,,ii  #aac? ,,congress  #a/ ,session    
,s4 #affb  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,novemb] #g1 #bjac,mr4 
,mc,connell introduc$ ! foll[+ bill2 :i*
 0 read twice & ref]r$ to ! ,committee  
on ,vet]ans' ,affairs  ,a ,,bill  ,to   
provide = ! introduction (              
pay-=-p]=mance comp5sation me*anisms    
into contracts ( ! ,dep>tm5t ( ,vet]ans 
,affairs ) community-bas$ outpati5t     
cl9ics = ! provision ( heal? c>e        
s]vices1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,vet]ans
 ,heal? ,c>e ,improvem5t ,act ( #bjac4  
#b4 ,f9d+s ,congress makes ! foll[+     
f9d+s3 7#a7 ,vet]ans ( ! ,arm$ ,=ces h  
made trem5d\s sacrifices 9 ! def5se (   
fre$om & lib]ty4  7#b7 ,congress        
recognizes ^! great sacrifices &        
reaffirms ,am]ica's /rong commitm5t to  
its vet]ans4  7#c7 ,z "p ( ! on-go+     
congressional ef=t to recognize !       
sacrifices made by ,am]ica's vet]ans1   
,congress has dramatically increas$     
fund+ = ! ,dep>tm5t ( ,vet]ans ,affairs 

= vet]ans heal? c>e 9 ! ye>s s9ce       
,septemb] #aa1 #bjja4  7#d7 ,"p ( !     
fund+ = ! ,dep>tm5t ( ,vet]ans ,affairs 
= vet]ans heal? c>e is allocat$ t[>d    
community-bas$ outpati5t cl9ics         
7,c,b,o,cs74  7#e7 ,a numb] ( ,c,b,o,cs 
are adm9i/]$ by private contractors4    
7#f7 ,c,b,o,cs adm9i/]$ by private      
contractors op]ate on a capitat$ basis4 
7#g7 ,"s curr5t contracts = ,c,b,o,cs   
may create an inc5tive = contractors to 
enroll z _m vet]ans z possible1 )\t     
ensur+ timely access to high quality    
heal? c>e = su* vet]ans4  7#h7 ,! top   
priorities = ,c,b,o,cs %\ld be to       
provide quality heal? c>e & pati5t      
satisfaction = ,am]ica's vet]ans4  7#i7 
,! ,dep>tm5t ( ,vet]ans ,affairs        
curr5tly tracks ! quality ( pati5t c>e  
?r\gh its ,comput]iz$ ,pati5t ,record   
,sy/em4 ,h[ev]1 fees paid to contractors
 are n curr5tly adju/$ automatically to 
reflect ! quality ( c>e provid$ to      
pati5ts4  7#aj7 ,a pay-=-p]=mance paym5t
 model (f]s a promis+ approa* to heal?  

c>e deliv]y by align+ ! paym5t ( fees to
 contractors ) ! a*ievem5t ( bett] heal?
 outcomes = pati5ts4  7#aa7 ,! ,dep>tm5t
 ( ,vet]ans ,affairs %\ld beg9 to       
emphasize pay-=-p]=mance 9 its contracts
 ) ,c,b,o,cs4  #c4 ,pay-=-p]=mance "u   
,dep>tm5t ( ,vet]ans ,affairs contracts 
) community-bas$ outpati5t heal? c>e    
cl9ics  7a7 ,plan requir$ ,n lat] ?an "o
 ye> aft] ! date ( ! enactm5t ( ?is     
,act1 ! ,secret>y ( ,vet]ans ,affairs   
%all submit to ,congress a plan to      
introduce pay-=-p]=mance measures into  
contracts :i* comp5sate contractors ( ! 
,dep>tm5t ( ,vet]ans ,affairs = !       
provision ( heal? c>e s]vices ?r\gh     
community-bas$ outpati5t cl9ics         
7,c,b,o,cs74  7b7 ,elem5ts ,! plan      
requir$ by subsection 7a7 %all include !
 foll[+3 7#a7 ,measures to ensure t     
contracts ( ! ,dep>tm5t = ! provision ( 
heal? c>e s]vices ?r\gh ,c,b,o,cs beg9  
to utilize pay-=-p]=mance comp5sation   
me*anisms = comp5sat+ contractors = !   
provision ( su* s]vices ?r\gh su*       

cl9ics1 includ+ me*anisms z foll[s3 7,a7
 ,to provide inc5tives = cl9ics t       
provide high-quality heal? c>e4  7,b7   
,to provide inc5tives to bett] assure   
pati5t satisfaction4  7,c7 ,to impose   
p5alties 7includ+ t]m9ation ( contract7 
= cl9ics t provide sub/&>d c>e4  7#b7   
,me*anisms to collect & evaluate data on
 ! outcomes ( ! s]vices g5]ally provid$ 
by ,c,b,o,cs 9 ord] to provide = an     
assessm5t ( ! quality ( heal? c>e       
provid$ by su* cl9ics4  7#c7 ,me*anisms 
to elim9ate abuses 9 ! provision ( heal?
 c>e s]vices by ,c,b,o,cs "u contracts t
 cont9ue to utilize capitat$-basis      
comp5sation me*anisms = comp5sat+       
contractors4  7#d7 ,me*anisms to ensure 
t vet]ans are n d5i$ c>e or face undue  
delays 9 receiv+ c>e4  7c7              
,implem5tation ,! ,secret>y %all comm5ce
 ! implem5tation ( ! plan on ! date t is
 #fj days aft] ! date ( ! submittal ( ! 
plan4 ,9 implem5t+ ! plan1 ! ,secret>y  
may initially c>ry out "o or m pilot    
programs to assess ! feasibility &      

advisability ( me*anisms "u ! plan4  7d7
 ,reports ,n lat] ?an #ahj days aft] !  
date ( ! enactm5t ( ?is ,act & e #ahj   
days !reaft]1 ! ,secret>y %all submit to
 ,congress a report sett+ =? !          
recomm5dations ( ! ,secret>y z to !     
feasibility & advisability ( utiliz+    
pay-=-p]=mance comp5sation me*anisms 9 !
 provision ( heal? c>e s]vices by !     
,dep>tm5t by means 9 addition to        
,c,b,o,cs4