HERC: About Us
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About Us



The mission of the VA Health Economics Resource Center (HERC) is to increase the quality of VA health economics research and cost-effectiveness studies so that the nation and the nation’s veterans may get the best possible health care value from available resources. HERC was created in 1999 to respond to the VA Health Services Research and Development Service request for proposals to create a resource center on health economics.

Located in Menlo Park, California, HERC helps VA researchers determine the cost of VA care, assess cost-effectiveness, and evaluate the efficiency of VA programs and providers. The center conducts two seminar series on health economics, coordinates monthly economic Cyber Seminars, and operates an economics consulting service for VA researchers.

VA researchers who have a specific question not already addressed by the web site may contact our consulting service. Due to the great demand for health economics expertise, HERC economists do not ordinarily respond to requests for consulting assistance by becoming involved as co-investigators.  HERC maintains a database of VA health economists, including key words listing their research interests.

HERC estimates the cost of all VA health care encounters, develops guidebooks to VA data, and issues technical reports with analyses of economic data. The expertise of HERC economists is developed in their participation in economic studies that are funded by VA HSR&D, the QUERI Initiative, the Cooperative Studies Program, and the National Institutes of Health.


Ongoing Research Studies

The HSR&D HERC is dedicated to increasing VA's capacity to conduct high-quality health economics research and cost-effectiveness studies. It is the economics resource center of the VA Health Services Research and Development Service, the VA Quality Enhancement Research Initiative (QUERI) Program, and the economics coordinating center for the VA Cooperative Studies Program (CSP). HERC research studies are supported by these VA intramural research agencies, by the National Institutes for Health, and by other research sponsors.

Health Services Research & Development (HSR&D)

The VA Health Services Research and Development (HSR&D) service supports research on innovative strategies that lead to accessible, high quality, and cost-effective care for veterans and the nation. HERC receives core support from HSR&D to act as a national center that helps VA researchers determine the cost of VA care, assess cost-effectiveness, assess the budget impact of adopting and implementing new technologies, and evaluate the efficiency of VA programs and providers. HERC operates an economics consulting service for VA researchers. It offers health economics seminars. HERC works to improve methods and data available to VA economics researchers. HERC develops micro-costing methods, evaluates VA cost and utilization databases, estimates the cost of all VA health care encounters, and analyzes VA Managerial Cost Accounting (MCA; formerly Decision Support System) cost data. HERC publishes guidebooks and technical reports.

HERC economists conduct investigator-initiated research funded by VA HSR&D Service. They also assist with cost-effectiveness analysis in projects funded by HSR&D and the HSR&D QUERI Program.

Cooperative Studies

The VA Cooperative Studies Program (CSP) conducts multi-site randomized clinical trials of innovations in health care. HERC economists help plan, implement, and analyze data from trials coordinated by CSP that evaluate economic hypotheses.

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Current Projects

The following table lists select projects organized by HERC's current strategic initiatives.

Strategic Initiative


Access to Care

Virtual Care
  • Enhancing Veterans’ Access to Care Through Video Telehealth Tablets
  • Virtual Integrated Multi-site Patient Aligned Care Teams (V-IMPACT): Economic Evaluation Center (VEC)
  • Evaluation of Telehealth Expansion via VA’s V-IMPACT and Clinical Resource Hub Programs: Associations with Patients’ Health Care Utilization and Costs
  • The Economic Benefits of Virtual Care
  • The Economic Effects of VA’s National Telestroke Program (Operations)

Medical Specialty Care

Opiates & Medication Safety
  • Testing a Novel Strategy to Improve Implementation of Medication-Assisted Treatment for Veterans with Opioid Use Disorders in Low Performing Facilities
  • Effectiveness of a Rescue Medication in Preventing Opioid Overdose in Veterans
  • Cost Effectiveness of Interventions to Reduce Morbidity from Opioid Dependency
  • Promoting Benzodiazepine Cessation Through an Electronically-Delivered Patient Self-Management Intervention
  • Use of Virtual Care and Adherence to Chronic Medications During the COVID-19 Crisis
  • Veteran Access to Emergency Care During and After the COVID-19 Pandemic and Related Outcomes
  • The Impact of VA-Issued iPads During COVID-19 on Rural Veterans’ Suicide Screenings and Mental Health Utilization
  • Off Label Medication and the Risk of Death When Hospitalized From COVID
  • Geriatrics and Extended Care Data and Analysis Center (GECDAC) (Operations)
  • Does VA Home-Based Primary Care Reduce Costs Among Veterans Eligible for Independence at Home?
  • Helping VA Optimize its Long-Term Care Services
Women’s Health
  • Women’s Health Evaluation Initiative (WHEI) (Operations)
  • VA-DoD Long-Term Impact of Military-Relevant Brain Injury Consortium (LIMBIC): Health Economics Study
  • Improved Understanding of Medical and Psychological Needs (I-MAP) in Veterans and Service Members with Chronic TBI
  • Participatory System Dynamics vs Audit and Feedback: A Cluster Randomized Trial of Mechanisms of Implementation Change to Expand Reach of Evidence-based Addiction and Mental Health Care

VA vs. non-VA Care

  • Is there a VA advantage, evidence from dual enrolled Veterans?
  • Veterans’ Choice in Hospital Care
  • Utilization and Health Outcomes for Veterans with Expanded Health Care Access
  • Make Versus Buy – Examining the Evidence on Access, Utilization and Cost: Are We Buying the Right Care for the Right Amount?

Staffing & Productivity

  • How nursing staff skill mix, education and experience modify patient acuity-based estimates of required unit staffing
  • Primary Care Productivity Measurement
  • Real-Time Infection Prediction in Inpatient Postoperative Care

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Special Priorities

Each year HERC is engaged in several special priorities. These special priorities are topics of high interest or demand and often require collaboration with other researchers and/or VHA program offices. We believe these initiatives and collaborations will help us to disseminate health economics information, to make VA data more accessible, and to create stronger relationships, studies, and resources within VA.

Data Access (Handbook 1200.12)

HERC is a part of the group re-writing VHA Handbook 1200.12 on data access. We want to ensure economics data are represented when discussing issues to data access and data transparency. Todd Wagner, PhD is a part of the workgroup re-writing Handbook 1200.12.

Understanding Choice and Community Care Data

HERC is involved in research projects on Choice data and community care. HERC has convened with other researchers working with Choice and Community Care data, as well as the Office of Community Care, to discuss data, trends, and findings. Todd Wagner, PhD initiated the group of HSR&D researchers, which includes others such as Megan Vanneman, PhD (Salt Lake City VAMC) and Amy Rosen, PhD (Boston VAMC).

Standardizing documentation

Customer feedback from our focus groups and survey suggest that customers often search the HERC documentation, as well as VA Information Resource Center (VIReC) and VA Informatics and Computing Infrastructure (VINCI) documentation when looking for answers to data-related questions, and are uncertain of which source is the most complete, up-to-date, or accurate. We have spoken with VIReC and VINCI about this problem and both groups have heard similar responses. We propose a joint effort to standardize our documentation format as well as a common location for our data documentation to be stored, similar to the VHA Data Portal. This effort will combine administration, staff, and customers from all three centers to ensure these changes are effective and promote efficiency in health services research. Todd Wagner, PhD is working with Maria Souden, PhD of VIReC and Scott DuVall, PhD of VINCI.

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