The overall goal of this research is to compare VHA and non-VHA health care systems and the choice of veterans to rely on VHA or non-VHA systems for their services. Using data from the VHA and Washington’s all-payer claims data (not linked), the project will compare various parts of VHA and non-VHA systems, such as ICU, primary care, mental health, and specialty care services. The project will assess differences in utilization patterns and outcomes. The project will also assess various policy and operational changes that occurred in the VHA recently that might have affected access to care and the care itself delivered to patients.