Comparing VHA vs Community Cardiovascular Care for Veterans
With nearly 50% of veterans in the Veterans Healthcare Administration (VHA) reporting at least 1 cardiovascular disease, researchers review the quality of cardiovascular care delivered by the VHA compared to community care, highlighting novel national care programs and valuable insights for health care decision-making.
The VHA has been providing health care to veterans since 1865. Recent laws, such as the 2014 Veterans Affairs CHOICE Act and the 2018 Veterans Affairs MISSION Act have aimed to increase access to non-VHA community care for veterans. This shift in care delivery raises questions about the quality and access to cardiovascular care, prompting a review of studies comparing VHA and community care from 2000 to 2024.
The VHA offers a wide range of cardiovascular care services, including prevention, general cardiology, interventions, and advanced heart failure treatment. With over 172 medical centers nationwide, VHA care is transitioning towards community providers for veterans' care due to perceived wait times. Studies have shown that VHA-treated veterans have comparable or better outcomes for heart failure compared to nonveterans. The VHA also outperforms community care in terms of inpatient mortality rates after acute myocardial infarction (AMI). Veterans receiving elective percutaneous coronary intervention (PCI) in VHA hospitals have lower mortality rates compared to those in community hospitals. Veterans undergoing transcatheter aortic valve replacement (TAVR) in the VHA have similar outcomes to historical controls from the community. The VHA offers programs for cardiovascular disease prevention and management, with high rates of statin prescriptions post-discharge for patients with AMI.
Researchers concluded that the VHA provides cardiovascular care that is equal to or better than non-VHA community care, with outcomes showing reduced mortality for heart failure and acute myocardial infarction. Veterans with high cardiovascular risk, such as those with diabetes, benefit from better risk factor control through VHA programs. Comparisons of VHA TAVR outcomes with those in the community are likely to be similar. Attention is needed to reduce readmissions after VHA hospitalizations for AMI.
Reference
Le DE, Arora BL, Kelly FR, et al. The quality of veterans healthcare administration cardiovascular care. JACC Adv. 2025;4(2):101533. doi:10.1016/j.jacadv.2024.101533
