BACKGROUND/RATIONALE:
Following an organizational transformation in the mid-1990's, the quality of care in the Veterans Affairs health care system (VA) compared favorably with care quality in some private-sector settings. Whether this performance advantage has persisted or its relation to geographic and socioeconomic variations in care is unknown.

OBJECTIVE(S):
To compare the quality and equity of care for older adults in the Veterans Affairs health
care system (VA) with that delivered in Medicare Advantage (MA) health plans using the same performance measures.

METHODS:
We will compare the quality of care and socioeconomic disparities in care in the VA and Medicare Advantage using comparable performance indicators assessing cardiovascular, diabetes, and cancer screening care. The study population includes 396,273 observations from enrollees in 142 VA medical centers (VAMCs) and 5,768,573 observations from enrollees in 305 MA plans.


FINDINGS/RESULTS:
Not yet available.

IMPACT:
The results from this study will inform efforts by the VA to understand geographic and sociodemographic variations in the quality of care for veterans and to benchmark VA care to that delivered in non-VA settings.

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External Links for this Project

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PUBLICATIONS:

Journal Articles

1. Trivedi AN, Swaminathan S, Mor V. Insurance parity and the use of outpatient mental health care following a psychiatric hospitalization. JAMA : the journal of the American Medical Association. 2008 Dec 24; 300(24):2879-85. [view]
2. Swaminathan S, Mor V, Mehrotra R, Trivedi A. Medicare's payment strategy for end-stage renal disease now embraces bundled payment and pay-for-performance to cut costs. Health affairs (Project Hope). 2012 Sep 1; 31(9):2051-8. [view]
3. Trivedi AN, Grebla RC. Quality and equity of care in the veterans affairs health-care system and in medicare advantage health plans. Medical care. 2011 Jun 1; 49(6):560-8. [view]

DRA: Cardiovascular Disease, Diabetes and Other Endocrine Conditions, Health Systems Science, Cancer
DRE: Treatment - Comparative Effectiveness
Keywords: Managed care
MeSH Terms: none