QUERI – Quality Enhancement Research Initiative

OEF/OIF/OND Veterans' Use of Primary and Specialty Care through Choice

Palo Alto, CA

Overview:

Implementation of the Veterans Choice Program (VCP) will impact Veterans' decisions about where to access their healthcare. With Choice Cards, some Veterans can now access medical care in non-VA medical ("Fee Basis") settings. For example, Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) Veterans might opt to use their Choice Cards to access primary care closer to home. Moreover, this may be in contrast to combat-related specialty care (e.g., behavioral health), which they might continue to receive at VA facilities. This QUERI project will examine OEF/OIF/OND Veterans' use of primary care in VA and non-VA ("Fee Basis") settings before and after implementation of the Choice Program.

Objectives:

This QUERI project will develop a method to identify Veterans' use of primary care in the Fee Basis data. Second, investigators will provide specific information about changes in primary care utilization after the Choice Act for a cohort of OEF/OIF/OND Veterans. This preliminary work also will be influential for future work examining the impact of the Choice Act.

Methodology:

This project's study cohort will consist of OEF/OIF/OND Veterans who used their Choice Cards in fiscal year (FY) 2015. Investigators will examine their use of primary care for three fiscal years prior to the Choice Act (FY2012-2014) and after receiving their Choice Cards in FY2015.

Operations Partner: Joe Francis, MD, MPH, Director, VA Clinical Analytics and Reporting.

Principal Investigator: Todd H. Wagner, PhD; contact at Todd.Wagner@va.gov.