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Julie Kiefer

Associate Director, Science Communications, University of Utah Health
Phone: 801-587-1293

Aug 03, 2020 2:00 PM

Press release provided by the U.S. Dept. of Veterans Affairs

A study published today in the August issue of the journal Health Affairs by U.S. Department of Veterans Affairs (VA) and led by University of Utah Health researcher Megan Vanneman, PhD, MPH, found that Veterans had high ratings overall for their experiences in both VA care and VA-purchased community care.

The study compared survey responses from 2016 and 2017  from more than 1 million VA-enrolled Veterans who either received outpatient care in VA or received primary, mental health or other specialty care in their communities.

“Veterans now have increased options for where they get their medical care, and VA is committed to ensuring they have an excellent experience regardless of where that care is received,” said VA Secretary Robert Wilkie. “This study helps affirm the quality of VA care, and also suggests community providers are doing a good job of meeting Veterans’ needs.”

The study focused on patient experience. The survey scores were nearly equal across the VA and community groups. However, VA care scored better than community care in three of the four categories covered: overall provider rating, communication, and coordination.

In the fourth area, access to care, VA scored slightly lower on access to specialty care, such as cardiology or orthopedics. There were no differences in access to primary or mental health care.

For provider ratings, average scores in both settings were mainly between eight and nine, with 10 being the highest rating. For the other areas—communication, coordination, and access—average composite scores for both settings were mainly between three and four, with four being the most favorable rating.

“Overall, patient experiences were quite good in both VA and community care,” says Vanneman, who is also part of the VA Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center. She emphasizes that VA’s goal is to promote the best patient experiences and health outcomes regardless of where Veterans end up receiving their care. “We want to see Veterans having access to high-quality care,” she says.

Thanks to recent laws, eligible VA patients—mainly those who live far from VA clinics and hospitals, or those who need types of care not provided adequately or in a timely fashion in VA—are able to see non-VA healthcare providers in their community, with VA paying for this care. These options widened under the VA MISSION Act of 2018. Prior to that, the Veterans Choice Program offered similar access to outside care, albeit on a less extensive scale.   

A partnership between the VA Salt Lake City and U of U Health has led the new South Jordan VA Clinic to locate directly across from U of U Health's South Jordan clinic, with a goal of improving referrals from the VA to the community. Vanneman serves on a committee that assists with coordinating the ongoing partnership. She additionally supports VA-community partnerships in her role at the national VA Community Care Research Evaluation and Knowledge Center, a policy and data expertise hub designed to share and disseminate community care information across research and operations.

Given the expanded options for Veterans to seek care outside VA, comparing the VA and community sectors “is more important than ever,” says Vanneman. Her group’s study is the first to compare the experiences of VA-enrolled Veterans in the two different care settings.

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In addition to Vanneman, co-authors are Todd Wagner, Michael Shwartz, Mark Meterko, Joseph Francis, Clinton Greenstone and Amy Rosen. The study published as “Veterans’ Experiences With Outpatient Care: Comparing The Veterans Affairs System With Community-Based Care” online in Health Affairs on August 3, 2020.

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