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Major study examining impact of equitable access to services on health outcomes of veterans

PITTSBURGH, Nov. 8, 2023 – A major study funded by The Heinz Endowments is examining the effectiveness and efficiencies of health and service outcomes for more than 4,000 veterans in southwestern Pennsylvania. It focuses on services provided by the region’s Veterans Affairs medical centers and PAServes-affiliated nonprofit service providers. The research is led by the Pittsburgh-based Veterans Health Foundation, a Veterans Affairs-affiliated nonprofit organization, and includes elements that identify and offer solutions to race and gender-based disparities in how services are accessed and provided.

An initial $230,000 grant from The Heinz Endowments funds the launch of the three-year study and supports the first year of the work, which began last month and continues through 2026. Members of the research team include experts in veterans and health research from the Veterans Affairs Pittsburgh Healthcare System, University of Pittsburgh, the D'Aniello Institute for Veterans and Military Families at Syracuse University, and Stanford University.

The study compares patients who used only the U.S. Department of Veterans Affairs (VA) traditional healthcare system with those who engaged both the VA and PAServes. PAServes is one of 18 AmericaServes network locations which help military personnel, veterans and their families easily connect with health and social service providers. During the 2018-20 period included in the study, PAServes made a total of 14,232 referrals to service providers on behalf of the 4,069 individuals in the study cohort. Since its launch in Pittsburgh in 2015 with support from the Endowments, PAServes has made a total of 31,300 service referrals for 10,800 individual clients.

A 2022 research project funded by the Veterans Health Administration (VHA) that examined the feasibility of matching PAServes clients with VHA electronic health records helped spark the new study. Data from that project found that veterans who were engaged with both VA healthcare services and PAServes were more likely to be women and veterans of color compared to those in the general Veterans Affairs patient population. The VA has recognized the need for addressing disparities in benefits provided to historically marginalized communities, and announced in late June that it has formed a committee to address the challenge.  

The 4,069 veterans who used PAServes in addition to a VA medical center from 2018-20 had one-stop access to more than 40 affiliated service organizations providing a wide array of services, including employment, physical and mental health, money management, food assistance, housing and shelter, and overall navigation of the benefits system. These participants’ experiences will be compared to a rigorously selected control group consisting of veterans who engaged only VA medical centers during the same period.

“Our aim is to help ensure that veterans from all walks of life and backgrounds have the best possible chance for a prosperous and successful post-military future,” said Endowments President Chris DeCardy. “This study will provide critical insight into the significant health improvements for veterans that are possible when their health and human service needs are simultaneously addressed.”

“As we and our grantee partners examine the findings of this study of the innovative work underway in southwest Pennsylvania, we are hopeful that we will identify solutions that can be replicated across the United States,” he added.

“There are many barriers that can keep service-members, veterans, and their families from receiving the services they need to successfully transition from the military to civilian life,” said Megan Andros, the Endowments’ Program Director for Veterans. “This research and forthcoming data analysis have the potential to significantly change the way critical services are identified, sourced, and provided for those who have served our country. There is no better way to thank them than to do all we can to ensure their path to a thriving future is as obstacle-free as possible, and strong partnerships between nonprofit community organizations and the VA have the potential to do just that.”

Founded in 2015 at Syracuse University’s D'Aniello Institute for Veterans and Military Families, the AmericaServes network of which PAServes is a part, was created to provide easy access to a coordinated network of organizations dedicated to connecting the military community to resources specific to their individual needs. With 18 AmericaServes networks across the country, each chapter guides those seeking services through the navigation of obstacles that can impede successful transition from active-duty military service to civilian life, and fosters lasting connections with service providers that can lead to a lifetime of stability and support for veterans and their families.

Dr. Leslie Hausmann, a researcher at the Center for Health Equity Research and Promotion housed within the VA Pittsburgh Healthcare System, is leading the study. Dr. Hausmann, who also serves as associate professor of medicine and assistant dean for medical student research at the University of Pittsburgh, has devoted her career to identifying and eliminating health care disparities in the veteran population.

“Ensuring that equity is part of any effort related to supporting service members, veterans, and their families through integrated health and social services is key,” said Dr. Hausmann. “We are excited to dive into this work, to understand if PAServes has a differential impact for veterans from typically marginalized groups, and to use what we learn to give all veterans the best outcomes possible when integrating health and social service delivery systems.”

The 2022 Veterans Health Administration research that inspired this new study found that nearly two-thirds of PAServes clients were also patients at VA medical centers, were more likely to be women and individuals from racial or ethnic minority backgrounds, and had a higher number of social risk factors documented in their records than those using only a VA facility. These risk factors include food insecurity, housing instability, and higher rates of justice system involvement and unemployment challenges.

Underscoring the urgency of better care coordination and connection to services for veterans, an Endowments-funded 2022 report from Penn State University’s Clearinghouse for Military Readiness and Syracuse University revealed only 34 percent of veterans experience successful transitions to civilian life within the first 30 months of exiting the military.

The Veterans Health Administration recently announced a 3 percent increase in employees during fiscal year 2023, its highest growth rate in over 20 years. Results of a nationwide Medicare survey released in June 2023 found veterans rated VA hospitals higher than private care facilities in all 10 categories of patient satisfaction.

“The VA has done a number of positive things to increase its capacity to meet the health and wellness needs of veterans,” said Ms. Andros. “The intentional partnership that has been built between Veterans Affairs medical centers and PAServes in southwest Pennsylvania has benefited both, as well as the veterans community as a whole. We and our VA partners are excited to examine how such a collaboration can bring more equitable access to services, as well as improve health and overall life success for our country’s 16.5 million veterans.”

Focusing on data gathered between 2018 and 2020, the research is being conducted by a multidisciplinary team consisting of experts on veterans’ health, health equity, health care costs, and longitudinal data analysis. A majority of the study is centered at the VA Center for Health Equity Research and Promotion with support from sector specialists around the country.

The study is identifying and categorizing clinical, social and health risk factors of veterans in the study’s pool; detailing the VA and non-VA benefits and services that veterans received after their referral to PAServes; examining the race- and gender-specific effects of PAServes’ services navigation and care coordination; and from those findings determining the effects on overall health and social outcomes, costs, and savings associated with care for patients in the study.

An advisory panel consisting of veterans, representatives of the Veterans Benefits Administration, the Veterans Health Administration Office of Health Equity, and the Center for Minority Veterans is helping steer the study. The panel will assist in translating the results into policy and practice recommendations, and initial research benchmarks will be presented in late summer of 2024.


Contact: Scott Roller
The Heinz Endowments