TY - JOUR
AU - Y. Ma
AU - J. Phelan
AU - E. J. Orav
AU - A. B. Frakt
AU - S. D. Pizer
AU - M. M. Garrido
AU - J. F. Figueroa
AU - T. C. Tsai
A1 - 
AB - With the rapid expansion of veterans' access to community care under the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act of 2018, ensuring that veterans receive high-quality community care has become a national priority. Using Veterans Health Administration (VHA) data and Medicare performance scores, we assessed how clinicians' performance on quality measures differed between those who treated veterans within the VHA Community Care Network and those who did not. We found that in 2022, 66.0 percent of community-based clinicians treated VHA enrollees. These clinicians were more likely to be male, have less practice experience, be affiliated with group practices, and be based in rural and socially vulnerable areas compared with clinicians who did not treat VHA enrollees. Notably, clinicians in the lowest quartile of quality performance measures were 8.8 percentage points more likely to treat VHA enrollees than those in the highest quartile. This pattern was most pronounced among primary care and mental health clinicians, and it persisted across VHA Community Care Network regions. These results underscore the need for federal efforts to ensure that veterans receive care from high-performing community clinicians.
AD - Yanlei Ma, Harvard University, Boston, Massachusetts.; Jessica Phelan, Harvard University.; E. John Orav, Harvard University and Brigham and Women's Hospital, Boston, Massachusetts.; Austin B. Frakt, Veterans Affairs Boston Healthcare System and Harvard University, Boston, Massachusetts.; Steven D. Pizer, Veterans Affairs Boston Healthcare System and Boston University.; Melissa M. Garrido, Veterans Affairs Boston Healthcare System, Boston University, and Brigham and Women's Hospital.; José F. Figueroa, Harvard University and Brigham and Women's Hospital.; Thomas C. Tsai (ttsai@hsph.harvard.edu), Harvard University and Brigham and Women's Hospital.
AN - 39761460
BT - Health Aff (Millwood)
C5 - Healthcare Disparities; Healthcare Policy
CP - 1
DA - Jan
DO - 10.1377/hlthaff.2024.00900
DP - NLM
IS - 1
JF - Health Aff (Millwood)
LA - eng
N2 - With the rapid expansion of veterans' access to community care under the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act of 2018, ensuring that veterans receive high-quality community care has become a national priority. Using Veterans Health Administration (VHA) data and Medicare performance scores, we assessed how clinicians' performance on quality measures differed between those who treated veterans within the VHA Community Care Network and those who did not. We found that in 2022, 66.0 percent of community-based clinicians treated VHA enrollees. These clinicians were more likely to be male, have less practice experience, be affiliated with group practices, and be based in rural and socially vulnerable areas compared with clinicians who did not treat VHA enrollees. Notably, clinicians in the lowest quartile of quality performance measures were 8.8 percentage points more likely to treat VHA enrollees than those in the highest quartile. This pattern was most pronounced among primary care and mental health clinicians, and it persisted across VHA Community Care Network regions. These results underscore the need for federal efforts to ensure that veterans receive care from high-performing community clinicians.
PY - 2025
SN - 0278-2715
SP - 117
EP - 125+
ST - Veterans May Be Seeing Lower-Quality Clinicians In The VHA Community Care Network
T1 - Veterans May Be Seeing Lower-Quality Clinicians In The VHA Community Care Network
T2 - Health Aff (Millwood)
TI - Veterans May Be Seeing Lower-Quality Clinicians In The VHA Community Care Network
U1 - Healthcare Disparities; Healthcare Policy
U3 - 10.1377/hlthaff.2024.00900
VL - 44
VO - 0278-2715
Y1 - 2025
ER -