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MISSION Act Quality Standards

The MISSION Act Quality Standards comparison data allows consumers to examine VA and regional community provider performance on key clinical quality and experience metrics. These comparisons depict VA facility performance and community provider performance at the measure level to aid consumers in understanding the quality of care available in their geographic region.

The metrics included are fundamental indicators of inpatient, outpatient, and patient experience performance that align with three central tenants of VA care:

  • Effective Care: Is based on scientific knowledge of what is likely to provide benefit to Veterans
  • Safe Care: Avoids harm from care that is intended to help Veterans
  • Veteran-Centered Care: Anticipates and responds to Veterans’ and their caregivers’ preferences and needs, and ensures that Veterans have input into clinical decisions

Comparative benchmark data is obtained primarily from the Centers for Medicare and Medicaid Services (CMS) Care Compare and from the National Committee for Quality Assurance (NCQA).

  • VA outpatient measures closely follow the specifications set forth by the National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data and Information Set (HEDIS). VA has utilized data from NCQA’s Quality Compass® to establish regional averages for hospitals that fall within geographic boundaries that match areas covered by Veterans Integrated Service Networks (VISN).
  • Most metrics reported on CMS Care Compare apply to Medicare beneficiaries (e.g., age 65 and older), while metrics reported for VAMCs may include patients who are not eligible for Medicare due to age and other factors.
  • VA uses the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) family of surveys to measure patient experiences. CAHPS was developed by the Agency for Healthcare Research and Quality (AHRQ) and is considered the industry standard for measuring patient experiences. More information about the CAHPS family of surveys can be found here.
  • Veteran-Centered Care inpatient measures align with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS includes measures like Overall Rating of Hospital and Care Transition, among others, that contribute to an overall patient survey rating. These measures are not comprehensive indicators of overall hospital quality unto themselves, but rather an important contributor to the global evaluation of hospital performance. Reported data is an approximation and does not represent official HCAHPS results. For more information on HCAHPS, please visit the HCAHPS website: or download the HCAHPS Fact Sheet. To learn more about CMS patient survey ratings, please visit CMS Care Compare’s patient survey page.
  • There is no industry standard method for fairly comparing performance on ambulatory CAHPS measures among hospitals or health systems, hence VA National average is used as benchmarks for the Veteran-Centered Care outpatient measures.

NOTE: Metric score comparisons contain a margin of error, therefore there may be instances where the VA score appears better or worse than the community benchmark score, but is listed as "SAME." In these cases, the VA score is within the margin of error of the community benchmark and is listed as "SAME."