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Editorials |7 June 2011

Reconsidering the Veterans Health Administration: A Model and a Moment for Publicly Funded Health Care Delivery

Joan J. Ryoo, MD, MSHS; Jennifer L. Malin, MD, PhD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0383.
Requests for Single Reprints: Jennifer L. Malin, MD, PhD, Division of Hematology Oncology, Department of Internal Medicine, Veterans Affairs Greater Los Angeles Healthcare System, West Los Angeles Medical Center, 11301 Wilshire Boulevard, Fourth Floor, Los Angeles, CA 90073; e-mail, jennifer.malin@va.gov.
Current Author Addresses: Dr. Ryoo: UCLA Jonsson Comprehensive Cancer Center, 650 Charles E. Young Drive South, Room A2-125 CHS, Box 956900, Los Angeles, CA 90095-6900.
Dr. Malin: Division of Hematology Oncology, Department of Internal Medicine, Veterans Affairs Greater Los Angeles Healthcare System, West Los Angeles Medical Center, 11301 Wilshire Boulevard, Fourth Floor, Los Angeles, CA 90073.
  • From UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095-6900, and Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073.
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Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0383.
Requests for Single Reprints: Jennifer L. Malin, MD, PhD, Division of Hematology Oncology, Department of Internal Medicine, Veterans Affairs Greater Los Angeles Healthcare System, West Los Angeles Medical Center, 11301 Wilshire Boulevard, Fourth Floor, Los Angeles, CA 90073; e-mail, jennifer.malin@va.gov.
Current Author Addresses: Dr. Ryoo: UCLA Jonsson Comprehensive Cancer Center, 650 Charles E. Young Drive South, Room A2-125 CHS, Box 956900, Los Angeles, CA 90095-6900.
Dr. Malin: Division of Hematology Oncology, Department of Internal Medicine, Veterans Affairs Greater Los Angeles Healthcare System, West Los Angeles Medical Center, 11301 Wilshire Boulevard, Fourth Floor, Los Angeles, CA 90073.
Since the Veterans Health Administration (VHA) was systemically (and systematically) “reengineered” to follow a more decentralized, managed care template more than 15 years ago (1–3), it has demonstrated accumulating achievements in health and health care delivery, over time outshining not only its own performance but that of others (4–6). In chronic disease management and preventive care, the VHA has surpassed Medicare (7), commercial managed care (8), and various community health systems in adherence to broadly accepted process measures (9).
Furthermore, beneficiaries of the VHA seem to have health outcomes—including mortality—that are the same as or better than those of Medicare (10–12) and private-sector patients (13). These findings are noteworthy given the population served by the VHA, which is recognized to be highly and relatively burdened by socioeconomic disadvantage, comorbid illness, and poor self-reported health (1)....
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Ryoo JJ, Malin JL. Reconsidering the Veterans Health Administration: A Model and a Moment for Publicly Funded Health Care Delivery. Ann Intern Med. 2011;154:772–773. doi: 10.7326/0003-4819-154-11-201106070-00010

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Published: Ann Intern Med. 2011;154(11):772-773.

DOI: 10.7326/0003-4819-154-11-201106070-00010

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