunity to discuss with Secretary Collins his vision for bringing the organizational and governance structure of the VA's direct care into the 21st century. Today, we're here to discuss how to achieve that same goal for the VA's community care system. Health care is local, and for many veterans in Kansas and across the country, the ability to see a doctor in their community is not a luxury, it's an essential part of their health care and well-being and the ability to use the VA health care benefits they earned through their service. Congress recognized the reality of this circumstance in 2018 with the enactment of the MISSION Act. The MISSION Act intended to make certain that no veteran, no veteran would be limited by geography, long wait times, bureaucratic barriers, the need for specific kind of care in seeking care from the VA, and that every veteran would have the opportunity for meaningful choice in where and how they receive their care they require. This afternoon, we're here to discuss where the VA has made strides in delivering on that promise and where it's fallen short. We will also discuss where improvements are needed to make the VA's community care program stronger, more sustainable, and more successful by putting the veteran first, expanding meaningful choice, and providing care when and where veterans need it and want it. To that end, I was encouraged to see the VA release a request for proposals in December for the next generation of community care network contract, followed yesterday by a separate request for proposals to establish a national dental community care contract. In many ways, these procurements reflect a welcome focus on innovation, competition, and accountability. They also signal a long overdue progress toward upholding industry standards, embracing value-based care, strengthening program integrity, and addressing persistent challenges such as timely return of medical documentation that have frustrated veterans, providers, and policymakers alike. Achieving these lofty goals can't be easy. The contracts must do more than look good on paper. The VA must deliver results for veterans, VA staff, and community care providers and taxpayers by leading to real measurable improvements in access, choice, outcomes, and costs. I look forward to hearing from the VA witnesses this afternoon about how the department can meet that mission and how this committee can support them. With that, I recognize the ranking member, Senator Blumenthal.
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