Optimizing Veteran Decision-Making About Use of VA and Non-VA Health Care

NIH RePORTER · VA · I01 · · view on reporter.nih.gov ↗

Abstract

Background: Major health care transformations within and outside of VA are now providing Veterans with unprecedented health care choices. Within VA, under recent federal legislation integrated networks of community providers and public reporting of access and quality at VA facilities are aiming to expand health care choices for Veterans and improve the timeliness of services. Outside of VA, many lower-income Veterans in states that expanded Medicaid now have a public insurance option, while privately-insured Veterans are increasingly facing high deductibles in their health plans. Significance/Impact: Major shifts in health care financing and delivery present Veterans with opportunities to make decisions about their use of VA and non-VA health care that optimize the timeliness, affordability, quality, and patient-centeredness of their care. However, these decisions also carry great potential for unintended consequences if they are not well-informed. Despite such high stakes, little is known about how Veterans are making decisions about using VA and non-VA care, what information they want to use in this decision-making, and how provision of information to Veterans about their health care options could be improved. Understanding these issues is critical to the success of national efforts to expand health care choices for Veterans under the VA MISSION Act and to achieve a VA health care system that is maximally responsive to Veterans’ needs. Innovation: This study is the first to assess the views, experiences, and information needs of Veterans who are users and non-users of VA health care. Specific Aims: Aim 1: Examine how Veterans are making decisions about VA and non-VA care and what information they want to use when making these decisions. Aim 2: Identify correlates of Veterans’ decisions to use and experiences with using VA and non-VA health care. Aim 3: Engage Veterans and VA leaders to identify opportunities to optimize Veterans’ decisions about use of VA and non-VA care and VA’s responsiveness to Veterans’ health care preferences. Methodology: We will partner with Veterans organizations to conduct focus groups and semi-structured interviews that will examine decision-making experiences of Veterans who use VA care, non-VA care, or both; the sources of information Veterans have used and would want to use in this decision-making; and Veterans’ experiences with the timeliness, affordability, quality, and patient-centeredness of VA and non-VA care. We will use these findings to develop and field a national survey of Veterans’ use of and decision-making about VA and non-VA care; factors related to their decision-making and health needs; and perceptions of the timeliness, affordability, quality, and patient-centeredness of their health care. The nationally representative sample of 3,000 Veterans will include both users and non-users of VA health care. We will identify Veteran characteristics associated with use of VA and non-VA health care services a...

Key facts

NIH application ID
10844339
Project number
5I01HX002751-03
Recipient
VETERANS HEALTH ADMINISTRATION
Principal Investigator
JEFFREY KULLGREN
Activity code
I01
Funding institute
VA
Fiscal year
2024
Award amount
Award type
5
Project period
2020-02-01 → 2024-07-31