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Health Services Research & Development

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HSR&D In Progress

December 2020

In This Issue: Enhancing Primary Care for Veterans with Chronic Illness
» Table of Contents

Overview: HSR&D Improves VA Primary Care for Veterans with Chronic Illness

VA aims to improve health outcomes for Veterans by shifting from a system focused on disease management to one based on partnering with Veterans throughout their lives with a focus on whole health. This approach is especially important to Veterans with chronic illness. More than 30% of Veterans suffer from multiple chronic conditions that require consistent and complex healthcare management, and which account for about two-thirds of VA’s total healthcare costs.1

VA Primary Care provides long-term patient-provider relationships, coordinates care across a spectrum of health services, educates (providers and patients), and offers disease prevention programs. Primary care serves as the foundation of VA healthcare and often is the first point of contact for Veterans with chronic illness who use VA healthcare. VA utilizes a PACT (Patient Aligned Care Team) model that assists in transforming primary care by providing patient-driven, personalized, team-based care that promotes self-empowerment, self-care, and improving social determinants of health. Other national programs and services provided under VA Primary Care include:

  • Primary Care-Mental Health Integration (PC-MHI) promotes full incorporation of mental health staff into the PACT allowing provision of depression, anxiety, PTSD, and substance abuse services without the need of a separate mental health consult.
  • Post-Deployment Integrated Care (PDIC) features the development of specialized PACTs with expertise and training in syndromes common to returning combat Veterans, such as depression, substance abuse, PTSD, chronic pain, sleep disorders, and anxiety.

HSR&D conducts studies on primary care and chronic conditions, particularly regarding quality improvement, cost-effectiveness, and the implementation and efficacy of evidence-based interventions. In addition, as part of HSR&D, the Quality Enhancement Research Initiative (QUERI) supports several programs and projects on primary care and chronic illness, including the Care Coordination QUERI: Improving Patient-Centered Care Coordination for High-Risk Veterans in PACT; QUERI for Team-Based Behavioral Health; Evaluating VA Patient-Centered Care: Patient, Provider, and Organizational Views; and Evaluating Evidence-Based Quality Improvement of Comprehensive Women’s Health Care in Low-Performing VA Facilities.


Balbale S, Etingen B, Malhiot A, et al. Perceptions of chronic illness care among Veterans with multiple chronic conditions. Military Medicine. May 2016;181(5):439-444.


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