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Non-VA Medical Care (formerly Fee Basis)

CDW Disclaimer

VA data, including HERC data, are currently in transition to the VA Corporate Data Warehouse (CDW), a national VA data repository. The National Data Systems (NDS) oversees the request and approval process through the Data Access Request Tracker (DART) system. For more information on data available at CDW and the current request procedures, please see the VHA Data Portal (VA intranet site - contact HERC for the url).

The Non-VA Medical Care files report financial and limited clinical information on covered care provided to VA patients outside of VA facilities. They include care provided to veterans at military facilities, primarily in Alaska and Hawaii. The files exclude most care provided through sharing agreements at university affiliates and services at state Veterans homes.

There is some overlap between Non-VA Care files and standard VA utilization data files. Community nursing home stays appear in both the VA extended care PTF and the DSS outpatient national data extract. A record is created in the PTF Non-VA Hospitalization file when authorization is given for inpatient non-VA medical care. Once the stay is completed and claims from the provider are submitted and paid, the record will be updated as needed to conform as closely as possible to standard PTF format. A record for the same stay will appear in the Non-VA Medical Care data only after a claim is paid. For this and other reasons, overlap between the PTF NVH and Non-VA Medical Care inpatient files is only moderate. The HERC technical report features an analysis of the overlap.

While VA data sets apply for the year when health care services are rendered (i.e., SE13 indicates outpatient encounters that occurred in FY14), Fee Basis data sets are named for when services are paid (i.e., MED13 indicates outpatient encounters paid in FY13). This is a very important distinction. Furthermore, in Fee Basis, each record is not an encounter, but a CPT payment.

Contents

There are eight Non-VA Medical Care files for each fiscal year. Four record details of individual health care services, one each for inpatient stays, inpatient ancillary services and physician payments, outpatient care, and outpatient pharmacy. There are additional files for travel reimbursement data and for information on Fee Card holders, veterans who receive long-term outpatient care through the Non-VA Medical Care services. The final two files contain information on Non-VA Medical Care providers, known as vendors, one for pharmacy vendors and another for all other vendors.

Three of the clinical files contain basic characteristics about care provided, including procedure and surgery codes. Non-VA Medical Care records provide a wealth of detail on charges and payments for services. The files can be linked by patient ID to standard VA utilization files.

Non-VA Medical Care files have been stored in SAS format at the Austin IT Center, but are expected to be available in the Corporate Data Warehouse (CDW) through the VA Informatics and Computing Infrastructure (VINCI). Tables 1 and 2 provide the contents (PROC CONTENTS) for each Non-VA Medical Care file from FY2000-FY2012.

