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Completing the MISSION: a Blueprint for Helping Veterans Make the Most of New Choices

  • Jeffrey T. KullgrenEmail author
  • Angela Fagerlin
  • Eve A. Kerr
Perspective

Abstract

The June 6, 2019, implementation of the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act commenced a new era in health care for Veterans in which the more than 9 million Veterans who use VA care can now choose community (i.e., non-VA) clinicians or facilities when certain new criteria are met. This expansion of Veterans’ health care options could give many Veterans more freedom to decide which settings best meet their individual needs and expectations, and could also lead to unintended consequences for Veterans who do not have all of the information they need to make personalized decisions about VA and community care. In this Perspective article, we recommend initial steps that VA leaders and VA clinicians need to take, and community clinicians should be aware of, in order to ensure that Veterans’ expanded health care options translate into improvements in their access and outcomes.

Notes

Acknowledgments

We thank Megan Adams, MD, JD, of the VA Center for Clinical Management Research and the University of Michigan for her valuable feedback on an earlier version of this manuscript.

Funding Information

Support was provided by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development (HSR&D) Service. Dr. Kullgren is a VA HSR&D Career Development awardee (CDA 13-267) at the Ann Arbor VA.

Compliance with Ethical Standards

Conflict of Interest

Dr. Kullgren has received consulting fees from SeeChange Health and HealthMine, and honoraria from AbilTo, Inc., the Robert Wood Johnson Foundation, the American Diabetes Association, and the Kansas City Area Life Sciences Institute. Dr. Kerr is on the clinical advisory board for BIND Health Insurance.

Disclaimer

The views expressed in this article are those of the authors and do not reflect the position or policy of the Department of Veterans Affairs or the United States government.

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Copyright information

© Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2019

Authors and Affiliations

  1. 1.VA Center for Clinical Management Research VA Ann Arbor Healthcare SystemAnn ArborUSA
  2. 2.Department of Internal MedicineUniversity of Michigan Medical SchoolAnn ArborUSA
  3. 3.Institute for Healthcare Policy and InnovationUniversity of MichiganAnn ArborUSA
  4. 4.Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for InnovationSalt Lake City VA Medical CenterSalt Lake CityUSA
  5. 5.Department of Population Health SciencesUniversity of UtahSalt Lake CityUSA

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