How Gen. John Bartrum Wants to Turn Community Care from Bureaucratic Maze to Open Highway
The moment that lit the fuse
Room 418 in the Russell Senate Office Building was already stuffy when retired Air Force Maj. Gen. John J. Bartrum—broad‑shouldered, gavel‑ready jaw—leaned into his microphone and dropped a line that sent aides scribbling:
“If a doctor and a veteran decide they need a Community Care referral, that referral should occur. It doesn’t take another doctor or technician to review it.” (Military Times)
Bartrum didn’t stop there. The hoops, he said, had to go. “Veterans … shouldn’t jump through a thousand hoops just because they live too far from a VA clinic.” (Military Times)
For senators weary of five years of testimony about clogged phone lines and opaque approval queues, the promise landed like fresh air.
Why that promise finally has teeth
Ten weeks earlier, VA Secretary Doug Collins had quietly signed away the department’s controversial “second‑doctor” review—meaning a veteran’s own clinician now makes the final call on outside care. The May 19 directive took effect the same day it was announced, framing Community Care as a best‑medical‑interest decision, not a paperwork gauntlet. (VA News)
Under the new rules, the classic bottlenecks—20‑ and 28‑day wait‑time standards and 30‑/60‑minute drive‑time caps—still exist, but they’re no longer the only route to eligibility. (Veterans Affairs)
A $34 billion bet on choice
Follow the money and Bartrum’s marching orders get even clearer. The FY‑2026 budget request spikes Community Care funding from roughly $22.6 billion to $34 billion, a 51 percent leap that would make outside care 39 percent of all VA clinical spending—co‑equal with in‑house services for the first time. (U.S. Department of Veterans Affairs)
Critics worry the price tag will cannibalize hospitals; watchdogs note Community Care already tops $30 billion yet still averages two‑plus weeks just to schedule an appointment. (Axios) Bartrum counters that the money is finally paired with streamlined rules and modern tech.
Wiring the outside world into the VA record
At HIMSS this spring, VA officials touted the Veteran Interoperability Pledge and its sibling Veteran Confirmation API—digital pipes that let civilian EHR systems identify veterans in real time and shove visit notes straight into VA charts. (GovCIO Media & Research, Veterans Affairs)
Bartrum calls Community Care “VA care delivered through a broader network,” a framing that dissolves the us‑versus‑them divide and makes room for virtual programs—from cardiology consults to tele‑Tai Chi sessions—so long as the data flow is seamless. (Military.com)
Where the nomination stands
Bartrum’s paperwork (PN 246‑2) reached the Senate on June 2; the Veterans’ Affairs Committee held its hearing on July 23 and hasn’t yet voted. (Congress.gov) With the chamber’s August recess looming, insiders say the markup could slip to September unless Ranking Member Richard Blumenthal gets more workforce‑reduction data. Still, even skeptical Democrats concede Bartrum is likely to be confirmed in a GOP‑run Senate. (Military Times)
Why it matters to the folks who read this blog
- Faster green‑lights. Clinician‑driven referrals mean fewer denials and shorter queues for rural vets desperate for specialty or wellness options.
- Stable funding. A locked‑in $34 billion pot lets small providers plan multi‑year staffing instead of hopping from pilot to pilot.
- No more fax tag. The Interoperability Pledge’s APIs promise automatic data hand‑offs—goodbye scanning treadmill, hello real‑time outcomes reporting.
- Room for innovation. Bartrum’s “balance” mantra explicitly includes digital modalities; virtual Tai Chi meets every access box he ticked in the hearing. (Military.com)
The road ahead
If the committee votes before recess, Senate floor time is still tight. Miss that window and the confirmation drama resumes after Labor Day—just as FY‑2026 appropriations fights heat up. Either way, the die is cast: red tape has been slashed, dollars are on the table, and a two‑star health‑care wonk is poised to turn Community Care into a true express lane. For nine million veterans—and for every provider ready to meet them where they are—that could be revolutionary.