# Center for innovation to implementation

> **NIH VA I50** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2024 · —

## Abstract

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 ...

## Key facts

- **NIH application ID:** 9666360
- **Project number:** 2I50HX001238-04
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** STEVEN M. ASCH
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 2
- **Project period:** 2013-10-01 → 2023-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9666360

## Citation

> US National Institutes of Health, RePORTER application 9666360, Center for innovation to implementation (2I50HX001238-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9666360. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*