Coordinating Care Across VA Providers and Settings: Policy and Research Recommendations from VA’s State of the Art Conference

Cordasco, Kristina M.; Frayne, Susan M.; Kansagara, Devan; Zulman, Donna M.; Asch, Steven M.; Burke, Robert E.; Post, Edward P.; Fihn, Stephan D.; Klobucar, Thomas F.; Meyer, Laurence; Kirsh, Susan; Atkins, David C.

doi:10.1007/s11606-019-04970-3

Cited by 13 publications

(12 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With the implementation of the Choice and MISSION Acts, VA tasked VA clinicians with coordinating care when veterans receive purchased care in the community. Although the VA is hoping that this will prevent many of the problems that have been associated with fragmentation in the early Choice era, [31][32][33][34] this requires that VA physicians integrate information across multiple systems. Our cost estimates do not include time for care coordination.…”

Section: Discussionmentioning

confidence: 99%

Estimating the Cost of Surgical Care Purchased in the Community by the Veterans Health Administration

Beilstein‐Wedel

Vanneman

et al. 2021

MDM Policy & Practice

View full text Add to dashboard Cite

Background. Veterans’ access to Veterans Affairs (VA)-purchased community care expanded due to large increases in funding provided in the 2014 Veterans Choice Act. Objectives. To compare costs between VA-delivered care and VA payments for purchased care for two commonly performed surgeries: total knee arthroplasties (TKAs) and cataract surgeries. Research Design. Descriptive statistics and regressions examining costs in VA-delivered and VA-purchased care (fiscal year [FY] 2018 [October 2017 to September 2018]). Subjects. A total of 13,718 TKAs, of which 6,293 (46%) were performed in VA. A total of 91,659 cataract surgeries, of which 65,799 (72%) were performed in VA. Measures. Costs of VA-delivered care based on activity-based cost estimates; costs of VA-purchased care based on approved and paid claims. Results. Ninety-eight percent of VA-delivered TKAs occurred in inpatient hospitals, with an average cost of $28,969 (SD $10,778). The majority (86%) of VA-purchased TKAs were also performed at inpatient hospitals, with an average payment of $13,339 (SD $23,698). VA-delivered cataract surgeries were performed at hospitals as outpatient procedures, with an average cost of $4,301 (SD $2,835). VA-purchased cataract surgeries performed at hospitals averaged $1,585 (SD $629); those performed at ambulatory surgical centers cost an average of $1,346 (SD $463). We also found significantly higher Nosos risk scores for patients who used VA-delivered versus VA-purchased care. Conclusions. Costs of VA-delivered care were higher than payments for VA-purchased care, but this partly reflects legislative caps limiting VA payments to community providers to Medicare amounts. Higher patient risk scores in the VA could indicate that community providers are reluctant to accept high-risk patients because of Medicare reimbursements, or that VA providers prefer to keep the more complex patients in VA.

show abstract

Section: Discussionmentioning

confidence: 99%

Estimating the Cost of Surgical Care Purchased in the Community by the Veterans Health Administration

Beilstein‐Wedel

Vanneman

et al. 2021

MDM Policy & Practice

View full text Add to dashboard Cite

show abstract

“…A second SOTA workgroup focused on coordination within the VA system for Veterans with greater needs for care coordination. This workgroup, whose recommendations are described by Cordasco and colleagues, 8 used key articles and expert opinion to formulate recommendations for VA policies, organizational initiatives, and future research topics. The third SOTA workgroup, described in a separate manuscript by Mattocks and colleagues, 9 focused on care coordination between VA and non-VA providers for care paid for by VA.…”

Section: S1mentioning

confidence: 99%

Improving Care Coordination for Veterans Within VA and Across Healthcare Systems

et al. 2019

Self Cite

View full text Add to dashboard Cite

“…For SUD patients who have increased vulnerability to COVID-19 ( Volkow, 2020 ) and experience barriers to treatment (e.g., transportation, scheduling), the relaxed regulations ( Lin, Fernandez, & Bonar, 2020 ) and recommendations promoting reduced disease transmission ( Farhoudian, Baldacchino, & Clark, 2020 ) may increase engagement and treatment access. Changing trends suggest that providers and health systems were interested in enhancing virtual care options ( Cordasco et al, 2019 ; Ferreri, Bourla, Mouchabac, & Karila, 2018 ; Molfenter, Boyle, Holloway, & Zwick, 2015 ) even before COVID-19. Some, including ourselves, hope that decreased barriers and increased reimbursement for remote services will continue beyond the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Considerations for remote delivery of behavioral economic interventions for substance use disorder during COVID-19 and beyond

Coughlin

Bonar

Bickel

2021

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

The response to the COVID-19 crisis has created direct pressure on health care providers to deliver virtual care, and has created the opportunity to develop innovations in remote treatment for people with substance use disorders. Remote treatments provide an intervention delivery framework that capitalizes on technological innovations in remote monitoring of behaviors and can efficiently use information collected from people and their environment to provide personalized treatments as needed. Interventions informed by behavioral economic theories can help to harness the largely untapped potential of virtual care in substance use treatment. Behavioral economic treatments, such as contingency management, the substance-free activity session, and episodic future thinking, are positioned to leverage remote monitoring of substance use and to use personalized medicine frameworks to deliver remote interventions in the COVID-19 era and beyond.

show abstract

Coordinating Care Across VA Providers and Settings: Policy and Research Recommendations from VA’s State of the Art Conference

Cited by 13 publications

References 34 publications

Estimating the Cost of Surgical Care Purchased in the Community by the Veterans Health Administration

Estimating the Cost of Surgical Care Purchased in the Community by the Veterans Health Administration

Improving Care Coordination for Veterans Within VA and Across Healthcare Systems

Considerations for remote delivery of behavioral economic interventions for substance use disorder during COVID-19 and beyond

Contact Info

Product

Resources

About