Rural Veterans Case Study

The VHA scheme presents an issue when it comes to highly rural veterans since only half of the Highly Rural enrollees reside within an hour of primary care. Approximately 70% of rural veterans still have to travel for more than two hours in order to get to acute care facilities and more than four hours to obtain tertiary care (West, et al). The discrepancy between the RUCA distances to the VA and the actual drive times are why The American Legion endorses the VA developing their own criteria for determining rural and highly rural veterans based on drive times rather than the US. (Legion.org)

The Problem with Distance

The problem with distance is that many rurally based veterans have to drive several hours in order to receive specialty

The main cause of this is the disparity between federal and private sector salaries. In an effort to remedy this situation, due to the number of enrollees who reside in rural or highly rural communities, the VA offers recruitment and retention bonuses along with student loan repayment in order to entice physicians to work in rural areas.

This is why the VHA has attempted to make rural outreach a priority, by creating the Office of Rural Health to address the concerns and needs of rural veterans. The biggest of these concerns involved lack of access to healthcare because of transportation difficulties that include travel distances, lack of transportation, or the inability to drive, these issues affect 33% of rural residents (Buzza, et. al.). According to Mooney et al., rural veterans travel farther to VHA hospitals than to non-VHA hospitals because of the 153 VHA hospitals in existence less than 38 of them are located in rural or highly rural areas. Buzza et. al., found three themes that influenced rural veterans ability to obtain VHA healthcare; the first is predictably distance, which is influenced by such things as age, health and functionality. Many elderly and disabled veterans can no longer drive and may not have access to public transportation or people who are willing to drive them such great

Notably, the VHA is not happy with the lack of control they have over the situation. The VHA claims this is because private physicians do not always bother to share or obtain information regarding a patient’s health.The third theme is distance to acute and emergency services, which is seen as potentially life threatening situation for veterans and a complex burden for primary care clinics. Finally theme four, which is CBOC’s that appear to be a positive step towards providing primary care access points, though many would like them to provide a larger array of