title: VA-Medicare dual beneficiaries' enrollment in Medicare HMOs: access to VA, availability of HMOs, and favorable selection.
abstract: 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.
authors.affiliation: Rutgers University, NJ, USA.
authors.forename: Yujing
authors.initials: Y
authors.lastname: Shen
authors.forename: Ann
authors.initials: A
authors.lastname: Hendricks
authors.forename: Duozhe
authors.initials: D
authors.lastname: Li
authors.forename: John
authors.initials: J
authors.lastname: Gardner
authors.forename: Lewis
authors.initials: L
authors.lastname: Kazis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003258:Consumer Behavior / Q000191:economics* / Q000706:statistics & numerical data; D003710:Demography; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics*; D006304:Health Status; D006801:Humans; D015273:Insurance Selection Bias; D008297:Male; D016345:Medicare Part B / Q000706:statistics & numerical data*; D008875:Middle Aged; D012959:Socioeconomic Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*