Health Services Research & Development

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VA Priorities and VHA Strategic Plans

2019 VA Priorities

The U.S. Department of Veterans Affairs (VA) is undergoing a major reorganization to transform the way it provides services for its Veterans nationally. This transformation has already involved new legislation such as the VA Maintaining Systems & Strengthening Integrated Outside Networks (MISSION Act). The MISSION Act focuses on community care program implementation, including the coordination of VA and non-VA care, virtual care (e.g., telemedicine), use of value-based payment models, enhancing access to and quality of care in VA medical service lines, and improving access to and quality of care in medically underserved areas. With the implementation of the MISSION Act, Veterans are being given more options for where to receive care, and more care is being delivered in the community outside the VA Healthcare System. Overall the MISSION Act involves a dramatic shift in the delivery of VA health care services and evolution of the Veterans Health Administration (VHA)'s role as a payer in addition to provider of health care for millions of Veterans nationwide. This follows a period of other major national initiatives within VHA, including the national deployment of patient-centered medical homes, implementation of new telehealth and connected health programs, promotion of patient-centered care, and adoption of several specialty-care transformational initiatives, among others.

Updated VA priorities and modernization efforts (see Table below) bring forth additional opportunities for researchers to facilitate VA's further transformation into a Learning Healthcare System. Specifically, the Learning Healthcare System as described by the National Academy of Medicine involves the alignment of science with clinical priority goals to conduct more rapid and efficient studies that leverage existing data to deploy and evaluate innovations and spread of effective practices. VA has a unique opportunity to take the concept of the Learning Healthcare System to the next level through rigorous, time-sensitive studies that evaluate the effectiveness and/or implementation of new national programs or policies that address VA leadership priorities. In concert with its strive towards a Learning Health Care System, VA is also focused on becoming a High-reliability Health Care System, particularly in response to recent reports by the Government Accountability Office and the VHA Commission on Care to ensure VA care is provided optimally and consistently across different settings.

Table: VA Priorities

Greater Choice for Veterans

Driven by clinical rather than administrative requirements (no more 40-mile, 30 day rule)

Alternative payment methodologies (i.e. pay for quality)

Expanded provider agreements to create high performing integrated networks

Modernize accounting practices

Implementation of the “Forever GI Bill”

Modernize our systems

Infrastructure improvements and streamlining services

EMR interoperability (Cerner) with DoD and private sector and IT modernization

Emphasis on veteran and employee experience

Field based functional groups

Priorities set and decisions made locally for local asset allocation

Utilization of market area optimization process

Decommissioning aging structures

Focus resources more efficiently

VA will excel at its foundational health services, which include: Primary Care Services, Urgent Care Services, Mental Health Services, Geriatrics and Extended Care Services, Rehabilitation Services, VA Care Coordination, Post Deployment Health Services (PDHS) and War Related Illness and Injury Study Centers (WRIISC), and Pain Management and Opioid Safety. VA's emphasis on foundational services ensures Veterans receive quality care for those conditions most attributed to military service and best provided by VA that optimizes their health, well-being, and quality of life.

VA/DOD/Community coordination

Deliver on accountability and effective management practices

Improve timeliness of services

Access to care and wait times

Decisions on appeals

Performance on disability claims

Empower Veterans through transparency of information (public reporting of quality, wait times)

Telehealth – VA video care anywhere to anywhere

Suicide prevention

Getting to zero

Partnerships with DoD

Opioid use disorder management

Open access to mental health services (for those less than honorably discharged)

VA Fiscal Year 2018-2024 Strategic Plan

The VA FY 2018-2024 Strategic Plan describes the major efforts the Department will undertake through the next five to seven years to deliver tailored and desired outcomes for Veterans. The plan's goals, objectives, and strategies describe essential VA focus areas that are intended to contribute to Veteran well-being, encourage independence, and enhance Veterans' quality of life. Please see for details.

VHA and ORD Strategic Plans

VA Research's fundamental mission is to advance the healthcare of Veterans. The strategic plan focuses on conducting research that best addresses this mission, and ensures that research professionalism and protection of Veterans' rights are top priorities.