ederal healthcare programs have a way of generating acronyms faster than clinicians can absorb them. CCN, TPA, NPI, VCA, MISSION Act, EHR, EMR, HSRM, EPS, HPP. Most of them you can ignore in daily practice. Three you cannot.
HSRM, EPS, and HPP are the three operational systems that determine whether a CCN-participating practice receives referrals on time, schedules appointments efficiently, and surfaces favorably in the veteran’s care experience. Practices that understand them well operate cleanly. Practices that do not spend a lot of time wondering why referrals do not arrive or why claims sit in pending status.
The Three Acronyms
- HSRM (HealthShare Referral Manager) — VA’s electronic referral and documentation exchange system. The pipeline for receiving referrals and returning clinical records.
- EPS (External Provider Scheduling) — VA-side scheduling system that allows VA staff to book directly into a community practice’s calendar.
- HPP (High Performing Provider) — Quality-based designation awarded by TPAs that affects how often a practice surfaces in veteran scheduling.
HSRM — HealthShare Referral Manager
HSRM is the system. If a CCN practice does only one thing well operationally, it should be HSRM hygiene. HSRM is how VA sends referrals out and how clinical documentation comes back. Every authorized community care encounter — primary care, specialty care, surgical care, behavioral health, ancillary services — generates an HSRM record. That record is the legal and operational basis for the encounter.
What HSRM does
On the inbound side, HSRM delivers the referral to your practice. It contains the veteran’s identifying information, the authorized service, the authorization number (which is also the billing reference), the reason for referral, the relevant clinical context, and the documentation expectations for the return.
On the outbound side, HSRM is where the community practice uploads the encounter documentation back to VA. Operative reports, consultation notes, imaging results, treatment plans, follow-up recommendations — all of it flows through HSRM to the authorizing VA medical facility.
The deadline
VA’s stated expectation is that documentation returns “as soon as possible after care has been provided.” In operational practice, the standard is within seven business days. Practices that consistently hit that window build trust with the authorizing VA facilities, which translates into smoother future referrals and faster authorization renewals.
The Most Common Mistake
Practices new to CCN sometimes treat HSRM documentation as optional — a courtesy to send back if there is time. It is not. Without the record back at VA, the veteran’s primary care team cannot adjust their care plan, cannot prevent medication conflicts, and cannot authorize the next referral cleanly. The patient experiences the gap as a system failure. Practices that miss the HSRM return consistently get fewer future referrals.
EPS — External Provider Scheduling
EPS is the system that lets VA schedulers book appointments directly into a community practice’s scheduling system. Pre-EPS, scheduling a veteran into a community appointment was a multi-step phone-tag exercise: VA scheduler calls practice, practice offers time slots, VA scheduler calls veteran, veteran picks slot, VA scheduler calls practice back, practice books it, confirmation goes back to VA. Days of delay for a single appointment.
EPS collapses that to under six minutes. The VA scheduler sees the practice’s real-time availability, books directly, and the appointment is confirmed immediately on both sides.
The catch
EPS only works if your practice management system is EPS-compatible. Many of the major systems are. Some are not. Practices on EPS-compatible systems see noticeably faster referral flow because VA schedulers can fill appointments quickly. Practices on non-compatible systems are still in the phone-tag world.
For practices evaluating CCN participation at scale, EPS compatibility is worth checking with your practice management vendor. For practices already in CCN with an older system, an EPS-compatible upgrade may pay for itself through reduced front-desk scheduling time alone.
HPP — High Performing Provider Designation
HPP is the quality-based designation that affects how often a practice surfaces in the veteran’s appointment scheduling experience. The TPAs — Optum and TriWest — analyze practice performance against a set of quality metrics: clinical outcomes, patient satisfaction, cost-effectiveness, guideline adherence, documentation completeness.
Practices that consistently meet or exceed those measures earn the HPP designation. Practices with the designation are surfaced more frequently during VA-side scheduling. Veterans booking community care, particularly when given a choice of practices, are more likely to land at HPP-designated practices.
What you cannot do
HPP is not something a practice applies for. There is no application form, no fee, no certification process. The TPAs award it based on observable performance data. Practices cannot pay for HPP, cannot petition for HPP, and cannot accelerate HPP through marketing efforts.
What you can do
What practices can do is operate well. HSRM documentation returned on time. Clean billing. Strong outcomes data where the practice management system captures it. Patient satisfaction. Practices that do those things well generally earn HPP within the first year or two of participation. Practices that do not, do not.
The Strategic Read
HSRM is the operational floor — fail at it and your participation in CCN suffers immediately. EPS is the operational lubricant — get on it and your scheduling flow improves measurably. HPP is the long game — it is the cumulative result of doing the first two well. Practices that sequence their attention in that order tend to thrive.
The Underlying Principle
All three acronyms have something in common: they are systems VA built to make community care work at scale. They reflect lessons learned from the patchwork of programs that preceded the MISSION Act, where referrals sometimes got lost, scheduling sometimes took weeks, and quality sometimes varied widely without VA having visibility into it. HSRM, EPS, and HPP are the operational answer to those problems.
A practice that engages with all three is operating inside a system designed for veteran care to flow. A practice that engages with none of them is operating outside that system, with predictable friction. The practical work for any CCN-participating direct care provider is to learn all three early and operate them well.