Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004.

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  • Additional Information
    • Affiliation:
      VA Information Resource Center, Edward Hines Jr. VA Hospital
      Center for Management of Complex Chronic Care, Edward Hines, Jr. VA Hospital
      New York State Psychiatric Institute
      Florida State University
      University of Illinois
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Objective: To examine care system choices for Veterans dually-eligible for VA and Medicare FFS following changes in VA eligibility policy, which expanded availability of VA health care services. Data Sources: VA and Medicare FFS enrollment and outpatient utilization databases in 1999 and 2004. Study Design: Multinomial logistic regression was used to examine odds of VA-only and Medicare-only utilization, relative to dual utilization, in 1999 and 2004. Observational cohort comprising a 5% random sample of dually-eligible Veterans: 73,721 in 1999 and 125,042 in 2004. Principal Findings: From 1999 to 2004, persons with the highest HCC risk scores had decreasing odds of exclusive VA reliance (OR=0.26 in 1999 and 0.17 in 2004, p<0.05), but had increasing odds of exclusive Medicare reliance (OR=0.43 in 1999 and 0.56 in 2004, p<0.05).Persons in high VA priority groups had decreasing odds of exclusive VA reliance, as well as decreasing odds of exclusive Medicare reliance, indicating increasing odds of dual use. Newly eligible Veterans with the highest HCC risk scores had higher odds of dual system use, while newly eligible Black Veterans had lower odds of dual system use. Conclusions: Veterans newly eligible for VA healthcare services, particularly those with the highest risk scores, had higher odds of dual system use compared to earlier eligibles. Providers should ensure coordination of care for Veterans who may be receiving care from multiple sources. Provisions of the Patient Protection and Affordable Care Act may help to ensure care coordination for persons receiving care from multiple systems.
    • Journal Subset:
      Health Services Administration; USA
    • Instrumentation:
      Hierarchical Condition Category (HCC)
    • ISSN:
      2159-0354
    • MEDLINE Info:
      NLM UID: 101548901
    • Grant Information:
      Department of Veterans Affairs, Veterans Health Administration, Office ofResearch and Development, Health Services Research and Development Service, VA Information Resource Center(SDR 98-004), VA/CMS Data for Research Project (SDR 02-237).
    • Publication Date:
      20131002
    • Publication Date:
      20160629
    • Accession Number:
      http://dx.doi.org/10.5600/mmrr.002.03.a06
    • Accession Number:
      90410734
  • Citations
    • ABNT:
      HUMENSKY, J. et al. Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004. Medicare & Medicaid Research Review, [s. l.], v. 2, n. 3, p. E1–E21, 2012. DOI 10.5600/mmrr.002.03.a06. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ccm&AN=90410734&custid=s6224580. Acesso em: 14 jul. 2020.
    • AMA:
      Humensky J, Carretta H, de Groot K, Brown MM, Tarlov E, Hynes DM. Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004. Medicare & Medicaid Research Review. 2012;2(3):E1-E21. doi:10.5600/mmrr.002.03.a06.
    • AMA11:
      Humensky J, Carretta H, de Groot K, Brown MM, Tarlov E, Hynes DM. Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004. Medicare & Medicaid Research Review. 2012;2(3):E1-E21. doi:10.5600/mmrr.002.03.a06
    • APA:
      Humensky, J., Carretta, H., de Groot, K., Brown, M. M., Tarlov, E., & Hynes, D. M. (2012). Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004. Medicare & Medicaid Research Review, 2(3), E1–E21. https://doi.org/10.5600/mmrr.002.03.a06
    • Chicago/Turabian: Author-Date:
      Humensky, Jennifer, Henry Carretta, Kristin de Groot, Melissa M. Brown, Elizabeth Tarlov, and Denise M. Hynes. 2012. “Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004.” Medicare & Medicaid Research Review 2 (3): E1–21. doi:10.5600/mmrr.002.03.a06.
    • Harvard:
      Humensky, J. et al. (2012) ‘Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004’, Medicare & Medicaid Research Review, 2(3), pp. E1–E21. doi: 10.5600/mmrr.002.03.a06.
    • Harvard: Australian:
      Humensky, J, Carretta, H, de Groot, K, Brown, MM, Tarlov, E & Hynes, DM 2012, ‘Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004’, Medicare & Medicaid Research Review, vol. 2, no. 3, pp. E1–E21, viewed 14 July 2020, .
    • MLA:
      Humensky, Jennifer, et al. “Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004.” Medicare & Medicaid Research Review, vol. 2, no. 3, July 2012, pp. E1–E21. EBSCOhost, doi:10.5600/mmrr.002.03.a06.
    • Chicago/Turabian: Humanities:
      Humensky, Jennifer, Henry Carretta, Kristin de Groot, Melissa M. Brown, Elizabeth Tarlov, and Denise M. Hynes. “Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004.” Medicare & Medicaid Research Review 2, no. 3 (July 2012): E1–21. doi:10.5600/mmrr.002.03.a06.
    • Vancouver/ICMJE:
      Humensky J, Carretta H, de Groot K, Brown MM, Tarlov E, Hynes DM. Service Utilization of Veterans Dually Eligible for VA and Medicare Fee-For-Service: 1999-2004. Medicare & Medicaid Research Review [Internet]. 2012 Jul [cited 2020 Jul 14];2(3):E1–21. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ccm&AN=90410734&custid=s6224580