Kristin M Mattocks1,2, Elizabeth M Yano3,4, Amber Brown2, Jose Casares2, Lori Bastian5,6. 1. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester. 2. VA Central Western Massachusetts Healthcare System, Leeds, MA. 3. VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Sepulveda. 4. Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA. 5. Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven. 6. Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
Abstract
BACKGROUND: The Veterans Choice Program (VCP) was launched in 2014 to address the growing concerns about the timeliness and quality of Veterans Health Administration (VHA) care. Given that many sex-specific health services, such as mammography and maternity care, are not routinely provided in all VHA facilities, women Veterans may disproportionately rely on VCP care. Understanding the provision and coordination of VCP care is crucial in order to ensure that care is not fragmented across the 2 health care systems. OBJECTIVES: The main objective of this study was to understand women Veterans' experiences, perceptions, and challenges with VCP care. DESIGN: This study was a semistructured interview with 148 women at 13 VHA facilities nationwide. RESULTS: Four major themes emerged: (1) eligibility information for the VCP was limited and confusing; (2) women experienced difficulty scheduling VCP appointments; (3) VCP care results were not shared with women Veterans or their VHA providers in a timely manner; and (4) concerns with unpaid VCP bills were common. CONCLUSIONS: Our study highlights challenges women experienced with VCP care, and the need for improved care coordination. An ideal care coordination system would be the one in which all Veterans' non-Veteran Affairs care, including scheduling, follow-up, communication with community providers, coordination of services, and transition back to Veteran Affairs care is ensured.
BACKGROUND: The Veterans Choice Program (VCP) was launched in 2014 to address the growing concerns about the timeliness and quality of Veterans Health Administration (VHA) care. Given that many sex-specific health services, such as mammography and maternity care, are not routinely provided in all VHA facilities, women Veterans may disproportionately rely on VCP care. Understanding the provision and coordination of VCP care is crucial in order to ensure that care is not fragmented across the 2 health care systems. OBJECTIVES: The main objective of this study was to understand women Veterans' experiences, perceptions, and challenges with VCP care. DESIGN: This study was a semistructured interview with 148 women at 13 VHA facilities nationwide. RESULTS: Four major themes emerged: (1) eligibility information for the VCP was limited and confusing; (2) women experienced difficulty scheduling VCP appointments; (3) VCP care results were not shared with women Veterans or their VHA providers in a timely manner; and (4) concerns with unpaid VCP bills were common. CONCLUSIONS: Our study highlights challenges women experienced with VCP care, and the need for improved care coordination. An ideal care coordination system would be the one in which all Veterans' non-Veteran Affairs care, including scheduling, follow-up, communication with community providers, coordination of services, and transition back to Veteran Affairs care is ensured.
Authors: Kristin M Mattocks; Kristin Cunningham; A Rani Elwy; Erin P Finley; Clinton Greenstone; Michelle A Mengeling; Steven D Pizer; Megan E Vanneman; Michael Weiner; Lori A Bastian Journal: J Gen Intern Med Date: 2019-05 Impact factor: 5.128
Authors: Jeffrey M Pyne; P Adam Kelly; Ellen P Fischer; Christopher J Miller; Patricia Wright; Kara Zamora; Christopher J Koenig; Regina Stanley; Karen Seal; John C Fortney Journal: Mil Med Date: 2019-07-01 Impact factor: 1.437
Authors: Catherine Chanfreau-Coffinier; Donna L Washington; Emmeline Chuang; Julian Brunner; Jill E Darling; Ismelda Canelo; Elizabeth M Yano Journal: Health Serv Res Date: 2019-04-15 Impact factor: 3.402
Authors: Kristin M Mattocks; Aimee Kroll-Desrosiers; Rebecca Kinney; Anashua R Elwy; Kristin J Cunningham; Michelle A Mengeling Journal: Med Care Date: 2021-06-01 Impact factor: 2.983
Authors: Denise M Hynes; Samuel Edwards; Alex Hickok; Meike Niederhausen; Frances M Weaver; Elizabeth Tarlov; Howard Gordon; Reside L Jacob; Brian Bartle; Allison O'Neill; Rebecca Young; Avery Laliberte Journal: Med Care Date: 2021-06-01 Impact factor: 3.178
Authors: Kevin T Stroupe; Rachael Martinez; Timothy P Hogan; Elisa J Gordon; Beverly Gonzalez; Ibuola Kale; Chad Osteen; Elizabeth Tarlov; Frances M Weaver; Denise M Hynes; Bridget M Smith Journal: J Gen Intern Med Date: 2019-08-06 Impact factor: 6.473