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Medical Care Research and Review
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VA-Medicare Dual Beneficiaries’ Enrollment in Medicare HMOs: Access to VA, Availability of HMOs, and Favorable Selection

Yujing Shen

Rutgers University

Ann Hendricks

Center for Health Quality, Outcomes, and Economic Research (CHQOER) and Boston University

Duozhe Li

Center for Health Quality, Outcomes, and Economic Research (CHQOER)

John Gardner

Center for Health Quality, Outcomes, and Economic Research (CHQOER)

Lewis Kazis

Center for Health Quality, Outcomes, and Economic Research (CHQOER) and Boston University

This study examined the association between Veterans Administration (VA)-Medicare dual beneficiaries’ HMO enrollment and factors including sociodemographics, access/attachment to VA, self-reported health status, and characteristics of Medicare HMO markets. The results showed that availability of Medicare HMOs and less access to VA care were the major predictors of VA-Medicare dual beneficiaries’ HMO enrollment. Other significant predictors of HMO enrollment were age (65-69), having no college education, VA priority status (low income; less than 50 percent service disability). There was some evidence of favorable selection measured by self-reported health status. The identified HMO enrollment profile can position VA better in attracting and managing the care of these beneficiaries and in meeting potentially large shifts in their need for VA care if Medicare benefits or policies change markedly.

Key Words: VA • Medicare HMO • access to care • favorable selection

Medical Care Research and Review, Vol. 62, No. 4, 479-495 (2005)
DOI: 10.1177/1077558705277396


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