Journal article
Developing network adequacy standards for VA Community Care
Health services research, Vol.56(3), pp.400-408
06/01/2021
DOI: 10.1111/1475-6773.13651
PMCID: PMC8143680
PMID: 33782979
Abstract
Objectives To inform how the VA should develop and implement network adequacy standards, we convened an expert panel to discuss Community Care Network (CCN) adequacy and how VA might implement network adequacy standards for community care.
Data Sources/Study setting Data were generated from expert panel ratings and from an audio-recorded expert panel meeting conducted in Arlington, Virginia, in October 2017.
Study Design We used a modified Delphi panel process involving one round of expert panel ratings provided by nine experts in network adequacy standards. Expert panel members received a list of network adequacy standard measures used in commercial and government market and were provided a rating form listing a total of 11 measures and characteristics to rate.
Data Collection Methods Items on the rating form were individually discussed during an expert panel meeting between the nine expert panel members and VA Office of Community Care leaders. Attendees addressed discordant views and generated revised or new standards accordingly. Recorded audio data were transcribed to facilitate thematic analysis regarding opportunities and challenges with implementing network adequacy standards in VA Community Care.
Principal Findings The five highest ranked standards were network directories for Veterans, regular reporting of network adequacy data to VA, maximum wait time/distance standards, minimum ratio of providers to enrolled population, and qualitative assessments of network adequacy. During the expert panel discussion with VA Community Care leaders, opportunities and challenges implementing network adequacy standards were highlighted.
Conclusions Our expert panel shed light on priorities for network adequacy to be implemented under CCN contracts, such as developing comprehensive provider directories for Veterans to use when selecting community providers. Remaining questions focus on whether the VA could reasonably develop and implement network adequacy standards given current Congressional restraints on VA reimbursement to community providers.
Details
- Title: Subtitle
- Developing network adequacy standards for VA Community Care
- Creators
- Kristin M. Mattocks - University of Massachusetts Chan Medical SchoolA. Rani Elwy - Edith Nourse Rogers Memorial Veterans HospitalElizabeth M. Yano - Health Services Research & DevelopmentJustin Giovannelli - Georgetown UniversityMichael Adelberg - Faegre Drinker Consulting, Washington, District of Columbia, USA.Michelle A. Mengeling - Iowa City VA Health Care SystemKristin J. Cunningham - United States Department of Veterans AffairsKameron L. Matthews - United States Department of Veterans Affairs
- Resource Type
- Journal article
- Publication Details
- Health services research, Vol.56(3), pp.400-408
- DOI
- 10.1111/1475-6773.13651
- PMID
- 33782979
- PMCID
- PMC8143680
- NLM abbreviation
- Health Serv Res
- ISSN
- 0017-9124
- eISSN
- 1475-6773
- Publisher
- Wiley
- Number of pages
- 9
- Grant note
- SDR 17--156 / VA Health Services Research and Development; US Department of Veterans Affairs
- Language
- English
- Date published
- 06/01/2021
- Academic Unit
- General Internal Medicine; Internal Medicine
- Record Identifier
- 9984363185302771
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