Who Pays When VA Users Are Hospitalized in the Private Sector?

Abstract

VA enrollees use the private sector for most of their inpatient care, which is funded by multiple sources. Developing a national UB-92/VA dataset would be critical to understanding veterans' use of the private sector for specific diagnoses and procedures, particularly for the fast growing population of younger veterans.

TNF-α Antagonist Use and Risk of Hospitalization for Infection in a National Cohort of Veterans With Rheumatoid Arthritis

“…Prior studies suggest that dual use is more common among patients aged ≥65 years. [29,34] This practice may potentially introduce bias in our study population. First, if dual users are more likely to be hospitalized for infection at non-VA hospitals, the HFI rate will be decreased in the current study.…”

Comparing measures of patient safety for inpatient care provided to veterans within and outside the VA system in New York

“…For instance, approximately 95% of VA patients who are aged 65 and older are concurrently enrolled in Medicare8 (a national system in the US that funds healthcare for those who have contributed to a trust fund for 40 quarters and who are either disabled or have reached age 65) and are known to obtain much of their routine outpatient care,9 acute cardiac care10 11 and elective coronary revascularisations12 in the private sector. Surveys of younger VA patients also report frequent use of private sector care 13 – 15. Therefore, a better way to provide consumer information to VA patients who are deciding whether to get their care in the VA or the private sector would be to compare the experiences of VA patients in each of those settings.…”

Comparing the Characteristics, Utilization, Efficiency, and Outcomes of VA and Non-VA Inpatient Care Provided to VA Enrollees

“…36 Third, for both older and younger veterans, VA/Medicare and self-reported data on inpatient utilization varies considerably from results obtained from examination of a merged VA/non-VA dataset. 37 Our study has several limitations. First, the data are from 1998 to 2000.…”