Background: Atherosclerotic cardiovascular disease (ASCVD) is a major contributor to morbidity and mortality in United States (US) Veterans and to healthcare costs in the United States Veterans Affairs (VA) Healthcare System. Optimizing Low-Density Lipoprotein Cholesterol (LDL-C) can improve Veteran health, reduce incidence of cardiovascular events and death, and lower healthcare costs.

Methods: The VA Lipid Optimization Reimagined - Quality Improvement (VALOR-QI) program is an innovative three-year multi-site quality improvement program leveraging various lipid optimization strategies tailored to unique barriers and needs at 50 VA Medical Centers. Program oversight is provided by the Boston VA Coordinating Center and the American Heart Association (AHA), and local teams include a site lead or Clinical Champion (CC), a Healthcare Coach (HC), and a Health Care Provider Network (HCPN) of clinicians treating Veterans with ASCVD. Outcome data are collected through the VA electronic health record database and QI data are collected through the VA Research Electronic Data Capture (REDCap) system. Primary and secondary outcomes include the percentage of Veterans with optimized LDL-C (