Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives

Many American Indian and Alaska Native veterans are eligible for health care from the Veterans Health Administration (VHA) and from the Indian Health Service (IHS). These organizations executed a Memorandum of Understanding in 2003 to share resources but little was known about how they collaborated to deliver health care. The researchers sought to describe dual use from the stakeholders' perspectives, including incentives that encourage cross-use, which organization's primary care is "primary," and the potential problems and opportunities for care coordination across VHA and IHS. The authors of this study learned that fostering closer alignment between VHA and IHS would reduce care fragmentation and improve accountability for patient care.