As the VA pivots toward a dual role as both payor and provider, we must ensure access to high quality care for Veterans wherever they receive it, while wisely using taxpayer resources. Value theory unites these health outcomes with costs in a ratio that we can measure in health services research. The mission of the Center for Innovation to Implementation (Ci2i) is to foster high-value health care for Veterans. We will do so by identifying opportunities to improve value, and by testing the implementation of innovations that respond to those opportunities, both crucial activities for any learning health care system. Organized around three foci (C.1.a.), our research addresses priority areas for HSR&D and the VA leadership (C.Table 1). 1) Fostering high-value mental health care: Ci2i has a 40-year history of conducting groundbreaking, policy-relevant mental health services research. Mental health disorders rank among the most common and costly conditions afflicting Veterans.1 In partnership with the Office of Mental Health and Suicide Prevention, we will identify opportunities for innovation in improving access, quality, and resource use in mental health care delivery, particularly for Veterans struggling with substance use disorders (SUD) and/or post-traumatic stress disorder (PTSD) (C.1.a.1.). 2) Fostering high-value medical and surgical specialty care: Specialists comprise 65% of the physician workforce,5 their decisions necessarily contribute substantially to increasing costs.6 Specialty care resources are frequently misallocated, with some patients struggling for access while others are over-treated.7 It is imperative to understand how and where costly medical and surgical specialty care creates the most value. Likewise, it is imperative to create new approaches ensuring their optimal and judicious use.7,8 Ci2i will identify opportunities and test innovations that ensure the right Veterans get the right specialty services at the right time (C.1.a.2.). 3) Fostering high-value care beyond the VA: Many of the unrealized opportunities to improve Veteran health lie outside the bricks and mortar VA delivery system. While the VA's increasing role as a purchaser of community services aspires to expand access, it also poses new challenges in coordination and quality monitoring. High-risk Veterans with complex clinical and social needs require support not only during clinician visits, but also through daily caregiving and social services. Our research has shown the VA to outperform the community in some aspects of care. We will help to establish methods for wise resource allocation and extending high performance patient-centered care beyond VA walls to community providers and Veterans' homes (C.1.a.3.). Ci2i is a large and thriving center supporting a broad portfolio of research even beyond these three focus areas. We have published 1100 articles in the last three years and have been cited 184,000 times. Our senior researchers have been honored with ...