# Understanding Network Adequacy and Community Engagement in Veteran Care

> **NIH VA I01** · NORTHAMPTON VA MEDICAL CENTER · 2020 · —

## Abstract

In response to highly publicized concerns regarding Veteran deaths and Veterans’ access to care in the
Veterans Health Administration (VHA), 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 represents 17% of all users of VHA care. Due to the
recency of VCP implementation, research on its impacts is limited but highlights issues with inadequacies of
community provider networks to meet Veterans’ healthcare needs. Simultaneously, Veterans have also 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 define, measure, and evaluate network
adequacy for non-VA community care networks. Taken together, these steps will ensure that the needs of
Veterans carefully assessed and appropriate standards are developed to meet the healthcare needs among
Veterans seeking and requiring non-VA community care.
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
therefore, Veterans’ access to care. We will use quantitative methods to leverage standardized national data
and processes combined with qualitative methods to account for individual VA medical center contexts and
Veteran preferences. Using this design, the project will complete three main objectives. The first objective of
this study is to develop and validate measures of network adequacy for non-VA community care and evaluate
regional variations in network adequacy across VAMCs and VA’s 98 markets. Relatedly, the project seeks 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. The project
will also 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. These objectives have important implications for VHA healthcare and the development of strong
community networks and connections between VHA and surrounding community providers to provide quality
healthcare to Veterans. As a result, this study team and project will address an important priority with VHA and,
in the long-term, improve community services for Veterans who receive care in the VHA...

## Key facts

- **NIH application ID:** 9986463
- **Project number:** 5I01HX002642-02
- **Recipient organization:** NORTHAMPTON VA MEDICAL CENTER
- **Principal Investigator:** KRISTIN M. MATTOCKS
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-10-01 → 2021-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9986463

## Citation

> US National Institutes of Health, RePORTER application 9986463, Understanding Network Adequacy and Community Engagement in Veteran Care (5I01HX002642-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9986463. Licensed CC0.

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