Caribbean Veteran Access to Care Study

Department of Veterans Affairs

VISN 8 - VA Sunshine Healthcare Network

Puerto Rico and the U.S. Virgin Islands


Romanyk Consulting Corporation (RCC) conducted a feasibility study to review and evaluate the actual sufficiency and efficiency of Veterans’ access to VA and non-VA (i.e., other Federal, state, or community provided) care. The analysis portrayed the actual and projected Veteran Population, Enrollees, Unique Veteran patients, and workload, as well as expenses by type and volume of medical care services delivered and projections on future requirements.


The feasibility study was in accordance with the VA MISSION Act of 2018. VISN 8 sought to obtain an analysis of healthcare delivery options for Veterans residing in Puerto Rico and the United States Virgin Islands (the Caribbean Region). This analysis determined the feasibility of establishing new VA Community-Based Outpatient Clinics (CBOCs) where none existed and examined the options of eliminating medical facilities through partnering with community care. The study included appropriate business case and cost-benefit analyses resulting in specific recommendations for future care delivery options for Veterans residing in the Caribbean Region.


This project required RCC to complete required site of care evaluations, VA RVU conversions to FTE requirements, master planning assessments, space requirements, data analysis, demographic mapping, capital investment estimating and reviews, and overall evaluation of access to VA and non-VA care in the Caribbean Region. The analysis concluded with recommendations and alternative option development.