This first population-based study of care received by service members with mild traumatic brain injury in the Military Health System profiles patients, their care settings and treatments, co-occurring conditions, and risk factors for long-term care.

This report examines changes in behavioral health care delivered to service members by the Military Health System following the onset of the COVID-19 pandemic, including patterns of care, use of telehealth, and quality of care. The findings and recommendations are intended to inform improvements to behavioral health care in the Military Health System and provide insights into the implications of its ongoing integration of telehealth.

Concerns about access to behavioral health care for military service members and their dependents living in geographically remote locations prompted research into how many in this population are remote and the effects of this distance on their use of behavioral health care. The authors conducted geospatial and longitudinal analyses to answer these questions and reviewed current policies and programs to determine barriers and possible solutions.

Women make up an increasingly large share of the U.S. veteran population, and their numbers continue to grow while the overall number of veterans is on the decline. Yet programs designed to support veterans' health and well-being have largely focused on men. Women's military experiences and postservice needs often differ from those of men, and women veterans also differ in significant ways from their nonveteran counterparts. Few studies have explored these variations, and this has translated to potentially missed opportunities to improve support for women during and after their transition from military to civilian life. Adagio Health, a provider of health, wellness, and nutrition services based in Western Pennsylvania, has taken steps to improve care for women veterans in its service area. To identify opportunities to further expand and enhance Adagio Health's efforts to support women veterans' health and wellness, the authors quantitatively and qualitatively assessed the needs of women veterans in the Adagio Health service area. The assessment provides a clearer picture of this often-underserved population, available services and resources, gaps in support, barriers to access, and areas to prioritize to provide the best support possible for the health and well-being of women who served. With the approaches recommended in this assessment, Adagio Health can continue increasing its capacities and capabilities for supporting its women veteran patients and making progress toward its goal of advancing their health and well-being.

The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans’ health care. The RAND Corporation was tasked with an assessment of the Department of Veterans Affairs (VA’s) current and projected health care capabilities and resources. An examination of data from a variety of sources, along with a survey of VA medical facility leaders, revealed the breadth and depth of VA resources and capabilities: fiscal resources, workforce and human resources, physical infrastructure, interorganizational relationships, and information resources. The assessment identified barriers to the effective use of these resources and capabilities. Analysis of data on access to VA care and the quality of that care showed that almost all veterans live within 40 miles of a VA health facility, but fewer have access to VA specialty care. Veterans usually receive care within 14 days of their desired appointment date, but wait times vary considerably across VA facilities. VA has long played a national leadership role in measuring the quality of health care. The assessment showed that VA health care quality was as good or better on most measures compared with other health systems, but quality performance lagged at some VA facilities. VA will require more resources and capabilities to meet a projected increase in veterans’ demand for VA care over the next five years. Options for increasing capacity include accelerated hiring, full nurse practice authority, and expanded use of telehealth.

This report examines changes in behavioral health care delivered to service members by the Military Health System following the onset of the COVID-19 pandemic, including patterns of care, use of telehealth, and quality of care. The findings and recommendations are intended to inform improvements to behavioral health care in the Military Health System and provide insights into the implications of its ongoing integration of telehealth.

This report describes a health and human services needs assessment of Prince George's County, Maryland. Findings from this report can inform Prince George's County's pursuit of a Health in All Policies approach to policymaking.

The COVID-19 pandemic brought about restrictions on in-person care delivery and led to a marked increase in the use of telehealth. When the pandemic began, the Military Health System (MHS) was already exploring options to expand its use of telehealth, including for service members with behavioral health conditions. To inform this effort and to provide insights into the pandemic's impact, RAND researchers examined changes in behavioral health care delivered to service members with PTSD, depression, or substance use disorder by the MHS following the onset of the COVID-19 pandemic, including patterns of care, use of telehealth, and quality of care. Although the number of behavioral health visits in the MHS declined overall following the onset of the pandemic in 2020 compared with an equivalent period in 2019, the use of telehealth increased markedly, and service members who received care had more visits with providers. In addition, the quality of the care they received largely held steady or even improved. The findings and recommendations can help guide the MHS as it takes steps to expand the use of telehealth, improve service members' access to behavioral health care and the quality of care they receive, and increase the resilience of behavioral health care in the MHS in the face of future disruptions.

When the demand for behavioral health care outstrips supply at military treatment facilities, service members are referred to private-sector providers. This report examines readiness assessment for these service members.

Provides an in-depth analysis of ambulatory care sensitive (ACS) inpatient hospitalizations and emergency department visits among Baltimore City residents. ACS inpatient hospitalization rates and ACS emergency department visit rates are commonly used as markers for the availability and efficacy of primary care in an area. ACS rates in Baltimore City are substantially higher than those in other Maryland counties, in Maryland as a whole, and in the District of Columbia. While a range of factors contributes to ACS rates, evidence suggests that a key determinant is the availability of primary care. Baltimore City appears to need additional primary care and may also need to focus on the quality and effectiveness of care in order to.