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Health Services Research & Development

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HERC Health Economics Seminar

A System for Comparing Outpatient Use between VA and Medicare

by Paul Hebert, PhD
Seminar date: 10/21/2015

Description: Veterans who are dually eligible for Medicare receive a large amount of care through Medicare providers. We present a proposed system for organizing claims from Medicare and VA administrative data in order to better compare the outpatient use between the two systems. Each outpatient encounter is coded according to five dimensions of outpatient care: the visit type records the reason for the encounter (e.g., primary care or mental health care); the service type records the services received on the visit (e.g., evaluation and management or diagnostic test); the provider type identifies the training of the primary clinician (e.g., internist or cardiologist); the location identifies where the visit took place (e.g., clinic or home); and the cost records the HERC costs for VA care or reimbursed amount for Medicare provided care. We used this organizing scheme to code all outpatient visits in the VA from fiscal year 2003 through 2012. We present trends in veterans’ reliance on the VA versus Medicare across several of the dimensions. Target Audience: Researchers interested in using Medicare data

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