Opinion: VA Excels in Comprehensive, Integrated Health Care

“When’s the last time you got screened for breast and cervical cancer?” asked my community primary care doctor back in 2014. I squirmed a bit, unsure of the exact date, month or even year.

“I’m current on my screenings,” I assured him.

Later that year, at my annual women’s health appointment, that provider asked if I was current on my cholesterol screening and what specific doses of medication I was on. Once again, I did my best to remember.

It was frustrating to me as the patient — and probably to the provider as well — that my women’s health provider and my primary care doctor weren’t on the same computer system, so neither could see a full picture of me as a patient. Both had to trust that I was able to give them complete and accurate information, and I had to hope no recommended care slipped through the cracks.

Even more frustrating was the saga I had to go through every time I needed additional tests. As any American who has ever had to get tests done through private care could attest, it isn’t just as simple as showing up and getting blood drawn. Was the lab that my provider recommended covered by my insurance? Even though a hospital was “in network,” did that mean that the specialty provider was also in network? How about the radiology center my provider referred me to? The responsibility to double check all of that was mine — and failure to do so could mean paying thousands for basic lab tests.

When I came to the Department of Veterans Affairs to run the Center for Women Veterans in 2016, I felt obligated to start using my VA health care benefits. If I were going to encourage others to sign up for VA care, I wanted to do so with confidence in the system I was recommending, along with the VA education, disability compensation and home loan guaranty benefits that had improved my own life. Once I learned how much better comprehensive, integrated care from a patient-aligned care team is as a patient, I never wanted to go back.

Now that I’m getting my care from a women’s health primary care provider at VA, I see the same person for all my routine medical care instead of needing to schedule different appointments on different days. VA fully recognizes that breast and cervical cancer screenings are part of routine primary care for me as a woman and integrates them into my regular appointments. Every provider, lab and radiology clinic at the VA Medical Center is “in network,” and I don’t get any surprise bills. Plus, my entire care team can see my full chart, which greatly relieves me of the stress in navigating a private health care system that most Americans find confusing.

Integrated care isn’t just easier for me as a patient — it’s also better. Studies have shown that fragmented care increases the risk of adverse health outcomes, including prescription opioid overdose. The risks associated with using multiple systems of care are amplified in high-risk populations, such as those with dementia — and we know VA patients skew older and have higher health burdens than non-VA patients. More generally, American private care — and how to pay for it and how much to pay — has become so confusing that many Americans may be forgoing necessary care altogether. This is why I believe it is so important that we preserve a strong VA system that centers on comprehensive, coordinated and low-cost care.

VA is not a perfect system. I continue to advocate for ongoing improvements in how welcoming VA is for women veterans. And yet, having used both military, private and VA-provided care, I know of no other system that is more focused on caring for veterans as whole people, regularly screening for — and referring patients to services for — homelessness and housing instability, food insecurity, military sexual trauma, legal challenges, intimate partner violence and suicide risk. While VA, as with the civilian health care sector, experienced challenges with access and wait times during the pandemic, years of preparation enabled an incredibly rapid pivot to telehealth that could shape the future of care delivery.

Some may push for VA to act more like a health insurance company, but both my personal experiences over the past five years as a patient and the data I’ve seen have convinced me to Choose VA for comprehensive, integrated, culturally competent care for my military-specific experiences as a veteran. I hope you will, too. I encourage you to contact your nearest VA or even speak to others who may be receiving their care at VA to learn more about their experiences.

Kayla M. Williams is an Army veteran and the Assistant Secretary of Public and Intergovernmental Affairs at the Department of Veterans Affairs.