The “Partnered Evidence-Based Resource Center” a Veterans Administration funded resource center just published the Policy Brief titled “Economic and Policy Effects on Demand for VA Care”. The brief concludes that changes in the national, state, and local changes in healthcare policy along with outside forces can affect the Veterans Health Administration’s (VHA) www.va.gov/health enrollment and utilization.
Among the findings is that demand for VHA care is likely to decrease as the economy recovers, but this will only happen when veterans rejoin the labor force and find jobs. To date, labor force participation has been slow to recover especially among veterans.
The VA Office of Policy and Planning www.va.gov/op3 recently began to account for these variables in its enrollment and demand projection models that underlie budget requests. These projections also can inform access and demand management policy.
Under ACA, states may optionally expand Medicaid eligibility to all residents with incomes below 138 percent of the federal poverty level. Research has shown that states that have not expanded Medicaid under ACA have increased demand on the VHA by substantial amounts.
VHA may need to shift resources from expansion states to non-expansion states to accommodate the additional demand. The reorganization of VHA networks along state lines will make this kind of adjustment administratively easier.
Finally, as employer-based insurance plans increase co-payments and deductibles to limit premium growth, VHA care will become more attractive to veterans with multiple sources of coverage while further increasing demand.
In addition, reductions in housing prices are also a sign of fewer resources so help veterans purchase health insurance or care, which makes the VHA a more attractive option. Studies show that VHA enrollment, use of inpatient and outpatient care all rise as housing prices decline.
As a result, the wait time that balances supply and demand for VHA care is likely to increase, making it more difficult to improve access measures. VHA may need to increase co-payments for some priority groups to counteract this trend and preserve access for those veterans most in need.
The authors of the brief include Christine Yee PhD, Assistant Professor of Economics, University of Maryland, Austin Frakt, PhD, and Steven Pizer PhD both Health Economists at the VA Boston Healthcare System.
Go to www.queri.research.va.gov/partnered_evaluation/YeeFraktPizer.pdf to view the Policy Brief published March 2016. For more information on the Partnered Evidence-Based Policy Resource Center, go to www.queri.research.va.gov/partnered_evaluation/policy.cfm.