(Satisfaction) “Only because cardiologist, non-VHA put in my pacemaker. He knows me well; he saved my life. I feel comfortable with his care.”

(Relationship) “I've been in the VHA for 40 years.”

(Satisfaction) “I had a MI, brought to the Hospital, kept the Cardiologist since then because he more or less saved my life.”

(Relationship) “I've had non-VHA PCP for at least 20 years, and I like him.”

(Satisfaction) “[I] went to [outside hospital]. EMS took me there. I had a heart attack […] She is very efficient […]. I stayed with her care. She kept me under control.”

(Relationship) “My non-VHA PCP has been my doctor for 40 years […]”

(Proximity) “If I can't make it to the VHA, the non-VHA is closer. Go to non-VHA for minor things”

(Travel burden) “Convenience, location. Aging, I drive but maybe my car isn't safe, and I don't intend to replace it, so transportation will be in question.”

(Proximity) “Having assurance of having someone close if something happens…”

(Proximity for emergent care) “If something is wrong, I will come here but EMS would have to bring me to the nearest hospital”

(Proximity) “The non-VHA doctor and hospital is 3 blocks from my house. It's very close. He is a good doctor.”

(Travel burden) “Traveling is main reason. I can't handle it anymore.”

(VHA Benefits) “Because I served, the VHA is more convenient. I have no insurance except Medicare.”

(Out-pocket costs) “Starting to come here [VHA] now because of the payments.”

(Costs, out-of-pocket) “There are no payments here [VHA]. On the outside, it costs me. My medications are free here […].”

(Costs) “Prefer VHA now especially because cost increasing outside as I get older.”

(Costs, Medications) “Medications cost too much so I will start coming here to the VHA”

(Costs, Medications) “Now the specialists and the medicine are free at the VHA.”

(Specialty services) “Chiropractor is non-VHA because can't get one here at the VHA and can't get a referral for the chiropractor here. Also, Dental is non-VHA because can't get one here.”

(Choice of services) “I have a vast array of choices for providers and services at non-VHA”

(Specific services) “I use the VHA for specific reasons like optometry and service-related benefits.”

(Wait-time) “Because I have the insurance I use outside doctor, I know it gets busy in here. I let the other guys use the VHA.”

(Wait-time) “I can get an immediate appointment with my non-VHA primary.”

(Wait-time) “After finding out I had cancer, VHA would make me wait 2 weeks for MRI so contacted my pulmonologist and went to [non-VHA hospital].”

(One stop shop) “Everything is cohesive as far as the specialty doctors being all here”

(Wait-time) “Non-VHA for quicker treatment and emergencies”