Caring for Those Who Serve: Potential Implications of the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018

Ideas and Opinions2 October 2018Caring for Those Who Serve: Potential Implications of the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018Joel Kupfer, MD, Rachel S. Witmer, MHA, and Viet Do, DOJoel Kupfer, MDCarl T. Hayden VA Medical Center and University of Arizona College of Medicine–Phoenix, Phoenix, Arizona (J.K., V.D.), Rachel S. Witmer, MHACarl T. Hayden VA Medical Center, Phoenix, Arizona (R.S.W.), and Viet Do, DOCarl T. Hayden VA Medical Center and University of Arizona College of Medicine–Phoenix, Phoenix, Arizona (J.K., V.D.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1539 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail On 28 May 2018, Congress passed the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks (VA MISSION) Act, setting in motion a paradigm shift in the way health care will be delivered to the nation's veterans (Table). The most important of its many provisions is the replacement of the Choice Program with a new model of health care delivery for veterans based on networks of community providers designed to provide veterans with greater choice. Although the Choice Program expanded access to outside providers, the VA largely determined the circumstances under which those referrals were granted. The new program, ...References1. 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PMID: 26871642 doi:10.1097/MLR.0000000000000508 CrossrefMedlineGoogle Scholar9. Pizer SD, Gardner JA. Is fragmented financing bad for your health? Inquiry. 2011;48:109-22. PMID: 21898983 CrossrefMedlineGoogle Scholar10. Weeks WB, West AN, Wallace AE, Lee RE, Goodman DC, Dimick JB, et al. Reducing avoidable deaths among veterans: directing private-sector surgical care to high-performance hospitals. Am J Public Health. 2007;97:2186-92. PMID: 17971543 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Carl T. Hayden VA Medical Center and University of Arizona College of Medicine–Phoenix, Phoenix, Arizona (J.K., V.D.)Carl T. Hayden VA Medical Center, Phoenix, Arizona (R.S.W.)Disclaimer: The opinions in this article are not those of the Veterans Health Administration, the federal government, or the University of Arizona.Acknowledgment: The authors thank Dr. Kathy Carbone and Dr. Caroline Kim for their thoughtful suggestions and help in preparing the manuscript.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1539.Corresponding Author: Joel Kupfer, MD, Department of Cardiology, Carl T. Hayden VA Medical Center, 650 E. Indian School Road, Phoenix, AZ 85012; e-mail, joel.email protectedgov.Current Author Addresses: Dr. Kupfer: Department of Cardiology, Carl T. Hayden VA Medical Center, 650 E. Indian School Road, Phoenix, AZ 85012.Ms. Witmer: Phoenix VA Medical Center, 650 E. Indian Road, Phoenix, AZ 85012.Dr. Do: Mayo Clinic Hospital Arizona, 5777 E. Mayo Boulevard, Phoenix, AZ 85045.Author Contributions: Conception and design: J. Kupfer.Analysis and interpretation of the data: R.S. Witmer.Drafting of the article: J. Kupfer, V. Do.Final approval of the article: R.S. Witmer, V. Do.Administrative, technical, or logistic support: R.S. Witmer.Collection and assembly of data: R.S. Witmer.This article was published at Annals.org on 24 July 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRacial/Ethnic and Geographic Disparities in Comorbid Traumatic Brain Injury-Renal Failure in US Veterans and Associated Veterans Affairs Resource Costs, 2000–2020Data acquisition process for VA and non-VA emergency department and hospital utilization by veterans with spinal cord injury and disorders in California using VA and state dataHealth Care for Our Nation's Veterans: A Policy Paper From the American College of PhysiciansRyan Crowley, BSJ, Omar Atiq, MD, David Hilden, MD, MPH, and Thomas G. 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Thorpe, PhD, MPH, Joshua M. Thorpe, PhD, MPH, Florentina E. Sileanu, MS, John P. Cashy, PhD, Jennifer A. Hale, BA, Maria K. Mor, PhD, Thomas R. Radomski, MD, MS, Julie M. Donohue, PhD, Leslie R.M. Hausmann, PhD, Joseph T. Hanlon, PharmD, MS, Chester B. Good, MD, MPH, Michael J. Fine, MD, MSc, and Walid F. Gellad, MD, MPH 2 October 2018Volume 169, Issue 7Page: 487-489KeywordsChild healthHealth careHealth care facilitiesHealth care providersHealth care sectorHealth economicsHealth systems strengtheningMedicareRural areasVeteran care ePublished: 2 October 2018 Issue Published: 2 October 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...