Interviews with 30 rural Veterans about their experiences receiving VHA-purchased community mental health care, highlighting both improved access and persistent quality and continuity concerns.
A national study of inpatient RN turnover across rural and urban VHA hospitals, finding that individual RN characteristics and care delivery structure, not rurality itself, drive most of the variation in turnover.
We compare risk-adjustment scores calculated from VA-only, Medicaid-only, and combined diagnostic data for Veterans dually enrolled in VA and Medicaid, finding substantial non-overlap between the two data sources.
VHA facilities with a higher volume of VHA-purchased screening colonoscopies and more rural enrollees had more non-VHA physicians providing care. Geographic variation in referral networks may also explain differences in the effects of the MISSION Act on access to care and patient outcomes.
The VHA-share of screening colonoscopies among VHA enrollees fell in the 9 months immediately after the passage of the MISSION Act. This decline was larger for VHA enrollees who were targeted for eligibility due to a longer drive time. These results suggest that the MISSION Act led to more VHA-purchased care among targeted VHA enrollees, though it is unclear whether total utilization increased.