Carrie M. Farmer; Codirector, RAND Epstein Family Veterans Policy Research Institute
I'm a health services researcher by training and my research is focused on military and veteran health care, including care provided by the U.S. Department of Veterans Affairs (VA).
VA provides health care to nearly 7 million veterans every year, both through care delivered in VA facilities and through the Community Care program. Since 2014, over 3 million veterans have used VA Community Care, but whether this has resulted in more timely, high-quality care for veterans is not well understood.
Data also suggest that veterans have shorter wait times for care from a VA facility than from Community Care. In a recent analysis, VA researchers examined referrals for new patient appointments for VA-delivered care and VA Community Care. For each type of care, wait times for VA-delivered care were shorter than VA Community Care, and these findings persisted in different parts of the country.
It is critical that discussions about veterans’ access to care always consider care quality. As prior RAND research has demonstrated, VA typically provides care that is equal to or better than the private sector. While VA tracks and reports on dozens of quality measures and makes much of these data publicly available, equivalent data are not available for VA Community Care.
I have three recommendations for how Congress and VA could improve available data. First, VA should publicly report average wait times for VA Community Care appointments, using the same data and methodology used to report average wait times for VA-delivered care.
Second, VA should make use of existing data to systematically monitor and publicly report the quality of Community Care.
Third, VA should explore contract changes that would facilitate additional information sharing and new data collection about network providers and the quality of care they provide.