he Department of Veterans Affairs no longer expects to deliver every health care encounter inside its own walls. Roughly four in ten VA health care appointments now happen in private clinics, hospitals, and therapy offices — through what VA calls the Veterans Community Care Program, administered through the Community Care Network, or CCN. If you are a licensed clinician practicing anywhere in the United States, you have likely already treated a veteran through this system. What changes in 2026 is the operating picture around it.
The 60-Second Picture
- Two TPAs administer CCN: Optum (Regions 1, 2, 3) and TriWest (Regions 4, 5).
- CCN Next Generation is in market research; the current contracts continue to operate.
- Claims with dates of service on or after January 1, 2026 have been temporarily held for VA and CMS rate validation.
- Veterans Care Agreements (VCAs) remain a three-year alternative path for services where CCN coverage is insufficient.
- HSRM, EPS, and HPP are the three acronyms every CCN-participating practice needs to know.
The Two-TPA Structure
VA does not directly contract with the tens of thousands of community clinicians who treat veterans. Instead, VA contracts with two Third Party Administrators — TPAs — and the TPAs build, credential, and manage the networks. Optum Public Sector Solutions, part of UnitedHealth Group, administers CCN Regions 1, 2, and 3, which cover most of the eastern and central United States. TriWest Healthcare Alliance administers Regions 4 and 5, which cover the western United States and Alaska.
Which TPA you work with is determined by the region your practice is located in, not the veteran’s region. A practice in Florida joins Optum’s Region 3 network. A practice in Arizona joins TriWest’s Region 4 network.
| TPA | Regions | Geography |
|---|---|---|
| Optum | Region 1 | Northeast / Mid-Atlantic, including Washington, D.C. |
| Optum | Region 2 | Southeast and parts of the Midwest |
| Optum | Region 3 | South-Central states and certain territories |
| TriWest | Region 4 | Western states and parts of the Pacific |
| TriWest | Region 5 | Alaska |
How a Practice Joins
Path one: joining CCN through Optum or TriWest
Practices submit enrollment documentation directly to the TPA for their region. The TPA completes credentialing, executes a contract, and issues the practice the credentials it needs to begin accepting referrals. Practices must accept Medicare reimbursement to be eligible. Dental practices follow a separate path — Optum routes dental enrollment in Regions 1–3 through Logistics Health, Inc. (LHI), while TriWest handles dental in Regions 4 and 5.
Path two: a Veterans Care Agreement (VCA)
A VCA is a three-year direct agreement between an independent practice and a VA medical facility. VCAs exist for situations where CCN services are unavailable or insufficient — usually highly specialized care, certain geographic gaps, or services not in the CCN scope. Practices under a VCA are credentialed through VA’s own Credentials Verification Organization (CVO) contractor.
One Detail That Trips Up New Practices
Once enrolled, claims go to the TPA, not directly to VA — except for VCA care, which is billed to VA itself. Mixing those up is the single most common reason claims sit in pending status for weeks. Bookmark the right address for your contract type before your first patient walks through the door.
What Changed for 2026
The CCN Next Generation contract
VA’s Office of Integrated Veteran Care has been preparing a successor contract known as CCN Next Generation. As of early 2026, the program is in its market research phase. The intent is to incorporate lessons learned from the current CCN, streamline community care processes, and introduce industry best practices. The current Optum and TriWest networks remain the operating environment for the foreseeable transition window.
The January 1, 2026 claims hold
TriWest publicly notified network practices that claims with dates of service beginning on or after January 1, 2026 are being temporarily held to allow validation of updated VA and CMS reimbursement rates. The hold is expected to be temporary and not exceed thirty days. For practices with significant veteran volume, this is a cash-flow signal worth modeling into the first-quarter forecast.
The Senator Elizabeth Dole Act adjustments
The Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, signed in 2025, removed the secondary review requirement that previously slowed “best medical interest” community care determinations. For independent practices, this means more veterans arriving on referral with shorter VA processing times — particularly for community mental health referrals where the bottleneck had been most pronounced.
The Three Acronyms Every CCN Practice Should Know
HSRM — HealthShare Referral Manager
VA’s electronic referral and documentation exchange system. CCN practices use HSRM to receive referrals, view authorizations, and upload medical documentation back to the authorizing VA facility. Medical records returning to VA are not optional — they are how the veteran’s VA care team maintains continuity and how future referrals get approved.
EPS — External Provider Scheduling
EPS allows VA schedulers to book appointments directly into a community practice’s scheduling system. Appointments can be scheduled in under six minutes, eliminating phone-tag cycles. Practices considering CCN participation at scale should weigh whether their practice management system is EPS-compatible.
HPP — High Performing Provider designation
The TPAs analyze practice performance against quality metrics. Practices that consistently meet or exceed those measures earn the HPP designation, which VA staff consider during veteran appointment scheduling. HPP is not something practices apply for — it is awarded by the TPA, and it changes how often your practice surfaces in the veteran’s scheduling experience.
The Operational Question Underneath All of This
None of this is conceptually difficult. The difficulty is that government payer participation rewards practices that have the back-office capacity to absorb credentialing cycles, prior authorization workflows, claims follow-through, and the documentation rhythms VA requires. That is the gap the Direct Care Support Professional Hub exists to explain.