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Food insecurity is linked to poorer physical and mental health, including an increased risk of suicide. Therefore, addressing the needs of food-insecure veterans is a national priority. The U.S. Department of Veterans Affairs conducts routine screenings to identify veterans at risk of food insecurity and refer them to sources of support. Nonetheless, food-insecure veterans are consistently less likely than their nonveteran peers to be enrolled in the Supplemental Nutrition Assistance Program (SNAP). This research adds to the evidence base on food-insecure veterans who do and do not enroll in SNAP, as well as differences between food-insecure veterans' and nonveterans' reasons for starting and ending — or losing — SNAP benefits and patterns in these groups' use of other safety-net programs. For example, veterans' benefits could push their income above the eligibility threshold for SNAP. Although it is a federal program, SNAP is administered by the states, and the RAND analyses highlighted potential policy options to facilitate SNAP access for food-insecure veterans. Two groups of food-insecure veterans were much less likely to participate in SNAP than their nonveteran peers: older veterans and those who were not in the workforce because of a disability. Increasing SNAP access for food-insecure veterans who are falling through the cracks is one immediate step toward eliminating food insecurity, but there is also a need for early interventions to identify and support service members who are at risk of becoming food insecure as veterans.

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This report was initially published in 2019; this update was published in 2021 and includes clarification on RAND's definition of clean procedures. Medicare payment for many health care procedures covers not just the procedure itself but also most post-operative care over a fixed period of time (the "global period"). The Centers for Medicare & Medicaid Services (CMS) sets payment rates assuming that a certain number and type of post-operative visits specific to each procedure typically occur. This report describes how CMS might use new claims-based data on the number of post-operative visits to adjust valuation for procedures with 10- and 90-day global periods. There are links between the number of bundled post-operative visits and the components of valuation addressed in this report: work, practice expense (PE), and malpractice relative value units (RVUs). There is some ambiguity regarding how a reduction in post-operative visits translates into changes in work RVUs. In contrast, a reduction in post-operative visits has clear implications on physician time and direct PE. Changes in physician work, physician time, and direct PE will in turn affect the allocation of pools of PE and malpractice RVUs to individual services. The idiosyncrasies of the resource-based relative value scale system used to determine payment for Medicare services result in some ambiguity about how procedures should be revalued to reflect reductions in post-operative visits. These results may inform further policy development around revaluation for global procedures.

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Women make up an increasingly large share of the U.S. veteran population, and their numbers continue to grow while the overall number of veterans is on the decline. Yet programs designed to support veterans' health and well-being have largely focused on men. Women's military experiences and postservice needs often differ from those of men, and women veterans also differ in significant ways from their nonveteran counterparts. Few studies have explored these variations, and this has translated to potentially missed opportunities to improve support for women during and after their transition from military to civilian life. Adagio Health, a provider of health, wellness, and nutrition services based in Western Pennsylvania, has taken steps to improve care for women veterans in its service area. To identify opportunities to further expand and enhance Adagio Health's efforts to support women veterans' health and wellness, the authors quantitatively and qualitatively assessed the needs of women veterans in the Adagio Health service area. The assessment provides a clearer picture of this often-underserved population, available services and resources, gaps in support, barriers to access, and areas to prioritize to provide the best support possible for the health and well-being of women who served. With the approaches recommended in this assessment, Adagio Health can continue increasing its capacities and capabilities for supporting its women veteran patients and making progress toward its goal of advancing their health and well-being.

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With evolving demographics and a changing health system landscape, the Prince George's County Council, acting as the County Board of Health, is considering its future policy approaches and resource allocations related to health and well-being. To inform this path forward, the authors of this report used primary and secondary data to describe both the health needs of county residents and drivers of health within the county, inclusive of the social, economic, built, natural, and health service environments. This report integrates these findings, an analysis of budget documents, and a review of promising practices from other communities to situate recommendations in a Health in All Policies framework to foster aligned and integrated planning and budgeting across the county to promote health and well-being. Findings from the assessment indicate a shared interest among leaders and residents to embrace a holistic strategy for health and well-being in the county. Inefficient uses of the health care system are identified, highlighting a need to rebalance investments in health care use and drivers of health. Additionally, challenges in navigating health and human services and inequities in drivers of health across communities are noted, signaling broader concerns related to residents' access to health and human services that influence health and well-being outcomes. Recommendations are provided for several paths forward for the county to pursue a more integrated policy approach to influence health and well-being outcomes.