Where FREEDOM Flies #2 - Flipbook - Page 8
VA Aims To Enhance Care For Veterans
Reference: Veterans Affairs
VA’s most important mission is providing highquality healthcare and benefits when and where
Veterans need it.1 Through various ways such as the
Veterans Transportation Service (VTS), Telehealth,
and digital resources such as My HealtheVet and
VA Apps, VA takes an active role in improving
access to care.2
On April 7, 2014 the Veterans Access, Choice, and
Accountability Act (Choice Act) was signed into
law. The primary provision of the Choice Act was
to expand access to medical services from
community providers to eligible Veterans. In FY
2016, VA approved approximately 19 million
claims (a 13% increase over FY2015) for Veterans
receiving care from community providers.3
Secretary Shulkin further emphasized VA’s
commitment to Veterans by extending mental
healthcare to Veterans with other-than-honorable
discharges.4
HSR&D and QUERI investigators on issues critical
to improving Veterans’ access to quality care.
Improving Access and Outcomes for Rural
Veterans with HIV
In large cities, persons with HIV often receive care
in high-volume HIV specialty clinics that employ
co-located interdisciplinary care teams. Prior
research has demonstrated that rural-living Veterans
who seek VA care for HIV infection, having no
access to these clinics, enter care with more
advanced illness, are less likely to be early adopters
of important advances in HIV therapy, and
experience higher mortality than their urban
counterparts. This study sought to better determine
gaps in and barriers to care for rural Veterans with
HIV, and to develop and evaluate an innovative
delivery model using existing VA telehealth
resources. Findings were:
A significant part of HSR&D’s mission is to
identify and evaluate innovative strategies leading
to accessible, cost-effective, high-quality care for
Veterans.5 Following are descriptions and findings
from several specific research projects conducted by
Rural Veterans in care for HIV infection had
to travel nearly four times as far for VA
infectious disease specialty care (86 minutes
vs 23 minutes for urban Veterans).
Despite travel burdens, the majority of rural
Veterans who used infectious disease (ID)
specialty care received antiretroviral therapy
(95%) and had an undetectable viral load on
therapy (83%).
Rural Veterans with HIV who did not
receive ID specialty care were less likely to
receive antiretroviral therapy (68%) or have
an undetectable viral load on therapy (76%).
The Specialty Care Access Network Extension for Community Health Outcomes
(SCAN-ECHO) telemedicine model for
improving access to specialized care for
Veterans with HIV in rural settings had
limited adoption in Community Based
Outpatient Clinics (CBOCs) serving rural
areas, with only 9 of 21 clinics adopting and
only 5% of rural Veterans with HIV being
offered SCAN ECHO participating.