# Evaluating Care Coordination for Community Hospitalized Veterans to Improve Outcomes in Dual Use (ECHOeD)

> **NIH VA I01** · RALPH H JOHNSON VA MEDICAL CENTER · 2024 · —

## Abstract

Anticipated Impacts on Veterans Health Care: Hospitalization and Emergency Department (ED) visits in
community hospitals represent a vulnerable time for Veterans, since dual VA-Community healthcare can be
associated with adverse health outcomes. The rigorous evaluation of VA Office of Community Care (VAOCC)
Acute Hospital Care Coordination Program that we propose will yield valuable formative and summative
information to our operations partner. A systematic program evaluation has the potential to: expand knowledge
of best practices for hospital care transitions, better understand factors associated with program effectiveness,
and enable comparisons of differential impacts among rural vs. urban Veterans.
Background: While current VA access initiatives should have net-positive impacts for Veterans, there may be
negative unintended consequences. To address these concerns, the VAOCC is currently developing a
multicomponent, evidence-based care coordination program to help Veterans receiving acute (ED and
hospital) care at non-VA facilities navigate back to the VA system. Our Ralph H. Johnson VAMC team has
partnered with VAOCC in developing this program, and when implemented nationally, the VAOCC Acute
program will be the first in VA to address cross-system hospital care and the first national rollout in or outside
VA of a post-discharge care coordination intervention.
Objectives
Specific Aim 1: Evaluate the implementation of the VAOCC Acute Community Hospital Care Coordination
Program across multiple implementation domains including adoption of key program components, fidelity of
implementation, reach to community partners and eligible Veterans, and maintenance of program activities in 3
VISNs (7, 8, 19). Evaluation will be guided by the RE-AIM model collecting formative information using VA
operations data to be shared with VAOCC during program roll-out.
Specific Aim2: Determine overall program effectiveness (summative evaluation) in coordinating care for
Veterans through a) reducing subsequent acute healthcare utilization, b) fidelity to key intervention
components, and c) reducing/neutralizing costs.
H1: Veterans with acute community care events after program implementation will experience lower rates of a)
7-day, 30-day ED revisit, b) 7-day, 30-day hospital readmission, c) fewer total hospital days per episode of
acute illness as compared to Veterans from the pre-implementation period. H2: Facilities implementing
program components with higher measures of fidelity and higher satisfaction with/perception of care transition
quality will demonstrate larger relative improvements in healthcare utilization and as compared to facilities with
lower levels of implementation success. H3: In a formal cost benefit analysis considering program costs and
estimated savings including avoided acute care visits, the program will be deemed budget neutral or cost
saving based on cost-benefit ratios.
Methods. Patient-reported data will be collected using interactive ...

## Key facts

- **NIH application ID:** 10911045
- **Project number:** 5I01HX002437-05
- **Recipient organization:** RALPH H JOHNSON VA MEDICAL CENTER
- **Principal Investigator:** Mulugeta Gebreselassie Gebregziabher
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-03-01 → 2024-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10911045

## Citation

> US National Institutes of Health, RePORTER application 10911045, Evaluating Care Coordination for Community Hospitalized Veterans to Improve Outcomes in Dual Use (ECHOeD) (5I01HX002437-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10911045. Licensed CC0.

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