Raising the bar for veteran care

Approximately 502,000 veterans live in Washington state, with most residing in communities MultiCare serves. Through a new collaboration with the U.S. Department of Veterans Affairs (VA) and Epic, our electronic medical record platform, MultiCare is on a mission to improve the experiences and health outcomes of our veteran population.

Very few veterans receive care exclusively through the VA — most seek some health care services from civilian providers in the community, such as MultiCare. An Agency for Healthcare Research and Quality study found that 55 percent of veterans had only non-VA care visits over a 12-month period.

Many veterans are also dual-managed, typically a situation where a VA primary care provider refers a patient to a civilian provider for specialty care.

While the American Medical Association, American Academy of Nursing and other organizations recommend that doctors and other health care providers ask about a patients’ military background, it isn’t always common practice in civilian care settings.

“Knowing a patient has served in the military informs the way care is delivered,” says Matthew McCay, manager of the Veteran Advocacy Program at MultiCare Yakima Memorial Hospital. “Research shows that veterans as a population have trends in health care. They may be more likely to have certain diseases and injuries or experience exposure to ionizing radiation or certain chemicals like Agent Orange.”

In fact, one study found that the demands of service have increased to such an extent in recent years that veterans may be at even greater risk for experiencing poorer health outcomes.

Improving outcomes through data sharing

In 2024, MultiCare took an important step in improving veteran care by signing the Veteran Interoperability Pledge. Sponsored by the VA, the pledge creates a framework that supports the secure exchange of data between the VA and partner health systems in the community.

The seamless sharing of information better positions MultiCare to:

• Identify veterans in our care settings, supporting our ability to effectively address patients’ military service-related health risks
• Connect eligible veterans with VA medical or disability benefits and other community resources — improving access to care and lowering their out-of-pocket costs
• Improve coordination of care for dual-managed patients

MultiCare completed the first phase of framework development in 2024, work that allows us to access a VA database to confirm a patient’s veteran status (known as Title 38 status). This information is then pulled directly into Epic, our electronic medical record.

“Over time, this body of work will enable us to use veteran data to improve health outcomes for a population that commonly experiences health disparities,” McCay says. “It will also improve our community education efforts — ensuring those who are eligible are utilizing the benefits they’ve earned.”

Helping veterans access benefits

Identifying veterans is crucial, but it’s not our only opportunity to improve their health care outcomes and experiences. The next stage of this journey is to ensure veterans who qualify for compensation for a service-related condition are receiving it.

Veteran Benefits Administration (VBA) medical compensation and pension disability ratings qualify veterans to receive federal funds when they are diagnosed with certain conditions that are caused or exacerbated by military service, such as some types of cancer.

The funds pay for lifelong specialty care related to a person’s diagnosis, McCay shares. They also help offset the financial burden of living with a chronic or life-threatening condition, such as lost employment opportunities and the costs associated with frequent travel to medical appointments.

“Access to these funds can often make the difference between a patient choosing to pursue care or not,” McCay says. “I’ve unfortunately seen veteran patients in their last days who have suffered and died without the care they needed because they lacked VBA benefits.”

Applying for VBA ratings is a complex process, and some people may not even be aware they qualify. The Veteran Advocacy Program at Yakima Memorial Hospital has been a leader in helping Yakima region patients overcome these challenges through education and referrals to Veteran Service Officers — certified state employees who assist patients in filling out the required paperwork.

In 2024, the program successfully identified and referred 116 patients for VBA ratings, a more than 230 percent increase over the previous year’s referrals.

“Over time, this body of work will enable us to use veteran data to improve health outcomes for a population that commonly experiences health disparities. It will also improve our community education efforts — ensuring those who are eligible are utilizing the benefits they’ve earned.”

MultiCare and Epic are leveraging their ongoing partnership to scale up this practice across our entire organization in 2025. Through technological advancements powered by Epic, MultiCare will be able to use our electronic medical record to pull a patient’s VBA disability rating data directly from a VA database.

This work will position MultiCare to be the first health system in the nation to use VA data to identify patients who already have VBA ratings and patients who don’t but are likely eligible based on their diagnosis and service history.

“This will create an opportunity for MultiCare to perform targeted, proactive outreach and referrals for VA benefits at a magnitude we have not yet been able to do,” McCay says. “Veterans across the state of Washington will benefit from this collaboration.”