5031.0: Wednesday, November 15, 2000 - Board 7

Abstract #15355

Health insurance and demand for VHA care among Veterans health Administration (VHA) Enrollees'

Yujing Shen, PhD, Austin Lee, PhD, Ann Hendricks, PhD, and Lewis E. Kazis, ScD. Center for Health Quality, Outcomes, & Economic Research (CHQOER), Department of Veterans Affairs & Boston University School of Public Health, 200 Springs Road (152), Bedford, MA 01730, 781-687-3159, mei2@bu.edu

Purpose: This presentation will examine veterans’ insurance and utilization of VHA and non-VHA services in order to help policy makers better manage care and allocate funding.

Methods: The Insurance/Utilization module of VHA’s ‘1999 Health Survey of Veterans’ (175,276/300,00; 58.4%) asked about veterans’ public and private insurance coverage and their use of VHA and non-VHA inpatient and outpatient care in the 3 months preceding the survey. Inpatients and outpatients were grouped into VHA, non-VHA, and dual users.

Results: Only 23% of VHA users do not have any other type of health care coverage; 61% are enrolled in Medicare (18% are age <65). Of Medicare enrollees, 44% have basic Medicare coverage; 43% have Medigap; 7% are in HMOs and another 7% have both HMO and Medigap. VHA patients report considerable utilization: 22% had inpatient care and 77% used outpatient services; 24% of Medicare enrollees used inpatient care compared to 16% of non-Medicare population. As much as 76% of veterans without any other coverage received all of their inpatient care from VHA compared to 43% for veterans with some type of insurance. 60% of veterans’ having basic Medicare received all of their inpatient care from VHA compared to 32% for people who had Medigap or HMO. These patterns of utilization were similar for outpatient visits.

Conclusion: VHA is clearly a safety net for veterans with very limited insurance coverage (public or private) and also provides a great deal of care to veterans with alternative sources of health care coverage.

Learning Objectives: Participants will understand veterans' insurance coverage and their need for VA care and non-VA care

Keywords: Insurance,

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Office of Performance & Quality, Veterans Health Administration
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: grants & employment

The 128th Annual Meeting of APHA