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HSR&D 2004 National Meeting Abstracts

2024. May We Serve U? What if VA Healthcare was Available Through Medicare?
Iris I Wei, Dr.P.H., Houston VAMC, DA John, Houston VAMC, R Sundaravaradan, Baylor College of Medicine, MM Byrne, University of Pittsburgh, JA Davila, Houston VAMC and Baylor College of Medicine, RO Morgan, Houston VAMC and Baylor College of Medicine

Objectives: We examined geographical and ethnic/racial variation in the “intention-to-use” VA healthcare among Medicare FFS and HMO enrolled VA-using and VA non-using male veterans.

Methods: We used veterans’ response to a survey question, ‘If VA medical facilities were open to any veteran with Medicare, regardless of VA eligibility, how likely would you be to use a VA facility for your health care needs?’ Data used here is from 640 Black, 647 Hispanic, and 799 White, VA-using and VA non-using (no VA use in prior 3 years) elderly male veterans in six large metropolitan areas surveyed by mail in 2002 (response rate=52%). Samples were drawn from combined VA utilization and Medicare enrollment datasets. Logistic regressions were used to model the likelihood of intention-to-use VA facilities.

Results: Regardless of VA-using status, intention-to-use was higher for low-income veterans compared to higher income veterans, and was two-fold higher for Blacks compared to Whites. Among VA-using veterans, Hispanics reported higher interest than Whites. While among VA non-using veterans, Medicare HMO enrollees were twice as likely as FFS enrollees to report intention-to-use the VA. Significant variations were also observed among the six metropolitan areas. All findings were significant at p<=0.05.

Conclusions: If VA healthcare was available to all Medicare-enrolled veterans, there is likely to be wide geographical variation and substantial differences among ethnic/racial groups and veterans at different income levels in intent-to-use VA services.

Impact: Coordinating VA and Medicare benefits will require an in-depth understanding of how these two systems interleave in serving sub-groups of veterans.