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Have you ever wanted to know how wait times for specialty care between @VeteransHealth and the private sector?

I answer this in new research letter in @JAMANetworkOpen along with @joerianatalie and Steve Pizer:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2769826

QUICK">https://jamanetwork.com/journals/... THREAD 1/n

Wait times have been an important focus for the VA. Congress passed the CHOICE Act (2014) and the MISSION Act (2018) which allows veterans to seek care from private providers (at VA expense) if wait times or driving distances exceed certain thresholds (2/n)

We examined four high-volume specialties, and found that wait times for VA care have declined substantially since 2013. However, those declines mostly occurred before CHOICE act implementation (indicated by vertical black line). (3/n)

One figure that got dropped due to space constraints. The VA has to approve veterans to seek care from private providers. This adds a mean 6.4 days to those wait times, often shorter, but sometimes much longer (4/n)

But even after accounting for this administrative delay, we find average wait times at the VA are *lower* than private providers - 41.1 days versus 49.0 days. This may be unexpected for many... (5/n)

One potential explanation: we find that areas with poorer access to VA care also tended to have poorer access to private care. VA medical centers tend to be located in more populated areas - rural areas may lack both good access to VA *and* private care alternatives (6/n)

The big policy implication here is that certain areas are just underserved more generally - liberalizing veterans& #39; access to private providers will not solve their challenges with long wait times. They need more infrastructure or access to virtual services (7/n)

And of course, YMMV. Wait times are highly variable across the nation for both VA and non-VA care (figures not in final article due to space) (8/n)

Now, I& #39;m not a VA apologist. They aren& #39;t always the best, e.g. at fixing the elevator in my old building:

https://twitter.com/AssumeNormality/status/1178671623706173440?s=20

But">https://twitter.com/AssumeNor... it& #39;s important to remember that VA gaffes are well-reported, front-page news. This unfairly biases our perceptions of the institution. (9/n)

In contrast, private providers also make a lot of mistakes but when they lack the same mandatory reporting, and screw-ups are often buried by NDAs. So if these results seem surprising, keep that in mind! FIN (10/10)

My kingdom for the ability to edit tweets

How wait times for specialty care *compare*