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JGIM Supplement Features VA Research on Care Coordination Both within VA and with Non-VA Healthcare Providers

May 31, 2019

VA coordinates healthcare for Veterans within VA and with non-VA providers across a continuum of services—from basic care to treatment for complex conditions requiring multiple providers and healthcare settings. Coordinating care is essential for improving patients’ clinical outcomes, enhancing patients’ experiences of care, increasing provider satisfaction, and decreasing costs. In March 2018, a state-of-the-art (SOTA) conference on care coordination was jointly developed by VA HSR&D and the VA Offices of Primary Care, Community Care, Nursing Services, and Care Management and Social Work. SOTA participants – VA and non-VA health services researchers, clinicians, and policymakers – focused on measures and models of care coordination, care coordination within the VA system, and care coordination between VA and non-VA providers for care paid for by VA.

Funded by HSR&D, the JGIM Supplement titled Care Coordination in the Veterans Health Administration presents recommendations from the SOTA and original research papers on VA and non-VA care coordination strategies. Articles include but are not limited to:

  • Olmos-Ochoa and colleagues describe interviews with PACT (Patient Aligned Care Teams) clinical staff in five VA medical centers that revealed coordination-related resource barriers and challenges in aligning priorities across patients, staff, and leaders. Stakeholders recommended VA focus on staffing, training, clarifying roles and responsibilities, and launching care coordination initiatives.
  • Zulman and colleagues conducted a survey of VA patients who took part in a five-site demonstration of PACT Intensive Management (PIM). Veterans randomized to PIM were more likely to report having a VA healthcare provider who helps coordinate their care; that they were asked about their health goals; that they have a VA provider whom they trust and who respects them; and that their primary care satisfaction level was 10 on a 10-point scale. Findings suggest that the PIM model may hold promise for coordinating care for medically and socially-complex Veterans, although further investigations are needed to assess its impact on clinical outcomes.
  • Benzer and colleagues examined how Veterans with mental health (MH) issues may have care coordination needs that differ from Veterans without MH issues. Among nearly 6,000 Veterans with diabetes completing an online survey, Veterans with mental health conditions reported significantly lower experiences with coordinated care compared to Veterans without MH conditions.

Care Coordination in the Veterans Health Administration. Journal of General Internal Medicine. May 2019, Supplement;34(1).

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