Estimating lost revenue from a free-care mandate in the U.S. Department of Veterans Affairs.
OBJECTIVE
This study estimated the loss in outpatient copayment revenue for the U.S. Department of Veterans Affairs (VA) health care system from a mandate for free care related to military sexual trauma. s


METHODS
A retrospective database analysis located all VA enrollees who screened positive for military sexual trauma and received related care in fiscal years 2006-2008. The analysis predicted which individuals would face copayments for care related to military sexual trauma with and without the mandate and the cost to the VA in lost copayments in the outpatient setting.


RESULTS
Over 97% of persons receiving outpatient care for military sexual trauma would face no copayment even in the absence of a free-care mandate. The net cost to the VA health care system is small, .01%-.04% of annual collections of outpatient copayments.


CONCLUSIONS
Administrative data are readily available to estimate the cost of a VA mandate for free care. The case of military sexual trauma shows that the forgone revenue may be small even when the number of free encounters is very large.
Health Economics Resource Center, VA Palo Alto Health Care System, 795 Willow Rd. (152 MPD), Menlo Park, CA 94025, USA. mark.smith9@va.gov
Mark W
MW
Smith
Adam
A
Chow
Rachel
R
Kimerling
D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D005251:Fees, Medical / Q000706:statistics & numerical data*; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000191:economics* / Q000458:organization & administration; D006801:Humans; D008297:Male; D037141:Mandatory Programs / Q000191:economics / Q000706:statistics & numerical data; D011902:Rape / Q000706:statistics & numerical data; D017406:Sexual Harassment / Q000191:economics* / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States; D014493:United States Department of Veterans Affairs / Q000191:economics / Q000458:organization & administration