Understanding VA's Use of and Relationships With Community Care Providers Under the MISSION Act

Kristin M. Mattocks; Aimee Kroll-Desrosiers; Rebecca Kinney; Anashua R. Elwy; Kristin J. Cunningham; Michelle A. Mengeling

doi:10.1097/MLR.0000000000001545

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Understanding VA's Use of and Relationships With Community Care Providers Under the MISSION Act

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Understanding VA's Use of and Relationships With Community Care Providers Under the MISSION Act

Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca Kinney, Anashua R. Elwy, Kristin J. Cunningham and Michelle A. Mengeling

Medical care, Vol.59(6), pp.S252-S258

06/01/2021

DOI: 10.1097/MLR.0000000000001545

PMCID: PMC8132889

PMID: 33976074

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Abstract

Background: Congress has enacted 2 major pieces of legislation to improve access to care for Veterans within the Department of Veterans Affairs (VA). As a result, the VA has undergone a major transformation in the way that care is delivered to Veterans with an increased reliance on community-based provider networks. No studies have examined the relationship between VA and contracted community providers. This study examines VA facility directors' perspectives on their successes and challenges building relationships with community providers within the VA Community Care Network (CCN). Objectives: To understand who VA facilities partner with for community care, highlight areas of greatest need for partnerships in various regions, and identify challenges of working with community providers in the new CCN contract. Research Design: We conducted a national survey with VA facility directors to explore needs, challenges, and expectations with the CCN. Results: The most common care referred to community providers included physical therapy, chiropractic, orthopedic, ophthalmology, and acupuncture. Open-ended responses focused on 3 topics: (1) Challenges in working with community providers, (2) Strategies to maintain strong relationships with community providers, and (3) Re-engagement with community providers who no longer provide care for Veterans. Conclusions: VA faces challenges engaging with community providers given problems with timely reimbursement of community providers, low (Medicare) reimbursement rates, and confusing VA rules related to prior authorizations and bundled services. It will be critical to identify strategies to successfully initiate and sustain relationships with community providers.

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Details

Title: Subtitle: Understanding VA's Use of and Relationships With Community Care Providers Under the MISSION Act
Creators: Kristin M. Mattocks - University of Massachusetts Chan Medical School
Aimee Kroll-Desrosiers - University of Massachusetts Chan Medical School
Rebecca Kinney - VA Central Western Massachusetts Healthcare System
Anashua R. Elwy - Edith Nourse Rogers Memorial Veterans Hospital
Kristin J. Cunningham - United States Department of Veterans Affairs
Michelle A. Mengeling - Iowa City VA Health Care System
Resource Type: Abstract
Publication Details: Medical care, Vol.59(6), pp.S252-S258
DOI: 10.1097/MLR.0000000000001545
PMID: 33976074
PMCID: PMC8132889
NLM abbreviation: Med Care
ISSN: 0025-7079
eISSN: 1537-1948
Publisher: Lippincott Williams & Wilkins
Number of pages: 7
Grant note: 18-319 / Department of Veterans Affairs, Veterans Health Administration, Service Directed Research (SDR); US Department of Veterans Affairs
Language: English
Date published: 06/01/2021
Academic Unit: General Internal Medicine; Internal Medicine
Record Identifier: 9984363166402771

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