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

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2020 · —

## 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:** 9835987
- **Project number:** 1I01HX002751-01A1
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** JEFFREY KULLGREN
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-02-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9835987

## Citation

> US National Institutes of Health, RePORTER application 9835987, Optimizing Veteran Decision-Making About Use of VA and Non-VA Health Care (1I01HX002751-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9835987. Licensed CC0.

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