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How Does VA Healthcare Compare to Non-VA Healthcare?

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How the VA Compares to Non-VA Healthcare

Did you know that the VA is the largest healthcare provider in the US? In any health care system – especially one that serves millions of Veterans – ensuring timely access to high-quality healthcare services is extremely important.

The VA MISSION Act of 2018 improved access to healthcare services for Veterans meeting eligibility criteria. The VA determines who is eligible to receive healthcare at non-VA facilities based on specific criteria.

Recent research shows that VA healthcare is comparable to healthcare provided at non-VA hospitals. Considering how the VA compares to non-VA medical centers is important now that Veterans have more choices about where they receive medical care.

VA MISSION Act of 2018

Under Title I of the Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, veterans are eligible to receive health care at non-VA medical facilities if they meet certain eligibility criteria.

Service Not Offered

Veterans are eligible to receive non-VA care if their VA does not offer a healthcare service that is medically required. For example, the VA does not provide maternity services. Any female Veteran in need of maternity care is eligible for community healthcare services because these services are not offered by any VA.

Living a Long Distance from VA Facility

Veterans living in a state or territory without a full-service VA are eligible for non-VA care. Such locations include:

  • Alaska
  • Hawaii
  • New Hampshire
  • Guam
  • American Samoa
  • The Northern Mariana Islands
  • S Virgin Islands

Veterans living a significant distance from a VA facility are also eligible for non-VA care. Note that the distance factors in traffic and is determined by the VA using a specific software program. Examples of scenarios where a Veteran qualifies under this rule include:

  • The Veteran was eligible under the 40-mile criterion of the Veteran Choice Act, continues to reside in a qualifying location under that act and resides in North Dakota, South Dakota, Montana, Alaska, or Wyoming.
  • The average drive time to receive primary care or mental health care services exceeds 30 minutes.
  • The average drive time to receive specialty care exceeds 60 minutes.

Appointments Not Immediately Available

If the VA does not have an appointment for primary care or mental health within 20 days, the Veteran is eligible for community care. Veterans are eligible for community care if a specialty care – like cardiology or oncology – appointment is not available within 28 days.

Quality Standards Not Met

If the VA offers a particular medical service, but that service does not meet quality standards set by the VA, a Veteran is eligible to receive care at a non-VA hospital.

Fortunately, care provided at the VA is comparable and sometimes exceeds the care provided in non-VA healthcare facilities.

VA Surgical Care Outperforms Non-VA Surgical Care

A recent study published in the Journal of Surgical Research concluded that the surgical care provided by the VA was at least equivalent to non-VAs. Researchers compared 34 VA hospitals to 319 neighboring non-VA hospitals, looking at rates of post-surgery complications and patient satisfaction scores.

The rates of complications were lower at VA hospitals and patient satisfaction scores were comparable. The VA hospitals either matched or out-performed the non-VA hospitals in this study.

VA Care is Safe and Effective

Measuring safety in healthcare involves looking at rates of complication including complications after surgery and bed sores or pressure ulcers. Measuring effectiveness in healthcare involves looking at how well certain diseases are managed. For example, the number of people who receive cancer screening on time or how well diabetes is managed based on improvements in specific blood tests.

A review of the results of 69 studies published between 2005 and 2015 concluded that the VA generally provides safe and effective care in comparison to non-VA medical facilities.

The authors of this study note that the quality of VA health care has long been an area of concern. This concern led to the Veterans Access, Choice and Accountability Act of 2014, which required assessment of the quality of VA health care. This legislation was then followed by the VA Mission Act of 2018.

The study also compared timeliness, efficiency, and patient-centeredness and concluded that more information is needed to assess these concepts.

Always Room for Improvement

Healthcare is continuously changing to improve the quality of its services. VA hospitals compete with neighboring community hospitals and continuously monitor the quality of their services in comparison.

One of the ways that hospitals measure quality is through patient satisfaction surveys. As healthcare continues to work toward improvement, it relies on information about the quality of their services that is provided by patients through these surveys.

Veterans should know that they may be eligible for non-VA care under the VA MISSION Act of 2018. They should understand that the VA provides healthcare services that are comparable to non-VA facilities and that patient satisfaction surveys are important communication tools for helping hospitals improve their services.





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