Journal of Rehabilitation Research & Development (JRRD)

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Volume 47 Number 8, 2010
   Pages 773 — 780

Abstract — What can Medicaid data add to research on VA patients?

Ann Hendricks, PhD;1-2* John Gardner, PhD;1 Austin Frakt, PhD;1-2 Daniel Gilden, MS;3 Julia Prentice, PhD;1-2 Lynn Wolfsfeld, MPP;1 Steven Pizer, PhD1-2

1Health Care Financing and Economics, Department of Veterans Affairs Boston Healthcare System, Boston, MA; 2Department of Health Policy and Management, School of Public Health, Boston University, Boston, MA; 3JEN Associates, Cambridge, MA

Abstract — This article is the first to describe Department of Veterans Affairs (VA) patients' use of Medicaid at a national level. We obtained 1999 national VA enrollment and utilization data, Centers for Medicare and Medicaid Services enrollment and claims, and Medicare information from the VA Information Resource Center. The research team created files for program characteristics and described the VA-Medicaid dually enrolled population, healthcare utilization, and costs. In 1999, VA-Medicaid dual enrollees comprised 10.2% of VA's annual patient load (350,000/3,450,000); 304,000 were veterans. These veterans differed marginally from VA's veteran patients, being on average half a year younger and having 1% fewer males. Dual enrollees with mental health diagnoses and care were almost three times as numerous as long-term care patients; these two groups accounted for ~60% of dual enrollees. Dual enrollees disproportionately included housebound veterans and veterans needing aid and assistance. Half the dual enrollees had 12 months of Medicaid eligibility, and total Federal expenditures per patient not in managed care programs averaged >$18,000 (median >$6,000). Dually enrolled women veterans cost ~55% less than men. Medicaid benefits complement VA and are more accessible in many states. VA researchers need to consider including Medicaid utilization and costs in their studies if they target populations or programs related to long-term care or mental disorders.

Key words: costs, data quality, disability, healthcare utilization, long-term care, Medicaid, Medicare, mental health, veterans, vulnerable populations.

This article and any supplementary material should be cited as follows:
Hendricks A, Gardner J, Frakt A, Gilden D, Prentice J, Wolfsfeld L, Pizer S. What can Medicaid data add to research on VA patients? J Rehabil Res Dev. 2010;47(8): 773-80.DOI:10.1682/JRRD.2009.07.0107

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Last Reviewed or Updated  Monday, October 25, 2010 9:10 AM

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