Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

April 21, 2022

HSR&D Announces Best Research Paper of the Year Award Recipient

Liam Rose, PhD

Liam Rose, PhD

A Palo Alto-based team led by Liam Rose, PhD, is the recipient of the 2021 HSR&D Best Research Paper of the Year Award, which honors a single article or collection of articles resulting from one or more HSR&D- or QUERI-funded investigations. Research studies also must involve Veterans, with results that are important to Veterans’ health and care, and to the VA healthcare system.

Dr. Rose, along with Marion Aouad, PhD, Laura Graham, PhD, Lena Schoemaker, MS, and Todd Wagner, PhD, authored the article, “Association of Expanded Health Care Networks with Utilization among Veterans Affairs Enrollees,” which was published in JAMA Network Open in October 2021. This paper reports results from the HSR&D-funded study, “Utilization and Health Outcomes for Veterans with Expanded Health Care Access.” The authors were interested in how recent VA expansions of community care eligibility might affect health care utilization. This is a difficult question to answer because those who use more community care tend to be different from those who use VA more often. Utilizing causal inference methods, they determined that the VA Choice Act caused a significant increase in outpatient (+3%), laboratory (+3%), prescription (+1%), and psychotherapy (+8%) visits without changes to inpatient use or mortality. Increased outpatient use was most concentrated among Veterans with more service-connected disabilities – and among younger Veterans without service-connected disabilities.

These results have already contributed directly to decisions facing VA leaders and Congress. The Choice Act expanded community care eligibility for approximately 700,000 enrollees. The MISSION Act, which replaced the Choice Act, further expanded care for an additional 3 million Veterans. With many more individuals now eligible, it is likely that the increase in encounters induced by these programs will further increase, with pressure to shift resources away from VA provision and into community care. This translates into millions of additional encounters per year that VA must account for, along with the increased burden of monitoring and tracking costs, quality, and outcomes across systems. Dr. Rose and colleagues continue to work with the Office of Veterans Access to Care (OVAC) on making the best use of these findings.

Dr. Rose is a health economist with HSR&D’s Health Economics Resource Center (HERC) and HSR&D’s Center for Innovation to Implementation (Ci2i): Fostering High-Value Care, both in Palo, Alto, CA. He is also affiliated with Stanford-Surgery Policy Improvement Research and Education (S-SPIRE). Dr. Aouad is an Assistant Professor of Economics at UC Irvine, having completed a post-doctoral fellowship at S-SPIRE. Dr. Graham is an investigator at HERC and is also affiliated with S-SPIRE. Ms. Shoemaker is an analyst at HERC. Dr. Wagner is the director of HERC as well as a Professor of Medicine in the Stanford Department of Surgery.

HSR&D thanks the Palo Alto team for their exceptional work and contributions to the literature, which help VA improve access to the best quality of healthcare for Veterans.

HSR&D also thanks the following Best Research Paper of the Year Nominees for their outstanding work and contributions to the field of health services research.

Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.