Veterans use of non-VHA services: implications for policy and planning.

Most Veterans elect not to use the Veterans Health Administration (VHA), even if eligible, or access the VHA system but rely on non-VHA providers as well. Given considerable cross-system use, failure to account for non-VHA care can bias conclusions about prevalence and incidence in utilization, diagnoses, and other characteristics. Furthermore, though dual VHA and non-VHA use provides Veterans with additional service options, it makes it difficult for VHA to ensure continuity of care. To better coordinate services, the VHA needs to construct the necessary health information bridges while widening the purview of case management programs. These changes are especially important in light of increased demand for care among younger Veterans returning from Iraq and Afghanstain and older Veterans who served in previous wars.