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2023 HSR&D/QUERI National Conference Abstract

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4066 — What Information Do Veterans Want for Decisions about VA and Non-VA Health Care? Results from Focus Groups with Veterans from Across the United States

Lead/Presenter: Jeffrey Kullgren,  COIN - Ann Arbor
All Authors: Kullgren JT (Center for Clinical Management Research, Ann Arbor), Robinson C (Center for Clinical Management Research, Ann Arbor) Garlick BA (Center for Clinical Management Research, Ann Arbor) Metzger N (Center for Clinical Management Research, Ann Arbor) Forman J (Center for Clinical Management Research, Ann Arbor)

The Affordable Care Act and the VA MISSION Act have provided Veterans with increased options for how and where they seek health care. Yet, there is currently no single source of information to help Veterans make personalized decisions about their VA and non-VA health care options. This study sought to identify what information Veterans want when making decisions about VA and non-VA care and who they would most trust to deliver such information.

We conducted 5 virtual focus groups with 22 Veterans from across the United States who in the last 12 months had used: only VA care (1 group), only non-VA care (1 group), both VA and non-VA care (1 group), and mixed use of VA and/or non-VA care (2 groups). Recruitment materials were distributed through email and social media, including Veterans Service Organizations. Recruitment concluded when we reached data saturation. Focus groups were audio-recorded and transcribed verbatim. Results were generated using a thematic analysis approach conducted by 2 experienced qualitative analysts, the study Principal Investigator, and a qualitative methodologist.

We identified 6 key themes. First, primary information needs include eligibility, available services, and out-of-pocket costs; transportation options; and a consistent point of contact. Second, most participants thought information about health care options should be provided by VA. Third, participants generally thought fellow Veterans would be more trusted to deliver information and to triage Veterans to professionals with specific VA or non-VA care expertise. However, the delivery of accurate and consistent information was perceived as more important than its source. Fourth, those delivering information should be empathetic and have extensive knowledge of local VA and community resources. Fifth, participants felt that an informational support program would need to accommodate the unique needs of Veterans: already in VA and moving to a new location, being discharged from active duty, not enrolled in VA, with a negative perception of VA, living in a rural area, enrolled in higher education, willing and able to access technology, or experiencing homelessness. Sixth, many Veterans may not be aware they are eligible for VA benefits and there is a need for a multi-faceted outreach strategy that is tailored to local communities and Veteran subgroups.

We found that, when making decisions about VA and non-VA health care options, Veterans would most value access-related information and would ideally want this information to be provided through VA and delivered by both Veterans and trained professionals with expertise about VA and non-VA health care. Veterans also identified specific subgroups with unique needs who would need tailored outreach to maximize engagement and the effectiveness of information support.

We identified specific information support strategies to support diverse groups of Veterans in making personalized decisions about their VA and non-VA health care options. These findings will be shared with Veterans and VA operational leaders through deliberative forums to identify and prioritize policies and programs that could help optimize Veterans’ health care access and experiences.