In December 2025, the VA released the request for proposals for Community Care Network Next Generation — a 10-year multiple-award IDIQ contract structure with an estimated lifetime value approaching $700 billion to $1 trillion. Proposals were due in March 2026. By the second half of 2026, third-party administrator transitions will begin reshaping how community care flows through every provider office that sees veterans, including DOs operating the two-hat model. Practices that prepare now will come through the transition with the fewest disruptions.
The current CCN structure that’s being replaced
Today, VA Community Care is administered through five regional contracts. Optum Public Sector Solutions handles Regions 1, 2, and 3 (the eastern and central United States). TriWest Healthcare Alliance handles Regions 4 and 5 (the western states and territories). Every CCN-credentialed DO works with one of these two TPAs based on their geography. Credentialing, authorization, claim submission, and payment all flow through the regional TPA’s portal and processes.
The structure has been criticized in the Government Accountability Office and Office of Inspector General reviews for inconsistency, inadequate oversight, and IT challenges. The current contracts are set to expire in 2026, and the Next Generation procurement is the structural response.
How CCN Next Generation will be different
The Next Generation contract uses an Indefinite Delivery / Indefinite Quantity (IDIQ) vehicle, allowing multiple national and regional health plans to compete for task orders rather than locking each region into a single TPA for years. VA has stated the intent is to broaden the vendor base, including non-large-vendors with regional capabilities. Initial task orders will look similar to current operations, but VA plans to introduce value-based payment models, beginning with episode-based payments for lower-extremity joint replacements and adding at least three additional alternative payment models over the contract performance period.
The structural shift means: more potential TPAs your practice may need to credential with, more variation in submission and authorization workflows, and longer-term, a transition from fee-for-service toward value-based and episode-based payment in some service categories. For DOs with substantial CCN volume, this is a multi-year operational redesign.
If your TPA changes — even partially — your practice will need to recredential under the new TPA, reverify network participation, update payer information in your billing system, and confirm prior authorization continuity for active patients. Even if your TPA stays the same under the new contract structure, internal portal changes, claim format updates, and policy shifts are likely. This is not a back-office task; it’s a multi-month coordination project for any DO with material CCN volume.
The timeline DOs should be planning around
Pre-transition steps for two-hat DOs
The single most important pre-transition step is documentation. Pull together your current CCN credentialing files into a single packet that can be quickly resubmitted under a new TPA’s portal. Include: current malpractice insurance, NPI, taxonomy, state licenses, DEA registration, board certifications (osteopathic and any subspecialty), W-9, hospital privileges if applicable, and any specialty-specific certifications. Renew anything within 90 days of expiration now. A credentialing application sitting in queue at a brand-new TPA is the worst time to discover an expired malpractice cert.
Second, audit your active CCN patient panel. Identify every veteran with an active VA Community Care authorization and note: the issuing TPA (Optum or TriWest), the authorization end date, whether the service is on the standardized 12-month list, and whether continuity of care will be impacted by a TPA transition. This becomes your priority outreach roster the moment a transition affects your region.
Third, identify a single staff member as your CCN transition lead. Even in a small practice, the person responsible for tracking the transition cannot also be the person fielding daily authorization calls — the workload conflict means both jobs get done badly. The transition lead’s responsibilities: monitor VA Office of Integrated Veteran Care announcements, track award news, coordinate recredentialing if needed, and serve as the practice’s single point of contact during the handoff.
How this interacts with the two-hat model
CCN Next Generation affects only the CCN hat — your practice’s role as a VA Community Care provider. The state cannabis evaluation hat operates entirely outside CCN and is not affected by the procurement. For DOs operating in both hats, the practical implication is that the CCN side is going through a significant transition while the state cannabis side is in a parallel but separate transition driven by the April 23 DEA Schedule III order and the June 29 hearing. The two transitions don’t intersect, but they do compete for your administrative attention.
The pre-transition steps for the CCN hat (credentialing packet, patient roster, transition lead) and the pre-transition steps for the state cannabis hat (DEA registration application by June 22, 280E tax planning, Schedule III security and recordkeeping) are entirely separate workstreams. Don’t try to combine them. Manage them as two parallel projects, with separate ownership and separate timelines, and you’ll avoid the most common failure mode in 2026: dropping the ball on one because attention shifted to the other.
- Pull and update your full credentialing packet (malpractice, NPI, licenses, DEA, board certs, W-9)
- Renew any document within 90 days of expiration
- Build an active CCN patient roster with current TPA, authorization end date, and service category
- Identify a single CCN transition lead in your practice
- Subscribe to VA Office of Integrated Veteran Care updates and SAM.gov solicitation notifications
- Document your current Optum and/or TriWest portal credentials, claim formats, and key contacts
- Plan a budget line for transition costs — recredentialing fees, staff time, billing system updates
- Maintain strict separation from state cannabis hat workstream — different lead, different documentation, different timeline
- Review malpractice coverage continuity through the TPA transition
What’s coming in the value-based payment pilot
The Next Generation contract introduces episode-based payment for lower-extremity joint replacements as the first value-based payment model. For DOs whose CCN practice includes orthopedic or related musculoskeletal care, this is the first concrete shift in how VA pays for community care services. Episode-based payment bundles all the care associated with a defined clinical episode (typically pre-procedure evaluation, the procedure itself, post-acute care, and follow-up) into a single payment, with shared accountability for outcomes.
VA has indicated at least three additional alternative payment models will be added during the contract performance period. Watch for which clinical areas come next — chronic pain management, behavioral health, and primary care are commonly mentioned candidates for value-based redesign in healthcare more broadly.
CCN Next Generation is the largest single change to VA community care in seven years. The DOs who come through the transition cleanly will be the ones who prepared their credentialing packets, identified their transition leads, and built their patient rosters before award announcements forced their hand. Combined with the state cannabis hat transition driven by the April 23 DEA order, 2026 is the most operationally complex year for two-hat DOs since the model emerged. Plan separately, execute parallel, document everything.
GovConWire — VA Seeks Offers for Potential $700B CCN Next Gen Medical IDIQ (January 2026)
VA News — VA to improve health care choice and quality for Veterans with new community care contracts (December 2025)
Stars and Stripes — A second chance to improve veterans health care (February 2026)