The Future of Veterans

The next administration will need to ensure the VA is well-funded and run efficiently. It should also make sure the agency is prepared to support the needs of a growing veteran population, particularly women veterans.

In addition, the next administration must focus on suicide prevention and homelessness. It must do this in a way that recognizes the unique needs of veterans and their families.

The Future of the Veteran Population

The veteran population is made up of a diverse group of people who have served in the United States armed forces. This population faces numerous challenges as they transition to civilian life.

The veterans who serve in our armed forces come from all walks of life and serve as a valuable resource for their communities. They have unique health needs and differ from the general population in many ways, including social determinants of health, behavioral health risk factors, and the prevalence and severity of medical conditions.

As the veteran population ages, it will require new services and approaches to meet their needs. These efforts will also need to be accompanied by funding to keep pace with demand.

The Future of the VA

The VA needs to prepare for a decrease in the number of patients it will serve over the longer term, particularly as aging and demographic trends shift the veteran population. A large part of this preparation involves assessing how to provide care in different areas and for different types of care.

The Department should also continue its public health approach to reduce veterans suicides and work with communities to improve access to mental health services. These initiatives are important to addressing a rising share of veterans who struggle with mental health conditions, including posttraumatic stress disorder and depression.

We recommend that VA establish a clear roadmap and measure progress toward all that it must accomplish to ensure its policy management procedures are aligned with national standards. We also recommend that it use a contract–$7.2 million in fiscal year 2020–to address capacity needs for the policy management initiative, such as hiring professional writers to assist program offices in maintaining and updating their policies.

The Future of Health Care

Veterans have a unique set of health care needs that require a special commitment from VA to ensure they receive high-quality, timely care.

To meet those needs, VA operates one of the largest and most comprehensive health care systems in the country. Yet the department has struggled to effectively harness its resources to meet the needs of a growing number of veterans.

The Veteran Access, Choice, and Accountability Act of 2014 (VAAA) sought to address these concerns by requiring an independent assessment of the VA health care system. RAND conducted three assessments on various aspects of the VA’s delivery of health care.

The results of the assessments show that VA’s ability to provide care in-house is not sufficient to meet current demand. In response, the Department of Veterans Affairs has increased purchases of care from private-sector providers to provide a variety of services to meet veterans’ needs. These purchases are known as purchased care and they make up about 9 percent of VA’s medical expenditures.

The Future of Homelessness

After years of struggling to end veteran homelessness, cities and states across the country are finally putting it on the right track. This success is due in part to two factors: Housing First and investments in veteran-specific programs.

The Housing First program encourages communities to use federal resources to quickly place homeless veterans in permanent, stable housing. This has been an effective approach in reducing veterans’ rates of long-term homelessness by 80 percent.

But there are still challenges to overcome. In addition to providing Veterans with permanent supportive housing, it is important to ensure that they are able to successfully transition back to the community when they leave this type of housing.

This requires coordinated outreach to identify and connect Veterans to housing solutions, health care and community employment services. It also means working with federal, state and local agencies; employers; housing providers; faith-based and community nonprofits; and other groups to expand employment and affordable housing options for Veterans leaving homelessness.