Decoding the Veterans Affairs (VA) Care Assessment Need (CAN) Score
Within the U.S. Veterans Health Administration (VHA), the Care Assessment Need (CAN) score is a predictive analytics tool designed to identify patients at high risk for hospitalization or death within a specific timeframe. This automated system provides a numerical value from 0 to 99, with a higher score indicating greater risk. The score is calculated weekly using an individual's electronic health record (EHR) data.
How the VA CAN Score is Calculated
The VA CAN score is a data-driven model based on numerous factors from a patient's EHR, synthesizing a vast amount of information to provide a risk profile. Key components include:
- Demographic data
- Health care utilization history
- Diagnoses (inpatient and outpatient)
- Vital signs
- Medications
- Laboratory values
The Clinical Usefulness of the VA CAN Score
Primary care teams use the CAN score for targeted care coordination. A high score can alert a provider to a patient who may benefit from proactive management, potentially including referrals to specialized programs like nurse-managed home care, palliative care, or hospice. This shifts care towards prevention, aiming to improve patient outcomes.
The CANS Assessment for Children and Adolescents
Separate from the VA's metric, the CANS (Child and Adolescent Needs and Strengths) is a tool used in behavioral health for children and families. This trauma-informed assessment helps social workers and behavioral health professionals with case planning and identifying appropriate services.
The Purpose of the CANS Assessment
The CANS tool serves several key functions within child welfare and mental health services, including:
- Providing a common language for communication among those involved in a child's care.
- Directly informing the creation of personalized service plans.
- Helping track progress over time.
- Aiding in determining appropriate service levels and resource allocation.
The CANS Rating System
The CANS uses a 4-level rating system for various needs and strengths, designed to translate into action levels for service providers. Ratings consider the youth's age and current functioning.
Comparison of CAN Score Types
To avoid confusion, it is helpful to compare the two distinct applications of the term.
| Feature | VA Care Assessment Need (CAN) Score | Child and Adolescent Needs and Strengths (CANS) |
|---|---|---|
| Primary User | Veterans Health Administration (VHA) | Child welfare and behavioral health agencies |
| Target Population | Adult veterans with complex chronic diseases | Children and adolescents (ages 3-17) |
| Core Function | Predicts risk of hospitalization or death | Assesses behavioral health needs and strengths |
| Scoring Range | 0 to 99 (higher = greater risk) | 4-level rating for specific needs and strengths |
| Data Source | Electronic health records (EHR) | Assessment administered by certified professional |
| Purpose | Proactive risk stratification and care coordination | Informing service planning and monitoring outcomes |
| Output | A single numerical risk score | Detailed profile of needs, strengths, and action levels |
Implications for Healthcare and Patient Outcomes
Both versions represent a shift towards data-driven, preventative healthcare. In the VA, the score helps prioritize interventions for vulnerable veterans, potentially improving long-term health. Research suggests the VA CAN score can also be a valuable tool for risk-stratifying patients for specific procedures and identifying frailty in older adults.
For child behavioral health, the CANS assessment ensures service plans are tailored to individual needs. By providing a standardized tool, it helps different providers collaborate effectively, ensuring continuity of care and better outcomes for at-risk youth.
Conclusion
Ultimately, a CAN score's meaning is not universal; its interpretation depends entirely on the clinical setting. The VA's Care Assessment Need (CAN) score is a powerful predictive tool for adult veteran health risks, while the Child and Adolescent Needs and Strengths (CANS) assessment is a critical component of behavioral health for younger populations. Both underscore the increasing reliance on structured, data-informed approaches to deliver more effective and personalized healthcare.
For more detailed information on the VA's score, authoritative research can be found on sites like the VA's Health Services Research & Development (HSRD) website.
