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Health Services Research & Development

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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

1052 — What VA Researchers Need to Know about Fee Basis Care

Sinnott PL, HERC; Phibbs CS, HERC;

VA purchases health care services from a variety of non-VA providers under a variety of arrangements. The most common arrangement is Fee Basis Care which can be authorized when access to VA care is limited, when non-VA care would be more economical than VA care, and, in emergency situations, when travel to a VA facility would be medically unsafe. Fee Basis care covers the entire range of medical services, including inpatient, outpatient, surgical, ancillary and extended care. Since 2002, Fee Basis Care has risen dramatically and is expected, by 2012, to exceed 10% of all VHA spending. For researchers working with operational partners, accurate estimation of Fee Basis Care will be critical to estimating costs, budget impacts and cost-effectiveness of care, and in understanding opportunities for cost savings. The objective of this presentation is to provide detailed information on the use of the Fee Basis Files, including experience of HERC researchers exploring completeness, overlaps and time considerations using the data.

We will provide an instructional presentation on the Fee Basis files. An expert from the VHA Chief Business Office (CBO) will participate as a member of the panel to answer questions and provide operations expertise.

The presentation will include descriptions of two new research datasets created by HERC, and experience using Fee Basis files, from the Women’s Health Evaluation initiative (WHEI).

Fee Basis care is rapidly expanding, and important both to Operations and health care research.

Accurate estimation of costs, including Fee Basis care is critical to understanding both efficiency and effectiveness of care.

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