Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113846

Robert O. Morgan, PhD¹, Jennifer Hasche, MSc², Nora Osemene, PharmD³, Margaret Byrne, PhD⁴, Raji Sundaravaradan, BS⁵, Iris I.-Lien Wei, DrPH², Laura Petersen, MD¹, and Michael Johnson, PhD¹. (1) Houston Center for Quality of Care and Utilization Studies, Houston VA Medical Center and Baylor College of Medicine, 2002 Holcombe Blvd. (152), Houston, TX 77030, (713) 794-8635, rmorgan@bcm.tmc.edu, (2) Houston Center for Quality of Care and Utilization Studies, Veterans Affairs Medical Center, 2002 Holcombe Blvd. (152), Houston, TX 77030, (3) College of Pharmacy and Health Sciences, Texas Southern University, 3100 Cleburne Avenue, Houston, TX 77004, (4) Department of Epidemiology and Public Health, University of Miami School of Medicine, Highland Professional Building, 1801 NW 9th Avenue, Suite 200, Miami, FL 33136, (5) Houston Center for Quality of Care and Utilization Studies, Houston VA Medical Center, 2002 Holcombe Blvd. (152), Houston, TX 77030

Background. The objective of these analyses was to examine the overall contribution of the VA health system as a pharmacy provider to the Medicare population. Study Design. We combined national fiscal year (FY) 2002 Medicare enrollment data for Medicare-enrolled VA users with FY 2002 pharmacy cost records from the VA's national Decision Support System (DSS) files. VA users were identified as a Medicare managed care plan (HMO) enrollee if they were enrolled in a Medicare HMO at any time during FY 2002. Annual VA pharmacy cost data was aggregated for each individual VA user within each VA medical center (VAMC). We calculated the percent of all Medicare enrolled males and females who received pharmacy services from the VA, the total pharmacy costs attributable to Medicare enrolled veterans nationally and at each of 127 individual VAMCs, as well as the percentage of those costs accounted for by Medicare HMO enrolled VA users. Results. In FY 2002, 2.3 million Medicare enrolled veterans received some or all of their medications from the VA. This amounted to 5.4% of all Medicare enrollees (11.5% of all male Medicare enrollees and 0.7% of female enrollees). Nationally, the VA pharmacy services provided to Medicare-enrolled veterans totaled $2.4 billion (67% of all VA pharmacy costs). Medicare-HMO enrolled VA pharmacy users accounted for 11.2% of all VA pharmacy costs attributable to Medicare enrolled veterans. Across individual VAMCs there was wide variation in the percentage of HMO enrollees among Medicare enrolled pharmacy users (from < 1% to > 50%) and in the percentage of pharmacy costs associated with their use (from < 1% to > 43%). These percentages appear to parallel HMO enrollment among the overall Medicare population in each VAMC's geographic area. Conclusions. In meeting its mission of providing quality healthcare services to eligible veterans, the VA health system has become one of the largest single providers of pharmacy services to Medicare enrollees nationally, serving half as many Medicare enrollees as all Medicare managed care plans combined. VA users who are enrolled in Medicare HMOs continue to use VA pharmacy services, even though the large majority of them have access to pharmacy coverage through their HMO plans. Although the implementation of the Medicare prescription drug benefit in 2006 may increase access to prescription drugs for Medicare beneficiaries, it is likely that the VA will remain a significant pharmacy provider for Medicare enrolled veterans.

Learning Objectives:

• At the conclusion of this session, attendees will be able to discuss the contribution of the VA system to pharmacy care among Medicare beneficiaries.

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.