QUERI – Quality Enhancement Research Initiative

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OEF/OIF/OND Veterans' Use of Primary and Specialty Care through Choice

Palo Alto, CA


Implementation of the Veterans Choice Program (VCP) will impact Veterans' decisions about where to access their healthcare. With Choice Cards, some Veterans can now access medical care in non-VA medical ("Fee Basis") settings. For example, Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) Veterans might opt to use their Choice Cards to access primary care closer to home. Moreover, this may be in contrast to combat-related specialty care (e.g., behavioral health), which they might continue to receive at VA facilities. This QUERI project will examine OEF/OIF/OND Veterans' use of primary care in VA and non-VA ("Fee Basis") settings before and after implementation of the Choice Program.


This QUERI project will develop a method to identify Veterans' use of primary care in the Fee Basis data. Second, investigators will provide specific information about changes in primary care utilization after the Choice Act for a cohort of OEF/OIF/OND Veterans. This preliminary work also will be influential for future work examining the impact of the Choice Act.


This project's study cohort will consist of OEF/OIF/OND Veterans who used their Choice Cards in fiscal year (FY) 2015. Investigators will examine their use of primary care for three fiscal years prior to the Choice Act (FY2012-2014) and after receiving their Choice Cards in FY2015.

Operations Partner: Joe Francis, MD, MPH, Director, VA Clinical Analytics and Reporting.

Principal Investigator: Todd H. Wagner, PhD; contact at Todd.Wagner@va.gov.