Summary: This testimony discusses the Veterans Health Administration's (VHA) efforts to improve veterans' access to health care through its Community-Based Outpatient Clinics Initiative. Overall, through its clinics, VHA is steadily making primary care more available within reasonable proximity of patients who have used VHA's system in the past. However, the uneven distribution of patients living more than 30 miles from a VHA primary care facility suggests that access inequities across networks may exist. Also, the improvements likely to result from VHA's planned clinics indicate that achieving equity of access may be difficult. In addition, GAO's assessment suggests that new clinics may have contributed to, but are not primarily responsible for, the marked rise in the number of higher-income patients who have sought health care through VHA in recent years. Although the clinics have undoubtedly attracted some new patients to VHA, GAO's analysis suggests that new patients would have sought care at other VHA facilities in the absence of the clinics. Enhanced benefits and access improvements afforded by eligibility reform may have attracted more new patients, including those with higher incomes.
