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Preventive Care Delivery After the Veterans Choice Program.

Sri Lekha Tummalapalli1, Eric Vittinghoff2, Katherine J Hoggatt3

  • 1Division of Healthcare Delivery Science & Innovation, Department of Population Health Sciences, Weill Cornell Medicine, New York, New York; Department of Medicine, University of California San Francisco, San Francisco, California.

American Journal of Preventive Medicine
|April 6, 2021
PubMed
Summary
This summary is machine-generated.

The Veterans Choice Program (VCP) did not negatively impact preventive care for Veterans. However, VCP implementation was linked to increased podiatry visits for diabetic Veterans with Department of Veterans Affairs coverage.

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Area of Science:

  • Health Services Research
  • Preventive Medicine
  • Veteran Health

Background:

  • The Veterans Choice Program (VCP) aimed to improve community care access for Veterans.
  • Concerns existed that care fragmentation under VCP might reduce preventive care uptake.
  • This study evaluated the VCP's impact on 10 preventive care measures.

Purpose of the Study:

  • To assess the effect of the Veterans Choice Program on preventive care receipt among Veterans.
  • To determine if the VCP negatively impacted preventive care services for Veterans with Department of Veterans Affairs (VA) coverage.
  • To analyze changes in cardiovascular risk reduction, infectious disease prevention, and diabetes care.

Main Methods:

  • Utilized National Health Interview Survey data from Veterans before (Jan 2011-Oct 2014) and after (Nov 2015-Dec 2018) VCP implementation.
  • Assessed 10 preventive care measures including screenings, vaccinations, and specific care visits.
  • Employed unadjusted/multivariable pre-post analyses and difference-in-differences analyses.

Main Results:

  • No significant changes in cardiovascular risk reduction or influenza vaccination rates were observed.
  • Post-VCP, Veterans with VA coverage showed increased HIV testing, podiatry visits, and ophthalmology visits.
  • Multivariable and difference-in-differences analyses indicated increased podiatry visits for diabetic Veterans with VA coverage.

Conclusions:

  • Veterans with VA coverage and diabetes experienced increased podiatry visits following VCP implementation.
  • No evidence suggests the VCP negatively impacted overall preventive care receipt among these Veterans.
  • The VCP may have facilitated specific preventive care access for certain veteran subgroups.