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Exploring the Ripple Effect: Changes in Quality Measures Before and After Whole Health Adoption in Veterans Health
Xiaoyi Zhang1,2, Steven B Zeliadt3,4, Rendelle E Bolton5
1VA Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA.
Journal of General Internal Medicine
|May 11, 2026
Summary
Whole Health utilization in the Veterans Health Administration (VHA) improved clinical quality measures for chronic disease management and preventive care. This patient-centered approach enhanced patient engagement and health outcomes.
Area of Science:
- Health Services Research
- Patient-Centered Care Models
- Quality Improvement in Healthcare
Background:
- The Veterans Health Administration (VHA) is transitioning to patient-centered care models, emphasizing individual goal setting and patient engagement.
- The VHA's Whole Health model, implemented in 2011, embodies this patient-centered approach.
- This study investigates the impact of the Whole Health model on clinical quality measures.
Purpose of the Study:
- To determine if Whole Health utilization is linked to improved clinical quality measures.
- To assess the association between Whole Health and chronic disease management.
- To evaluate the impact on preventive health care services.
Main Methods:
- A controlled pre/post quality improvement evaluation was conducted, accounting for secular trends.
- The study analyzed data from 125 VHA medical centers between October 2022 and March 2023.
- Whole Health users (including educational classes, coaching, and clinical conversations) were compared to general VHA care users.
Main Results:
- The study included 548,968 Whole Health users and 5,428,413 general VHA users.
- All nine clinical quality measures showed improvement after Whole Health utilization, continuing over six months.
- Whole Health cohorts demonstrated greater quality improvements than reference cohorts; for example, diabetes patients saw a 5.2% increase in good HbA1c control.
Conclusions:
- Whole Health utilization is associated with subsequent improvements in healthcare quality.
- The patient-centered Whole Health model shows potential to augment primary care.
- Increased patient activation and engagement through Whole Health may improve chronic disease management and preventive care adherence.
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