The Department of Veterans Affairs is a pioneer in the patient-centered health home movement: In 2009, the VA adopted the model in the more than 1,400 VA medical centers and clinics nationwide.

The move at the VA, called the Patient Aligned Care Team, or PACT, comes on the heels of 15 years of similarly progressive efforts to incorporate behavioral and mental health into primary care, says psychologist Antonette Zeiss, PhD, acting deputy chief patient care services officer for mental health in VA Central Office.

“The change is more about making an already strong system even stronger and more veteran-centered than about changing the system itself,” she says.

The goals include making interdisciplinary teams more cohesive, using technology to better reach patients, and involving patients and families more completely in patient care, Zeiss adds.

“VA has fully embraced the concept that we are a comprehensive, integrated health-care system geared to fully serving and involving patients,” she says.

Psychologists are centrally involved in all of these developments as communicators who explain these changes to VA providers, staff and patients; as providers on integrated-care teams; and as managers of whole-health programs. As a result, the VA plans to hire even more psychologists than it has in the past, in particular those with health and behavioral health backgrounds, Zeiss says.

Such innovations are easier to enact at the VA than in the larger U.S. health-care system because of the VA’s centralized budget and mission of providing the best possible care to veterans, Zeiss admits. Still, the VA might serve as a model for larger health-care reform.

—T. DeAngelis