QUERI – Quality Enhancement Research Initiative

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Differences in Satisfaction with Choice: Laying the Foundation for the Evaluation of the Choice Act

Pittsburgh, PA


In order to support successful the implementation of the Veterans Choice Program (VCP), it is important to understand how receptive eligible Veterans are to obtaining care through the VCP, their reasons for choosing to enroll or not to enroll, as well as their satisfaction with the Program. In addition, while Veterans historically report a high degree of satisfaction with VA pharmacy care and benefits, it is unclear how the VCP will impact their satisfaction and experiences with medication therapy and VA pharmacy benefits. Given the potential challenges introduced by VA's filling of prescriptions from non-VA providers, it is critical to understand the impact of the VCP on pharmacy services and Veterans' satisfaction with these services Therefore, the Differences in Satisfaction with Choice project will conduct early and ongoing evaluations of the VCP on Veterans' satisfaction and experiences with VA healthcare, medication therapy, and pharmacy benefits in order to inform the implementation of the VCP and support the transformation of VA healthcare.


  • This QUERI evaluation project will conduct an early assessment of Veterans' satisfaction with the VCP - and the impact of the Program on VA medication therapy and pharmacy benefits. Investigators also will conduct a formative evaluation of the barriers and facilitators to the successful implementation of the VCP based on interviews with key VA stakeholders. This Project also will partner with:
  • Pharmacy Benefits Management (PBM) Services to create a pharmacy database to assess patterns of medication use, use of formulary and non-formulary medications, and quality and safety of medication therapy and medication costs for VCP enrollees; and
  • VA Informatics & Computing Infrastructure (VINCI) to collect Veteran feedback on satisfaction as called for in the VA Blueprint for Excellence.


Guided by a Stakeholder Advisory Group and experts in implementation science, Project investigators will:

  • Collect data from eligible VCP Veterans about their satisfaction and experiences with the VCP and VA healthcare, including medication therapy, pharmacy benefits, and access to and continuity of care;
  • Identify barriers and facilitators to successful implementation of the VCP, as identified by Veterans and key VA stakeholders;
  • Develop an innovative information technology using machine learning algorithms to capture and code Veteran satisfaction with the VCP; and
  • Develop a VCP pharmacy dataset to ensure high-quality, safe, and cost-effective VA medication therapy.

Operations Partners: Pharmacy Benefits Management (PBM) Services and VA Informatics & Computing Infrastructure (VINCI).

Principal Investigator: Susan L. Zickmund, PhD; contact at Susan.Zickmund@va.gov.