The dual site Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care is located at the VA Puget Sound and Eastern Colorado Health Care Systems. Research products from our Center's 47 investigators have impacted VA policy and care delivery across a spectrum of primary, specialty and mental healthcare services. We accomplished these impacts through partnerships with operational leaders and application of the National Academy of Medicine's Learning Health System (LHS). We employ the LHS through our research, implementation science, evaluation and training programs. Collectively, we help the VA become an efficient healthcare system where best practices and new knowledge are translated into clinical care. Our mission is to conduct high-quality health services research that promotes Veteran-centered and value- driven care, generate and disseminate knowledge that contributes to the well-being of Veterans, work collaboratively with VA policy and operational leaders to implement research finding into clinical care, and train the next generation of health services research leaders. In the next 5 years, we will continue to align our programs with challenges faced by patients, providers, and the VA health system. We have 2 research focus areas with 3 objectives embedded within each: 1. Promote Veteran-centered care and improve the patient experience across VA healthcare and community settings. We will accomplish the following: 1) develop methods to incorporate patient reported outcomes into routine clinical care and test interventions to improve these outcomes, 2) improve patient adherence and self-management through interventions targeting patients, providers and health systems, 3) innovate the delivery of specialty, mental, and/or primary health care services to patients using patient- centered approaches that bridge socioeconomic and geographic disparities. 2. Advance value-driven care by providing Veterans the highest quality care at lowest financial burden. We will develop new approaches to care that: 1) help the VA efficiently utilize, integrate, and coordinate health services received within the VA and in the community, 2) improve the quality and safety of care through appropriate implementation and de-implementation of healthcare services and 3) identify methods to improve workforce development, deployment, and provider satisfaction and well-being. Our emerging research areas include women's health, suicide prevention, and eliminating disparities. We have led and will continue to lead Veteran engagement efforts in research for VA nationally. Over the past 3 years, we obtained funding for 113 projects, generated $47 million in operating revenue and published 583 manuscripts. We trained 35 post-doctoral fellows and 12 VA and non-VA career development awardees. Our investigators were awarded the HSR&D best paper awards in 2015 and 2016. Our work has been recognized by national media, presented to Congress, resulted in legislati...