Medicare managed care enrollment by disability-eligible and age-eligible veterans.
OBJECTIVE
To assess factors associated with enrollment in a Medicare advantage (MA) plan versus Medicare fee-for-service plan in 2000-2004 by Medicare-eligible veterans. We also assessed whether these factors differed between disability-eligible veterans and age-eligible veterans.


METHODS
Medicare claims data, VA administrative data, and 2000 census data were constructed in a retrospective cohort study of 20,581 age-eligible veterans and 7541 disability-eligible veterans. MA enrollment in 2000-2004 was estimated in a logistic regression in a pooled sample of age-eligible and disability-eligible veterans that controlled for demographic, socioeconomic, and disease risk factors. Separate logistic regressions also were estimated for age-eligible and disability-eligible veterans.


RESULTS
Minority veterans and veterans with lower disease risk scores were more likely to be enrolled in an MA plan in 2000-2004 than white veterans or veterans with higher risk scores. Age-eligible veterans were more likely to be enrolled if aged 75 or older, female, able to receive free VA care, or not enrolled in Medicaid. Disability-eligible veterans were more likely to be enrolled if they were married or elderly.


CONCLUSIONS
Medicare Advantage plans appeared to benefit from favorable selection of Medicare-eligible veterans.
Maciejewski
Matthew L
ML
Center for Health Services Research in Primary Care, Department of Veterans Affairs, Durham, NC 27705, USA. matthew.maciejewski@va.gov
Birken
Sarah
S
Perkins
Mark
M
Burgess
James F
JF
Sharp
Nancy
N
Liu
Chuan-Fen
CF
D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*