Barriers Identified in Veterans' Community Emergency Care Access

Researchers gathered qualitative data from veterans about their experiences accessing community emergency care. The results, published in Military Medicine, show a lack of timely information, insufficient assistance in the medical billing process, and a need for multimodal policy and coverage explanations were primary barriers to care for veterans.  

Authors note current access to community emergency care for veterans can be confusing for patients and providers prompting them to conduct the first study to identify the importance of veterans’ understanding of community emergency care coverage. 

A comprehensive understanding of the barriers in veterans’ community emergency care is necessary for the improvement of current Veteran Health Administration (VHA) policies and for correcting disparities in veteran health care access. 

Fifty geographically diverse veterans who had recently sought emergency care were identified for the study using VHA data. Information about their emergency care experiences under VHA coverage were gathered via audio-recorded, semi-structured interviews. The interviews were transcribed verbatim before direct content analysis. 

Three major concerns for veterans navigating community emergency care were as follows:

• benefits and eligibility information is lacking when most needed;
• assistance is required with medical billing to avoid financial challenges and delays in care; and
• they desire multimodal communication about VHA policies or updates in emergency coverage.

Based on the feedback from participants, researchers suggest that the VHA could implement the following potential interventions: 

• increase transparency regarding eligibility and estimated out-of-pocket costs;
• resolve billing errors and rejections in a timely fashion; 
• improve access to prescriptions and ambulance services; and
• maximize communication preferences by using multifaceted, bidirectional strategies.

Study participants recommended more direct and personalized VHA communications such as emails, text messages, and phone calls instead of broader VHA website improvements. More efficient lines of communication with VHA employees for coverage and billing questions were also suggested.

“Our results may help VHA better address Veterans’ needs by improving the communication of policy information, resolving financial hardship, informing decisions about the appropriateness of emergency care or alternatives, and strengthening relationships with community providers,” concluded the researchers.

Reference:
Nevedal AL, Wong EP, Urech TH, Peppiatt JL, Sorie MR, Vashi AA. Veterans' experiences with accessing community emergency care. Mil Med. 2023;188(1-2):e58-e64. doi:10.1093/milmed/usab196