TABLE 1.
Underserved model variable list (FY21 a )
| Variable name | Variable definition | Variable influence |
|---|---|---|
| Clinic efficiency (physicians/APPs b ) | Total clinic encounters per day of clinic capacity. An important element of clinic operations, clinic efficiency mediates the relationship between clinic inputs and total encounters produced by the clinic. | − HIGH |
| Clinic capacity (physicians/APPs) | Total primary care clinic time for primary providers of the PACT c team. This measure accounts for all physicians and APPs who generate workload in primary care clinics and incorporates in‐person, virtual, and unscheduled care. | − HIGH |
| Medicare Advantage penetration | The percentage of eligible individuals who have Medicare Advantage coverage in the area surrounding a VAMC d . | − HIGH |
| Percent of established patient appointments scheduled > 90 days | The percentage of established patient visits scheduled 90 days or more in advance. | +HIGH |
| Number of community care visits | The number of community care visits purchased for Veterans living within 40 miles of a VAMC. | − MED |
| Household median income | The median household income in the area surrounding a VAMC. Median household income varies across the country and is used to measure affluence. | − MED |
| Percent with private insurance (males 18–64) | The percentage of males aged 18–64 years eligible for private health insurance coverage in the area surrounding a VAMC. | + MED |
| Percent of enrollees priority 7/8 | The percentage of a VAMC's Veteran enrollees who are classified as Priority 7 or 8. Veteran enrollees are placed in one (or more) of eight priority groups based on need, affluence, and eligibility for VA care. | − MED |
| Clinic capacity (non‐physicians/non‐APPs) | The total primary care clinic time for non‐physician/non‐APP members of the PACT teams. This measure accounts for all other providers and staff who generate workload in primary care clinics (nurses, social workers, clinical pharmacists, psychologists, and dieticians) and incorporates scheduled in‐person and virtual care. | − MED |
| Number of enrollees | The total number of Veteran enrollees within each facility's catchment area. | − MED |
| Percent of enrollees 65 or older 12 | The percentage of a VAMC's enrollee population that is over 65 years old. Medicare eligibility typically begins at 65 years old. This variable is a proxy for the number of VAMC's Veteran enrollees who have Medicare coverage. | − MED |
| Unemployment rate | The rate of unemployment in the area surrounding a VAMC. | − MED |
| Nosos risk score 13 | The average clinical risk/complexity for a Veteran enrollee at a VAMC. A higher average Nosos score signifies a more complex Veteran population. | − MED |
| Primary care HPSA e | Identifies HPSAs, geographical areas with an insufficient number of providers based on population size, and an overutilization or inaccessibility of existing providers. | − LOW |
| PACT panel size | The current capacity of a VAMC's PACT teams. PACT teams are a multidisciplinary team‐based approach to providing primary care. PACT teams are assigned a specific number of Veterans to serve (a panel). | + LOW |
| Zillow house price index | Measures changes to housing prices in the area surrounding a VAMC. Higher housing prices may be associated with higher monthly rents. | − LOW |
| Average drive time to primary care | The average drive time to a primary care clinic for a VAMC's Veteran enrollees. | − LOW |
| PACT return visit rate | The frequency with which a primary care clinic's established patient population returns to clinic each year. | + LOW |
| Mental health program complexity | The complexity of the mental health (MH) services provided at a VAMC. MH program complexity is scored in two parts: the percentage of a VAMC's Veteran enrollees who use MH services and the number and types of MH programs available. | − LOW |
| ICU f /surgical program complexity | The availability and complexity of both ICU care and surgical care provided at a VAMC. | − LOW |
| Complex clinical program complexity | The number of complex clinical programs provided at a VAMC. Twelve clinical programs, such as blind rehabilitation or polytrauma, are included and increase the administrative and clinical complexity of a VAMC. | − LOW |
Note: This table lists the variables included in the FY21 primary care underserved model, including variable definitions and variable influence over underservedness.
a
Fiscal Year.
b
Advanced Practice Provider.
c
Patient‐Aligned Care Team.
d
Veterans Affairs Medical Center.
e
Health Provider Shortage Area.
f
Intensive Care Unit.