The Veterans Choice Act: A Qualitative Examination of Rapid Policy Implementation in the Department of Veterans Affairs
UMass Chan Affiliations
Department of Quantitative Health SciencesDocument Type
Journal ArticlePublication Date
2017-07-01
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BACKGROUND: Congress enacted the Veterans Access, Choice, and Accountability Act of 2014 [Veterans Choice Act (VCA)] to improve access to timely, high-quality health care for Veterans. Although Congress mandated that VCA must begin within 90 days of passage of the legislation, no guidelines were provided in the legislation to ensure that Veterans had access to an adequate number of community providers across different specialties of care or distinct geographic areas, including rural areas of the country. OBJECTIVE: To examine VCA policy implementation across a sampling of Veterans Health Administration (VHA) Medical Centers. RESEARCH DESIGN: We conducted a qualitative study of 43 VHA staff and providers by conducting in-person interviews at 5 VA medical centers in the West, South, and Midwest United States. Interview questions focused on perceptions and experiences with VCA and challenges related to implementation for VHA staff and providers. RESULTS: We identified 3 major themes to guide description of choice implementation: (1) VCA implemented too rapidly with inadequate preparation; (2) community provider networks insufficiently developed; and (3) communication and scheduling problems with subcontractors may lead to further delays in care. CONCLUSIONS: Our evaluation suggests that VCA was implemented far too rapidly, with little consideration given to the adequacy of community provider networks available to provide care to Veterans. Given the challenges we have highlighted in VCA implementation, it is imperative that the VHA continue to develop care coordination systems that will allow the Veterans to receive seamless care in the community.Source
Med Care. 2017 Jul;55 Suppl 7 Suppl 1:S71-S75. doi: 10.1097/MLR.0000000000000667. Link to article on publisher's siteDOI
10.1097/MLR.0000000000000667Permanent Link to this Item
http://hdl.handle.net/20.500.14038/29122PubMed ID
28146037Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/MLR.0000000000000667