New Study Assessing VHA Outsourcing Reveals Worrisome Delays in VCCP Care

Yet another research study, this one published in the prestigious JAMA Health Forum, confirms what VHPI has warned about for years: that the VA MISSION Act has not delivered speedier care to veterans. In the introduction to the study — entitled “Racial and Ethnic and Rural Variations in Access to Primary Care for Veterans Following the MISSION Act” – Dr. Amy K. Rosen and her co-authors explain the purported premise of VA MISSION: to increase timely access to care by expanding veterans’ access to care outside of the VA walls, with private or so-called Community Care (CC). “Because health equity is a major VA priority,” they write, “it is important to know whether Black and Hispanic veterans compared with White veterans experienced equitable access to primary care within the VA MISSION Act.” In search of an answer, the researchers scrutinized community care wait-time data. They found that, “for all race and ethnicity categories, regardless of rurality status, CC mean wait times for primary care consultations remained consistently longer than those in VA. Five of the race and ethnicity categories experienced wait times of 35 days or shorter in VA, whereas all of the race and ethnicity categories had wait times of 35 days or longer in CC.”They also found that “Black veterans compared with white veterans had significantly longer wait times in CC but significantly shorter wait times in VA regardless of rurality status in VA and CC. CC wait times for Hispanic veterans compared with White veterans were longer in rural areas only and in VA rural and urban areas.” The research article was accompanied by an editorial co-authored by Dr. Baligh Yehia, who served as the VA’s first Deputy Under Secretary for Health for Community Care. (He later went to work for the private sector, first at Ascension Medical Group and now as President of Jefferson Health in Pennsylvania and New Jersey.) Yehia supervised the initial rollout out of VA’s Community Care Network and was a fierce champion of the program. In their JAMA comments, Yehia and his co-author cite VHPI’s study, “Disadvantaging the VA,” as their main reference when describing concerns that MISSION “could undermine VA-delivered care and negatively impact veterans’ health.”Both the editorial and research article raised concerns about these findings while calling for more research to solidify the results and explore the implications of these disparities. For, as the study concludes, “efforts to promote equitable primary care access for all veterans are needed so that policy changes can be more effective in ensuring timely access to care for all veterans.”