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Health Services Research & Development

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HSR&D In Progress

May 2020

In This Issue: Advancements in VA Primary Care
» Table of Contents


Understanding Network Adequacy and Community Engagement in Veteran Care

Feature Article


Takeaway: This project will help ensure that appropriate standards are developed to meet the healthcare needs among Veterans seeking and requiring non-VA community care, including a network directory of providers and quality ratings of providers to more completely understand their perspectives on community care.


In response to highly publicized concerns regarding Veterans’ access to care in the VA healthcare system, Congress enacted the Veterans Access, Choice and Accountability Act (VACAA) in 2014 to establish the Veterans Choice Program (VCP) and expand the availability of community care for eligible Veterans. Since its inception, VCP has grown considerably, comprising nearly half a million providers, and Veterans using VCP now account for 17% of all users of VA care. While research on the impacts of the Choice Program is limited, it highlights issues with inadequacies of community provider networks to meet Veterans’ healthcare needs. Simultaneously, Veterans also have not been given access to information regarding VCP provider networks and can be uncertain of which providers are available to them. As a result, further investigation is needed to better understand how Veterans receive information regarding community care and how this information informs their decision to seek VA-purchased community care. This is required in conjunction with a concerted effort to define, measure, and evaluate network adequacy for non-VA community care networks.

This HSR&D-funded study (October 2018 – September 2021) aims to develop and validate measures of network adequacy for non-VA community care and evaluate regional variations in network adequacy across VA medical centers and VA’s 98 markets. Related, investigators seek to examine the process by which community care decisions are made at individual VA facilities, and to identify existing and potential opportunities to expand community partnerships to deliver community care.

Methods

This project will use a mixed-methods design to identify healthcare market, medical center, Third-Party Administrator, and Veteran characteristics and preferences that support or impede network adequacy and, thus, Veterans’ access to care. Combined with qualitative methods, investigators will leverage standardized national data and processes to account for individual VA medical center contexts and Veteran preferences. Investigators also will interview Veterans regarding community care, including preferences for a network directory of providers and quality ratings of providers to more completely understand their perspectives on community care.

Findings

None at this time.

Anticipated Impact

Study objectives have important implications for VA healthcare and the development of strong community networks and connections between VA and surrounding community providers to provide quality healthcare to Veterans. This study will help ensure that appropriate standards are developed to meet the healthcare needs among Veterans seeking and requiring non-VA community care.

Principal Investigators: Kristin Mattocks, PhD, MPH, Research Chief of Staff at the VA Central Western Massachusetts Healthcare System, and Michelle Mengeling, PhD, HSR&D Center for Access & Delivery Research and Evaluation (CADRE), Iowa City, IA.

Publications

None at this time.

View study abstract

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