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VIReC Database and Methods Seminar

Updates on VA-Purchased Community Care Data

by Erin Beilstein-Wedel, MS ; Matthew Labo, MPA ; Megan Vanneman, PhD, MPH ; Todd Wagner, PhD
Seminar date: 9/12/2022

Description: The Veterans Health Administration (VA) has a long history of purchasing care in the community. However, as of 2014, the VA only spent approximately 10% of its healthcare budget on purchased care. This changed with the 2014 Choice Act and 2018 MISSION Act, both of which expanded Veterans' eligibility for VA purchased care (often referred to as community care). Currently, over a third of VA's nine million enrollees use community care in some manner. In response to this expansion, our research team compared utilization, cost, and access to both VA-delivered and VA-purchased community care. We gained expertise in claims data, including Veterans Health Information Systems and Technology Architecture (VistA) Fee, Fee Basis Claims System (FBCS), Program Integrity Tool (PIT), and Plexis Claims Manager (PCM); are developing expertise in newer claims datasets - Electronic Claims Adjudication Management System (eCAMS) and the Community Care Reimbursement System (CCRS); and have incorporated related datasets. As leaders of the Community Care Research Evaluation & Knowledge (CREEK) Center's Data and Measurement Science Hub and the Health Economics Resource Center (HERC), we are actively working with the Office of Integrated Veteran Care (IVC) to better understand these data and share resources with operational and research groups.
Our objectives for this session are to: 1) share information on how to access community care data for operational and research projects; 2) provide examples of how to examine utilization, cost, and access using these data; and 3) give updates on the development of IVC's consolidated community care datasets.

View archived session video:

DOWNLOAD: PDF handout | Audio only (mp3) | transcript

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