A Qualitative Study of VA Entrants' Experiences Discussing Community Care With Veterans

We conducted interviews with clinicians and staff involved in Veterans' decisions about where to receive their health care to assess experiences with community care coordination and identify areas for improvement. Insufficient time and knowledge were cited as barriers to assisting Veterans in making decisions about whether to use community care resources. Concerns regarding quality of community care and lack of patient understanding on the implications of accessing community care also arose. Clinicians need to be able to help Veterans make informed choices about where to receive their health care and may require decision support that integrates their informational needs with their values and preferences, clarity on the referral process, and improved ways to measure and describe quality of care to Veterans. VA has recognized issues with community care and established new initiatives but the rollout is complex and ongoing.