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2019 HSR&D/QUERI National Conference Abstract

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3003 — Understanding Care in the Community

Lead/Presenter: Todd Wagner,  Resource Center - HERC
All Authors: Wagner TH, HERC; Pettey W, Salt Lake City VA; Rosen A, Boston VA;

Workshop Objectives:
Access to care remains a priority for VA. One way of improving access is through VA-purchased community care. In 2014, VA spent approximately $10 billion on community care and by 2017, this totaled over $23 billion. Understanding community care use has become central to many VA research studies. Historically, community care data was exclusively entered into the "Fee Basis System." Since the 2014 Choice Act, VA has implemented a new data system for managing care purchased in the community known as the Program Integrity Tool (PIT). Our group has been collaborating with the Office of Community Care over the past 2 years, and has developed expertise in using the PIT data. PIT data are quite different from Fee Basis data. The first objective of this workshop is to explain how to use PIT data using specific examples from our research. The second objective is to build a community of VA users who are interested in learning to use community care data for research.

The workshop is organized around three projects. The first project examines how to identify patients who have ambulatory surgery in the PIT data. This project develops a denominator, numerator, and quality of care measures. The second project is focused on the costs of care, and describes the structure of professional and institutional fees captured in the PIT data. The third project focuses on geographic access. We use GIS mapping to show where community care was rendered relative to possible VA sites. Each project will include a short, 15-minute data demonstration; this will include de-identified PIT data to show specific variables used and how datasets were constructed, followed by 10 minutes of interactive examples, where audience members can test their new skills in answering research questions with the PIT data. We will conclude with 15 minutes of general questions and answers.

Target Audience:
Anyone with an interest in understanding how to use data for VA purchased care. No prior experience with data or GIS mapping is expected.

Assumed Audience Familiarity with Topic:
We assume that the audience will have minimal familiarity with the Fee Basis data, but are increasingly interested in understanding community care data given that it now accounts for almost 30% of VHA spending.