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Review
. 2025 Feb;4(2):101533.
doi: 10.1016/j.jacadv.2024.101533. Epub 2025 Jan 17.

The Quality of Veterans Healthcare Administration Cardiovascular Care

D Elizabeth Le  1 , Bhaskar L Arora  1 , Faith R Kelly  2 , Stephen W Waldo  3 , Merritt Raitt  1 , Paul Heidenreich  4 , Samit M Shah  5 , Ali E Denktas  6 , Kreton O Mavromatis  7 ; ACC Federal Cardiology Leadership Council  8
Affiliations
Review

The Quality of Veterans Healthcare Administration Cardiovascular Care

D Elizabeth Le et al. JACC Adv. 2025 Feb.

Abstract

A total of 9 million veterans receive care in a unique healthcare system, the Veterans Healthcare Administration (VHA), with nearly 50% reporting at least one cardiovascular disease. Despite evidence for high quality of health care in the VHA, more veteran care is being moved to the non-VHA community. An assumption of this shift in care is that the quality of non-VHA care is at least comparable to VHA care. This paper reviews the quality of cardiovascular care delivered by the VHA in comparison to community care, which is care delivered in non-VHA facilities by non-VHA providers and is authorized and paid for by VHA, examining quality metrics and highlighting novel national care programs. The critical examination of this data is valuable for deriving health care policy, sharing novel and effective quality initiatives throughout the healthcare sector, and will help veterans and their providers make important healthcare decisions.

Keywords: CART program; community care; quality; veterans Affairs; veterans health Administration.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Waldo has received unrelated investigator-initiated support from Abiomed, Cardiovascular Systems Incorporated, Janssen Pharmaceuticals, the National Institutes of Health, and VA Health Services Research & Development. Dr Shah has received funding from Abbott Vascular and the United States Food and Drug Administration. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Timeline of VHA Healthcare Legislation The VA CHOICE and MISSION Acts and funding of community care programs began in 2014 and developed into the veterans community care program by 2019. Created with Biorender.com.
Figure 2
Figure 2
Trend of Veterans Undergoing Community Care Percutaneous Coronary Artery Intervention The probability of veterans undergoing PCI procedures in the community increased by 1.3-fold over a 3-year period. Reproduced with permission.
Central Illustration
Central Illustration
Comparison of VHA and Community Cardiovascular Care Many VHA cardiovascular care outcomes are either comparable or superior to outcomes at non-VHA community hospitals. The readmission rate after acute myocardial infarction is lower in community hospitals. Created with Biorender.com.
Figure 3
Figure 3
Current State and Roadmap to Future State of VHA Cardiovascular Care VHA care utilization is discordant to its care quality in the current state. Increased federal funding of VHA quality-enhancing and innovative programs will favorably realign VHA market share and quality of care. Created with Biorender.com.
See this image and copyright information in PMC

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