Developing network adequacy standards for VA Community Care
Year: 2021
Type: article
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.
Source: Health Services Research
Authors: Kristin M. Mattocks, A. Rani Elwy, Elizabeth M. Yano, Justin Giovannelli, Michael Adelberg, Michelle A. Mengeling, Kristin J. Cunningham, Kameron L. Matthews
Institutions: University of Massachusetts Chan Medical School, VA Central Western Massachusetts Healthcare System, Brown University, Edith Nourse Rogers Memorial Veterans Hospital, Center for Health Optimization and Implementation Research, University of California, Los Angeles, Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Georgetown University, University of Iowa, Iowa City VA Health Care System, Iowa City VA Medical Center, Office of Rural Health, United States Department of Veterans Affairs, Veterans Health Administration
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
Awards: G1925962773, G7589571674
OpenAlex ID: W3143889388