AmericaServes is a network approach for coordinating care among health and human service organizations to address the needs of the military-connected population. The IVMF and researchers with the Veterans Health Administration (VHA) partnered on two studies to explore the extent to which Veteran Affairs Medical Centers (VAMCs) participate in AmericaServes and the benefits of collaboration for veterans.

First, we conducted a convergent parallel mixed-methods pilot study. We interviewed staff from 7 AmericaServes coordination centers and VAMCs in those locations. We then categorized VAMC participation into levels of intensity and complexity, and identified barriers and facilitators to participation. We found that participation of VAMCs in AmericaServes networks varied, with more operating at low (versus high) levels. Barriers were typically more prevalent on the VHA side, though clear communication and regular engagement facilitated better participation. We also matched AmericaServes clients to VHA patient data and assessed the resolution rates of requests for services, looking at those dually served by AmericaServes and VAMCs versus those only served by AmericaServes. Notably, when participation was stronger, requests were successfully addressed more often. Further, compared to the VHA patient population, AmericaServes clients tended to be younger, included more women and veterans from racial and ethnic minority groups, and lived in areas of higher socioeconomic deprivation.

Building on the pilot, we are assessing the association of navigation and care coordination services with VHA healthcare utilization (e.g., emergency department visits, inpatient admissions, and outpatient encounter days). We conducted a retrospective, longitudinal cohort study comparing those dually served by one AmericaServes network (PAServes) and VHA against a control group of VHA patients. Preliminary propensity-weighted comparisons suggest that PAServes clients have higher VHA utilization than the control group and that utilization decreases following exposure to PAServes. Further analysis is in progress, including an examination of effects on VHA healthcare costs.