Summary: The Department of Veterans Affairs (VA) has taken important steps to improve the efficiency of its health care system and veterans' access to it. VA medical centers have increased efficiency by expanding the use of outpatient care. Preventive care, including health assessments and patient education, has also increased, enabling patients to stay healthier and avoid expensive hospital stays. VA is further increasing efficiency by integrating services both within and among medical centers. VA is improving access to health care in several ways. For example, it has begun to emphasize primary care, in which generalist physicians see patients initially and coordinate any specialty care that patients may need. In addition, VA is providing outpatient care at additional community-based outpatient clinics, expanding evening and weekend hours for clinics, and exploring other innovations. As networks and medical centers continue to respond to incentives to improve the efficiency of their operations, headquarters' monitoring of the impact of such responses is necessary to help ensure that they do not compromise the appropriateness of health care that veterans receive.
