Racial and Ethnic Disparities Among Veterans in Community vs VHA Care

Key Takeaways:

• US veterans visiting community settings for primary care experienced greater racial and ethnic disparities compared to Veterans Health Administration (VHA) settings.
• Compared to White veterans, Black and American Indian or Alaska Native veterans reported lower satisfaction with care coordination, communication, and providers in community care settings.
• These findings highlight ongoing challenges in providing equitable care among veterans, and the authors recommend several policy interventions to reduce these gaps.

To improve care access among US veterans, the US Department of Veterans Affairs (VA) has funded health care from non-VA providers, also known as community care. However, the impact of community care on racial and ethnic disparities compared to VA care is unclear.

Researchers used cross-sectional data from the 2020-2023 VA Survey of Healthcare Experiences of Patients and VA Primary Care and Community Care surveys to compare racial and ethnic disparities in VA and community care. Categories included patient-reported access, care coordination, communication, and provider satisfaction. Differences-in-differences models were used to calculate findings according to race and ethnicity.

Reports of racial and ethnic disparities were higher for community care than VA care. Communication was lower among Black veterans by 13 percentage points compared to White veterans. Care coordination was worse among American Indian or Alaska Native, Black, and multi-race veterans by 22, 12, and 16 percentage points, respectively. American Indian or Alaska Native veterans also reported lower provider satisfaction by 34 percentage points.

Implications for Veterans Care

This study illustrated how veterans of racial or ethnic minorities experienced greater disparities in community care settings compared to VHA settings.

To address these gaps, the authors suggest various policy interventions, including improvements in community care navigation tailored to minority groups and care metrics to support informed decision-making among veterans.

Reference

Wong MS, Steers WN, Lind KE, Washington DL. Trade-offs between patient experience and health care access: comparing Veterans Health Administration versus community care by veteran race and ethnicity. Med Care. 2026. doi:10.1097/MLR.0000000000002368