Table 1 - Proc Contents for Non-VA Medical Care Data (FY00-FY09)
Non-VA Medical Care Data FY00 FY01 FY02 FY03 FY04 FY05 FY06 FY07 FY08 FY09
Inpatient Facility Austin FB PROC CONTENTS File (INPT FY00) Austin FB PROC CONTENTS File (INPT FY01) Austin FB PROC CONTENTS File (INPT FY02) Austin FB PROC CONTENTS File (INPT FY03) Austin FB PROC CONTENTS File (INPT FY04) Austin FB PROC CONTENTS File (INPT FY05) Austin FB PROC CONTENTS File (INPT FY06) Austin FB PROC CONTENTS File (INPT FY07) Austin FB PROC CONTENTS File (INPT FY08) Austin FB PROC CONTENTS File (INPT FY09)
Inpatient Ancillary / Physician Austin FB PROC CONTENTS File (IPANCIL FY00) Austin FB PROC CONTENTS File (IPANCIL FY01) Austin FB PROC CONTENTS File (IPANCIL FY02) Austin FB PROC CONTENTS File (IPANCIL FY03) Austin FB PROC CONTENTS File (IPANCIL FY04) Austin FB PROC CONTENTS File (IPANCIL FY05) Austin FB PROC CONTENTS File (IPANCIL FY06) Austin FB PROC CONTENTS File (IPANCIL FY07) Austin FB PROC CONTENTS File (IPANCIL FY08) Austin FB PROC CONTENTS File (IPANCIL FY09)
Outpatient Visit Austin FB PROC CONTENTS File (MED FY00) Austin FB PROC CONTENTS File (MED FY01) Austin FB PROC CONTENTS File (MED FY02) Austin FB PROC CONTENTS File (MED FY03) Austin FB PROC CONTENTS File (MED FY04) Austin FB PROC CONTENTS File (MED FY05) Austin FB PROC CONTENTS File (MED FY06) Austin FB PROC CONTENTS File (MED FY07) Austin FB PROC CONTENTS File (MED FY08) Austin FB PROC CONTENTS File (MED FY09)
Outpatient Pharmacy Austin FB PROC CONTENTS File (PHR FY00) Austin FB PROC CONTENTS File (PHR FY01) Austin FB PROC CONTENTS File (PHR FY02) Austin FB PROC CONTENTS File (PHR FY03) Austin FB PROC CONTENTS File (PHR FY04) Austin FB PROC CONTENTS File (PHR FY05) Austin FB PROC CONTENTS File (PHR FY06) Austin FB PROC CONTENTS File (PHR FY07) Austin FB PROC CONTENTS File (PHR FY08) Austin FB PROC CONTENTS File (PHR FY09)
Travel Reimbursement Austin FB PROC CONTENTS File (VTL FY00) Austin FB PROC CONTENTS File (VTL FY01) Austin FB PROC CONTENTS File (VTL FY02) Austin FB PROC CONTENTS File (VTL FY03) Austin FB PROC CONTENTS File (VTL FY04) Austin FB PROC CONTENTS File (VTL FY05) Austin FB PROC CONTENTS File (VTL FY06) Austin FB PROC CONTENTS File (VTL FY07) Austin FB PROC CONTENTS File (VTL FY08) Austin FB PROC CONTENTS File (VTL FY09)
Fee Basis ID Cards Austin FB PROC CONTENTS File (VET FY00) Austin FB PROC CONTENTS File (VET FY01) Austin FB PROC CONTENTS File (VET FY02) Austin FB PROC CONTENTS File (VET FY03) Austin FB PROC CONTENTS File (VET FY04) Austin FB PROC CONTENTS File (VET FY05) Austin FB PROC CONTENTS File (VET FY06) Austin FB PROC CONTENTS File (VET FY07) Austin FB PROC CONTENTS File (VET FY08) Austin FB PROC CONTENTS File (VET FY09)
Pharmacy Vendors Austin FB PROC CONTENTS File (PH VEN FY00) Austin FB PROC CONTENTS File (PH VEN FY01) Austin FB PROC CONTENTS File (PH VEN FY02) Austin FB PROC CONTENTS File (PH VEN FY03) Austin FB PROC CONTENTS File (PH VEN FY04) Austin FB PROC CONTENTS File (PH VEN FY05) Austin FB PROC CONTENTS File (PH VEN FY06) Austin FB PROC CONTENTS File (PH VEN FY07) Austin FB PROC CONTENTS File (PH VEN FY08) Austin FB PROC CONTENTS File (PH VEN FY09)
Other Vendors Austin FB PROC CONTENTS File (VEN FY00) Austin FB PROC CONTENTS File (VEN FY01) Austin FB PROC CONTENTS File (VEN FY02) Austin FB PROC CONTENTS File (VEN FY03) Austin FB PROC CONTENTS File (VEN FY04) Austin FB PROC CONTENTS File (VEN FY05) Austin FB PROC CONTENTS File (VEN FY06) Austin FB PROC CONTENTS File (VEN FY07) Austin FB PROC CONTENTS File (VEN FY08) Austin FB PROC CONTENTS File (VEN FY09)
Table 2 - Proc Contents for Non-VA Medical Care Data (FY10-FY12)
Non-VA Medical Care Data FY10 FY11 FY12              
Inpatient Facility Austin FB PROC CONTENTS File (INPT FY10) Austin FB PROC CONTENTS File (INPT FY11) Austin FB PROC CONTENTS File (INPT FY12)              
Inpatient Ancillary / Physician Austin FB PROC CONTENTS File (IPANCIL FY10) Austin FB PROC CONTENTS File (IPANCIL FY11) Austin FB PROC CONTENTS File (IPANCIL FY12)              
Outpatient Visit Austin FB PROC CONTENTS File (MED FY10) Austin FB PROC CONTENTS File (MED FY11) Austin FB PROC CONTENTS File (MED FY12)              
Outpatient Pharmacy Austin FB PROC CONTENTS File (PHR FY10) Austin FB PROC CONTENTS File (PHR FY11) Austin FB PROC CONTENTS File (PHR FY12)              
Travel Reimbursement Austin FB PROC CONTENTS File (VTL FY10) Austin FB PROC CONTENTS File (VTL FY11) Austin FB PROC CONTENTS File (VTL FY12)              
Fee Basis ID Cards Austin FB PROC CONTENTS File (VET FY10) Austin FB PROC CONTENTS File (VET FY11) Austin FB PROC CONTENTS File (VET FY12)              
Pharmacy Vendors Austin FB PROC CONTENTS File (PH VEN FY10) Austin FB PROC CONTENTS File (PH VEN FY11) Austin FB PROC CONTENTS File (PH VEN FY12)              
Other Vendors Austin FB PROC CONTENTS File (VEN FY10) Austin FB PROC CONTENTS File (VEN FY11) Austin FB PROC CONTENTS File (VEN FY12)              
Resources

