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Reliance on Veterans Affairs outpatient care by Medicare-eligible veterans.

Publication ,  Journal Article
Liu, C-F; Manning, WG; Burgess, JF; Hebert, PL; Bryson, CL; Fortney, J; Perkins, M; Sharp, ND; Maciejewski, ML
Published in: Med Care
October 2011

OBJECTIVE: To examine longitudinal changes in Medicare-eligible veterans' reliance on the Department of Veterans Affairs (VA) healthcare system for primary and specialty care over 4 years. METHODS: We merged VA administrative and Medicare claims data to examine outpatient use during fiscal years (FY) 2001 to 2004 by 15,520 Medicare-eligible veterans who used VA primary care in FY2000. Reliance on VA outpatient care was defined as the proportion of total (VA/Medicare) visits received in VA for primary or specialty care. RESULTS: Of 869,000 primary and specialty care visits in the study period, 39% occurred within VA and 77% were specialty care. Reliance on VA primary care was substantially higher than specialty care (66% vs. 50% in FY2001; P<0.001). Reliance on VA primary and specialty care decreased over time (57% vs. 31% in FY2004; P<0.001). Significant shifts occurred at both extremes of VA reliance. From FY2001 to FY2004, the proportion of patients in the top decile of reliance on VA primary care decreased from 39% to 31%, whereas the proportion in the bottom decile doubled from 8% to 18%. Similarly, the proportion of patients in the top decile of reliance on VA specialty care decreased from 24% to 13%, whereas the proportion in the bottom decile doubled from 22% to 47%. CONCLUSIONS: Reliance on VA primary and specialty care among VA primary care patients decreased substantially over time, particularly for specialty care. Increasing use of non-VA services may complicate VA's implementation of patient-centered medical home models and performance measurement.

Duke Scholars

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

October 2011

Volume

49

Issue

10

Start / End Page

911 / 917

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Primary Health Care
  • Medicine
  • Medicare
  • Male
  • Longitudinal Studies
  • Humans
  • Health Services Needs and Demand
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Liu, C.-F., Manning, W. G., Burgess, J. F., Hebert, P. L., Bryson, C. L., Fortney, J., … Maciejewski, M. L. (2011). Reliance on Veterans Affairs outpatient care by Medicare-eligible veterans. Med Care, 49(10), 911–917. https://doi.org/10.1097/MLR.0b013e31822396c5
Liu, Chuan-Fen, Willard G. Manning, James F. Burgess, Paul L. Hebert, Chris L. Bryson, John Fortney, Mark Perkins, Nancy D. Sharp, and Matthew L. Maciejewski. “Reliance on Veterans Affairs outpatient care by Medicare-eligible veterans.Med Care 49, no. 10 (October 2011): 911–17. https://doi.org/10.1097/MLR.0b013e31822396c5.
Liu C-F, Manning WG, Burgess JF, Hebert PL, Bryson CL, Fortney J, et al. Reliance on Veterans Affairs outpatient care by Medicare-eligible veterans. Med Care. 2011 Oct;49(10):911–7.
Liu, Chuan-Fen, et al. “Reliance on Veterans Affairs outpatient care by Medicare-eligible veterans.Med Care, vol. 49, no. 10, Oct. 2011, pp. 911–17. Pubmed, doi:10.1097/MLR.0b013e31822396c5.
Liu C-F, Manning WG, Burgess JF, Hebert PL, Bryson CL, Fortney J, Perkins M, Sharp ND, Maciejewski ML. Reliance on Veterans Affairs outpatient care by Medicare-eligible veterans. Med Care. 2011 Oct;49(10):911–917.

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

October 2011

Volume

49

Issue

10

Start / End Page

911 / 917

Location

United States

Related Subject Headings

  • Veterans
  • United States Department of Veterans Affairs
  • United States
  • Primary Health Care
  • Medicine
  • Medicare
  • Male
  • Longitudinal Studies
  • Humans
  • Health Services Needs and Demand