Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government
Veterans Benefits and Health Care About VA Find a VA Location

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website
FORUM - Translating research into quality health care for Veterans


In This Issue

Director's Letter

Director's Letter
by David Atkins, M.D., M.P.H., Director, HSR&D

Change is good, but too much change can be disorienting and demoralizing. After almost two years of important, and I think necessary, changes in HSR&D—the initiation of CREATEs and the transition of our Centers to COINS—I am thrilled to have been appointed as the new Director of HSR&D ...

Commentary

The Impact of the Affordable Care Act on VA's Dual Eligible Population
by Patricia Vandenberg, M.H.A., Gita Uppal, M.P.H., FACHE, Amyre Barker, M.P.H., and Duane Flemming, P.M.P., VHA Office of the Assistant Deputy Under Secretary for Health for Policy and Planning, VA Central Office

ACA will not change Veterans' current eligibility for VA health care, covered benefits, or co-payments for services. However, ACA is expected to have an impact on the coordination of care for dual eligible Veterans. As such, VA must understand its dual eligible Veterans in light of the changing health care environment...

Response to Commentary

What We Need to Know about Dual Use
by David Atkins, M.D., M.P.H., Director, HSR&D, Washington, D.C.

Receiving care from two separate systems is not ideal in today's health care environment (for reasons described in other papers in this issue) but it represents the willing choice of those Veterans and is thus not likely to go away. We need to understand this population and the care they seek for a number of reasons: first, to ensure that their current and future needs are met; and, second, to predict future demands on VHA resources. ...

Research Highlights

What are the Quality Consequences of Medicare-VA Dual Use?
by Steven D. Pizer, Ph.D., Health Care Financing and Economics, VA Boston Healthcare System, Boston, Massachusetts

...VA and Medicare are spending substantial resources on inpatient care for Veterans who could be managed more efficiently and more effectively if their care were better coordinated. Several initiatives are currently being implemented by VA management to facilitate sharing of electronic medical records between VA and non-VA health plans and facilities. These efforts have the potential to reduce the harm from fragmentation...


Health Information Exchange in the VA
by Michael Weiner, M.D., M.P.H. and David A. Haggstrom, M.D., M.A.S., both with HSR&D's Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana

HIE is technically achievable, and incremental implementation is recommended. HIE has shown early promise in improving important measures of health care, and the VA's program is now being studied. Care delivered across institutions is the reality in our mobile society...


Dual Use in Colon Cancer: What Have We Learned about Quality and Costs of Care?
by Denise M. Hynes, M.P.H., Ph.D., R.N., VA Information Resource Center (VIReC) and Center for Management of Complex Chronic Care (CMC3), located at the Edward Hines, Jr. VA Hospital, Hines, Illinois

...our findings signal potential concerns among patients with colon cancer who are dual users. In particular, efforts should be focused on exploring the apparent underuse of adjuvant chemotherapy among older Veterans with colon cancer. Greater understanding about the mechanisms of dual use is also important to determine causal and temporal relationships with subsequent health care use. Further research is recommended to understand the contribution of the possible causes of treatment variation..



Changes in Outpatient Care-Seeking by Medicare-Eligible Veterans of Care
by Matthew L. Maciejewski, Ph.D., Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina and Chuan-Fen Liu, Ph.D., M.P.H., Northwest Center for Outcomes Research in Older Adults, VA Puget Sound Health Care System, Seattle, Washington

A significant proportion of Medicare-eligible Veterans obtain outpatient or inpatient care in both systems, which can complicate continuity of care, care coordination, and medication management. Care that is fragmented due to dual use of VA and Medicare may result in under-use or over-use in services, which could adversely impact health outcomes of Veterans...


2013 USH Award

Bosworth Receives 2013 Under Secretary's Award for Outstanding Achievement in Health Services Research

Hayden B. Bosworth, Ph.D., will receive this year's Under Secretary's Award for Outstanding Achievement in Health Services Research. The highest honor for a VA health services researcher...


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.