Elderly veterans receiving care at a Veterans Affairs Medical Center while enrolled in Medicare-financed HMOs. Is the taxpayer paying twice?
- PMID: 9127230
- PMCID: PMC1497097
- DOI: 10.1046/j.1525-1497.1997.012004247.x
Elderly veterans receiving care at a Veterans Affairs Medical Center while enrolled in Medicare-financed HMOs. Is the taxpayer paying twice?
Abstract
Elderly veterans who visit our Veterans Affairs (VA) Medical Center primary care clinic often mention they are enrolled in HMOs. Approximately 20% of patients hospitalized at our facility report health insurance coverage. Of 1,000 hospitalizations during a 6-month period in which veterans reported insurance coverage, 337 involved elderly veterans. Of these 337 hospitalizations, 218 (65%) were for 174 veterans who stated they were enrolled in a Medicare-financed HMO. The VA's Medical Care Cost Recovery Program deemed only 46 (21%) of the hospitalizations billable and received reimbursement for 20 (9%). Thus, the VA is providing costly services already paid for by the Health Care Financing Administration under prepaid capitation contracts, and recovers minimal reimbursement from the HMOs.
Comment in
-
Veterans, Medicare, and health maintenance organizations. Where is the value?J Gen Intern Med. 1997 Apr;12(4):256-7. doi: 10.1046/j.1525-1497.1997.012004256.x. J Gen Intern Med. 1997. PMID: 9127233 Free PMC article. No abstract available.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical