Health Care for Rural Veterans: The Example of Federally Qualified Health Centers [January 13, 2014] [open pdf - 629KB]
"The Department of Veterans Affairs (VA) is statutorily required to provide VA-enrolled veterans with access to timely and quality medical care. It does so through the nation's largest integrated health care delivery system. Despite the existence of this system, Congress remains concerned that veterans, in particular rural veterans, may not be able to access VA health services. Among veterans enrolled in VA health care, approximately 41% reside in rural or highly rural areas. Compared to urban veterans, rural veterans have higher prevalence of physical illness, lower health-related quality of life, and greater health care needs. Congress has demonstrated continuing interest in modifying VA delivery of care to expand access for rural veterans. Such interest has been demonstrated through report language, statutory mandates, appropriation of funds, and authorization of demonstration projects. In particular, Congress has encouraged the VA to collaborate with federally qualified health centers (FQHCs)--facilities that receive federal grants and are required to be located in areas where there are few providers, particularly rural areas. […] To address these considerations and encourage VA-FQHC collaboration, there are a number of policy levers that Congress might use. These include oversight, an incentive fund, directed spending, statutory mandates, and watchful waiting. Congress may also consider a combination of these levers. This report discusses considerations that may arise during possible attempts to increase VA-FQHC collaboration, and describes policy levers Congress might use to encourage VA-FQHC collaboration. These approaches might also be employed to encourage collaboration between the VA and other types of facilities that may serve rural veterans."
CRS Report for Congress, R43029