A HERC Guidebook lists the variables in the Non-VA Medical Care files and offers guidance on how to use them for research. HERC Technical Report #26 features descriptive statistics on non-VA medical care spending, common outpatient procedures, and purpose-of-visit codes in FY2007.

The National Non-VA Medical Care Program Office is an excellent source of information on non-VA medical care rules and procedures. It features a variety of handbooks, fact sheets, and other resources for Non-VA Medical Care staff, many of which will also be useful to researchers. A listserv is also available for those who wish to learn more about non-VA medical care. See the CBO List of Brochures and Fact Sheets for an extensive set of questions and answers about Non-VA Medical Care eligibility and processing rules. New information is added frequently.

Related Content
Bibliography of VA Cost Studies: Use Fee Basis Data
(December 2012) | Download »
Non-VA Medical Care (Fee Basis) Data: A Guide for Researchers
Smith MW, Chow A
Guidebook, Health Economics Resource Center (October 2013) | Download »
  • This guidebook is intended to help researchers understand and use national Non-VA Medical Care (formerly Fee Basis) files. It describes characteristics of Non-VA Medical Care data such as contents, missingness, and concordance between files, and makes recommendations about its use for research. Chapter 1 presents an overview of the guidebook. Chapter 2 and its appendices describe all variables in the FY2009 Non-VA Medical Care files, including variable name, type, length, and missingness. Chapter 3 describes how to access the data through the Austin Automation Center or the VHA Support Services Center web site on the VA private network. Chapter 4 and its appendices offer detailed information about Non-VA Medical Care eligibility and payment rules, information critical to understanding utilization and cost patterns in the data. In Chapter 5 we summarize our notes and recommendations for researchers. Chapter 6 provides references for further information, including contact information for VA administrators knowledgeable about the Non-VA Medical Care program and data.
Use and Cost of Fee Basis Services in FY2007
Smith M, Chen S, Fan A
Technical Report #26, Health Economics Resource Center (December 2010) | Intranet only
  • The purpose of this brief report is to describe major patterns in the Fee Basis data. The HERC guidebook on Fee Basis data (Smith and Chow 2010) describes the contents of the eight annual Fee Basis files. It also notes the variety of ways to access Fee Basis data. This report is a companion that provides specific data on spending and counts of services. The next chapter describes outpatient services and costs. It presents a number of tables that show the most common categories of outpatient care by type and frequency. Chapter 3 discusses inpatient data and the overlap of Fee Basis data with other VA administrative datasets.