August 2017
Medicaid Enrollment has Minimal Impact on use of VA Services
Enrollment in Medicaid has little impact on non-elderly VA patients’ use of VA services, according to a new study lead by HERC investigator Jean Yoon.
This study, published online June 2017 in Health Services Research, analyzed VA and Medicaid utilization data and for a cohort of 19,890 nonelderly Veterans. The authors measured use of services in the 12 months before and after Medicaid enrollment. Reliance on VA services (i.e. the proportion of services received at VA) was calculated for outpatient, inpatient, and emergency department care.
Yoon and team found that VA continued to provide a large majority of services for dually (VA and Medicaid) eligible Veterans, but reliance on VA depended on factors such as sociodemographic characteristics, service-connected disability, Medicaid eligibility type, and drive time to VA. Yoon and team also found that while VA utilization remained consistent after enrollment in Medicaid, dually eligible Veterans also obtained care through Medicaid, leading to an increase in overall utilization.
Under the Affordable Care Act’s Medicaid expansion, low income VA patients may have the option of enrolling in Medicaid and switching their care to providers outside the VA, but the potential impact of this policy is unknown. These findings indicate that Medicaid expansion may have a limited effect on Veterans’ use of VA services. Given the overall increase in health care utilization after Medicaid enrollment, dual coverage may lead to both increased access and higher costs.
“Use of Veterans Affairs and Medicaid Services for Dually Enrolled Veterans” by Yoon J, Vanneman M, Dally S, Trivedi A, and Phibbs C, is available in Health Services Research, June 13, 2017 [Epub ahead of print] doi: 10.1111/1475-6773.12727.
