The Veterans Health Administration (VHA) manages an integrated health care system that has expenditures of nearly $100 billion per year and serves more than 9 million enrollees.1 Like other health care systems, the VHA has faced unprecedented challenges in responding to the COVID-19 pandemic. Although its large size, diverse operating environments, and geographically dispersed patient population make it difficult for the VHA to pivot nimbly and ensure access to care, this health system was able to leverage its existing infrastructure and prior planning to rapidly scale virtual care services (ie, telephone and video) for enrollees in 2020.2,3 In this study, we took a broad look at how VHA care patterns, including all forms of care either purchased (known as community care) or provided by the VHA, have shifted in association with the COVID-19 pandemic.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Accepted for Publication: August 10, 2021.
Published: October 14, 2021. doi:10.1001/jamanetworkopen.2021.29139
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Rose L et al. JAMA Network Open.
Corresponding Author: Liam Rose, PhD, Health Economics Resource Center, Veterans Affairs Palo Alto Health Care System, 795 Willow Rd, Bldg 324, Menlo Park, CA 94025 (email@example.com).
Author Contributions: Dr Rose and Dr Tran had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Rose, Tran, Vashi.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Rose, Vashi.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Rose, Tran.
Obtained funding: Vashi.
Administrative, technical, or material support: Rose.
Supervision: Rose, Asch, Vashi.
Conflict of Interest Disclosures: Dr Vashi reported receiving grants from the US Department of Veterans Affairs Health Services Research and Development Service. All authors reported receiving grants from and are employed by the US Department of Veterans Affairs. No other disclosures were reported.
Funding/Support: This study was funded by US Department of Veterans Affairs Health Services Research and Development Service Individual Investigator Research Award 16-266 (grant 1101HX002362-01A2 [Dr Vashi]).
Role of the Funder/Sponsor: The US Department of Veterans Affairs Health Services Research and Development Service had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
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