June 2022

In This Issue: HSR&D Research on Community Care
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Overview: HSR&D Research on Community Care

In 2014, Congress enacted the Veterans Access, Choice, and Accountability ACT (VACAA) to establish the Veterans Choice Program (VCP) and to expand the availability of community care for eligible Veterans. The VCP grew quickly and, in 2018, was updated and expanded under the VA MISSION ACT (should be “Act”). Since the implementation of the MISSION Act on June 6, 2019, more than 2.7 million Veterans have been referred to community care, representing 31% of the 8.9 million Veterans enrolled in VA care. Over the course of that time, 1.2 million providers have enrolled in VA’s Community Care Network (CCN) – VA’s direct link with community providers to ensure that Veterans receive timely, high-quality care. Care provided in the community includes services that VA does not offer, such as obstetrics care, as well as services that VA does provide. The challenge for VA is to determine what balance of in-person VA care, virtual VA care, and care in the community offers the optimal balance of timely high-quality care. HSR&D is working to provide the best available information for VA leadership as they take up this challenge.

Last October, VA Secretary Denis McDonough announced the development of a new integrated access and care coordination model to better deliver seamless care. Part of this effort is the integration of the Office of Veterans Access to Care and the Office of Community Care into Integrated Veteran Care, which will create a more coordinated experience for any Veteran accessing the VA healthcare system or VA-funded community care.

HSR&D conducts an array of research on community care that include topics from the value of improving access to community care to understanding the role of VA specialty care in an era of community care to identifying the effects of VA community care programs on healthcare quality and equity. In addition to numerous individual studies, HSR&D supports the Community Care Research Evaluation & Knowledge (CREEK) Center. The Center works to provide a seamless connection between HSR&D researchers and VA’s Office of Community Care (OCC), so that research findings are incorporated into ongoing conversations about how to improve access, coordination, and the delivery of community care to Veterans. Further, a recent Medical Care Supplement features 12 articles that highlight research focusing on Veterans’ use of community care and how VA facilities interact with community care (CC) providers. The Supplement offers a broad examination of VA’s expanded Community Care program, with articles by HSR&D investigators on topics such as: comparing wait times for specialty outpatient services in CC and VA (Gurewich, et al); comparing Veterans’ use of primary care services at VA facilities versus CC (Hynes, et al); and examining the challenges VA medical centers face in their relationships with engaging community providers in care (Mattocks, et al).