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2023 HSR&D/QUERI National Conference Abstract

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3003 — VA-Purchased Community Care: Addressing High-Priority Access and Quality of Care Research Questions with Available Data and Appropriate Methods

Lead/Presenter: Megan Vanneman,  COIN - Salt Lake City
All Authors: Vanneman ME, Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System; Rosen AK, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System; Beilstein-Wedel EE, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System;

Workshop Objectives:
The Choice Act and MISSION Act policies expanded eligibility for Veterans’ use of VA-purchased community care, with limited knowledge about whether access to care or quality of care would be better, the same, or worse than in VA. With over a third of the 9 million VA enrollees now using community care, it is more critical than ever that the research and operations communities understand how to measure and compare access to and quality of VA versus community care. As QUERI- and HSRandD-funded researchers and leaders of VA’s Community Care Research Evaluation and Knowledge (CREEK) Data and Measurement Science Hub, Dr. Vanneman, Dr. Rosen, and Ms. Beilstein-Wedel have been at the forefront of examining the completeness of VA-purchased community care data and how it can be leveraged to study access to and the quality of community care compared to VA-delivered care. The objectives of this workshop are to describe: 1) using research methods to compare access to and quality of VA-delivered and community care; 2) understanding data limitations and other roadblocks in achieving fair and equitable access and quality comparisons across settings of care; and 3) standardizing methods for measuring utilization of VA-delivered and community care across different health systems.

Activities:
This workshop is organized around three areas of expertise. There will be three 15-minute presentations, followed by 30 minutes of breakout sessions, and 15 minutes reporting back to the full group. In the first presentation, Dr. Vanneman will focus on the use of local supply/demand, distance/time, and patient experience data to compare access to VA-delivered and community care—using examples from studies on primary, mental health, and specialty care. In the second presentation, Dr. Rosen will focus on the feasibility of provider-specific versus aggregate provider methods and other measurement challenges for quality-of-care comparisons between VA-delivered and community care—using examples from several surgical studies. In the third presentation, Ms. Beilstein-Wedel will share resources on Centers for Medicare and Medicaid Services (CMS) data on healthcare providers and CMS methods for quality-of-care measurement to standardize comparisons between VA-delivered and community care—using the National Plan and Provider Enumeration System (NPPES) and CMS-endorsed quality measures. Following presentations, participants can join one of three breakout sessions hosted by the presenters to discuss a new or current study (brought up by participants or introduced by the presenters if needed). A participant volunteer will report back to the group with lessons learned.

Target Audience:
Researchers or operational partners with an interest in accurately measuring and comparing access to and quality of care for VA-delivered and community care.

Assumed Audience Familiarity with Topic:
Some familiarity with the Choice/MISSION Acts, access to care, and/or quality of care data and measurement science would be helpful.