Racial and Ethnic and Rural Variations in Access to Primary Care for Veterans Following the MISSION Act.

Area of Science:

• Health Services Research
• Health Equity
• Veterans Affairs Healthcare

Background:

• The VA MISSION Act aimed to improve timely access to care for veterans through community care options.
• Health equity is a key priority for the VA, necessitating an examination of access disparities.

Purpose of the Study:

• To assess if Black and Hispanic veterans experienced equitable access to primary care compared to White veterans after the VA MISSION Act's implementation.
• To analyze differences in utilization and wait times for primary care between racial/ethnic groups in rural and urban settings.

Main Methods:

• A cross-sectional study utilizing VA and community care outpatient and consult data from fiscal years 2021-2022.
• Fixed-effects multivariable models were employed to compare Black and Hispanic veterans against White veterans regarding community care utilization and primary care wait times.
• Adjusted risk ratios (ARRs) were calculated, stratified by rurality status.

Main Results:

• Black and Hispanic veterans were less likely to utilize community care for primary care compared to White veterans, irrespective of rurality.
• Primary care wait times were longer in community care than within the VA system.
• Black veterans experienced longer wait times in community care but shorter wait times within the VA compared to White veterans.

Conclusions:

• Findings indicate potential disparities in community care utilization and access for Black and Hispanic veterans.
• Further research is needed to understand the drivers of these utilization differences.
• Policy efforts should focus on promoting equitable primary care access for all veterans to ensure the effectiveness of healthcare reforms.