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Federal Register / Vol. 86, No. 20 / Tuesday, February 2, 2021 / Notices
assuring that each Veteran can receive the care they have earned and deserve.

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Criteria VA is conducting Market Assessments to design high-performing networks of care to provide high quality, readily accessible cost-effective care through VHA, Federal partners, academic affiliates and other private sector providers. This design provides VA
with the ability to plan for the continuing evolution of Veteran health care, incorporating major trends and events in the national and global health ecosystem e.g., the COVID19
pandemic and telehealth. Each assessment will create opportunities to position the VA health care system to increase health equity, enhance Veteran experience, account for social determinants and serve as the coordinator of health care provided by VA. Through thoughtful and constructive engagements with internal and external stakeholders, the following criteria were developed for the evaluation of VHA realignment and modernization opportunities.
The Secretary will use the criteria to make recommendations to the Asset and Infrastructure Review AIR
Commission, established by the MISSION Act for the modernization and realignment of VHA facilities and to improve Veteran access to high-quality health care across the country.
Recommendations submitted to the AIR
Commission will focus on creating Veteran-centric outcomes that retain or improve health care services for Veterans through the most equitable modalities and through services and locations that most benefit those we serve. The recommendations will then go through the AIR Commission review process as outlined in the MISSION Act.
Each criterion begins with a commitment statement, outlining VAs philosophy and commitment to current and future Veterans, followed by the criterion statement, sub-criteria and explanatory statement:
Veterans Need for Care & Services Demand Commitment Statement: VA is committed to providing Veterans the full range of care and services needed and desired throughout their lifetimes, to include preventive, acute and chronic care. These services will be carefully balanced to meet Veterans needs and preferences. We intend to ensure Veterans receive the personalized care they have earned. We will do this by matching the services and support they may need with our ability to provide those services in a timely manner,
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through VAs direct care system, through our Community Care Network and through government, academic and strategic partners.
Demand Criterion: The recommendation aligns VAs high performing network resources to effectively meet the future health care demand of the Veteran enrollee population.
Demand Sub-Criteria:
The recommendation:
Aligns the quality and delivery of care and services with projected Veteran demand across demographics and geography;
Retains or improves VAs ability to meet projected demand;
Considers health equity i.e., demographics;
Reflects consideration of factors underpinning observed utilization patterns e.g., rurality and other social determinants of health; and Incorporates trends in the evolution of U.S. health care.
When applying the demand criterion, VA will consider how a recommendation will impact VAs ability to meet the needs of Veterans in the future. VA will consider what Veterans may need through understanding the services that Veterans have accessed in the past and are projected to need and prefer in the future. VA will also consider how and where Veterans wish to receive services, including in ambulatory settings, hospitals, in the community, through telehealth, and through innovative models and modalities.
Accessibility of Care for Veterans Access Commitment Statement: We intend to provide Veterans with an accessible, whole health experience, with services thoughtfully designed to meet their needs. We will do this by making the services and support Veterans need accessible through locations, models and modalities that most benefit them and match their needs and preferences.
Access Criterion: The recommendation maintains or improves Veteran access to care.
Access Sub-Criteria:
The recommendation:
Aligns VA points of care and services with projected Veteran need across demographics and geography;
Retains or improves Veterans ability to access VA care;
Ensures Veterans are provided a range of health care options and the opportunity to choose care they trust, based on their preferences, throughout their lifetime;
Enables VA to serve as the coordinator of each Veterans health
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care whether provided within or beyond VA;
Considers health equity i.e., demographics;
Reflects consideration of factors underpinning observed access patterns e.g., rurality and other social determinants of health; and Incorporates trends in the evolution of U.S. health care.
When applying the access criterion, VA will consider how a recommendation will impact the convenience of care provided to Veterans in the future. Key components of access include the time it takes to receive care and the barriers and accelerators to receiving care, such as distance or availability of technology.
Impact on Mission Commitment Statement: VA is committed to delivering best-in-class care throughout Veterans lifetimes.
This means positioning the VA health care system at the leading edge of the health care industry in education, research and national emergency preparedness.
Impact on Mission Criterion: The recommendation provides for VAs second, third and fourth statutory missions of education, research and emergency preparedness.
Impact on Mission Sub-Criteria:
The recommendation:
Aligns resources to VAs education, research and emergency preparedness missions across demographics and geography;
Education: Maintains or augments VAs ability to execute its education mission;
Research: Maintains or augments VAs ability to execute its research mission;
Emergency Preparedness:
Maintains or augments VAs ability to execute its emergency preparedness mission;
Considers health equity i.e., demographics;
Reflects consideration of factors underpinning observed mission impacts of education, research and emergency preparedness efforts e.g., rurality and other social determinants of health; and Incorporates trends in the evolution of U.S. health care.
The impact on mission criterion allows VA to consider how a recommendation will impact our ability to execute our statutory missions of education, research and emergency preparedness in support of Veterans and the nation.

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