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The Impact of Medicaid Enrollment on Veterans Health Administration Enrollees' Behavioral Health Services Use
Author(s) -
Vanneman Megan E.,
Phibbs Ciaran S.,
Dally Sharon K.,
Trivedi Amal N.,
Yoon Jean
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13062
Subject(s) - medicaid , medicine , veterans affairs , depression (economics) , mental health , psychiatry , family medicine , health care , gerontology , economics , macroeconomics , economic growth
Objective To examine Veterans Health Administration ( VA ) enrollees' use of VA services for treatment of behavioral health conditions ( BHC s) after gaining Medicaid, and if VA reliance varies by complexity of BHC s. Data Sources/Study Setting VA and Medicaid Analytic eX tract utilization data from 31 states, 2006‐2010. Study Design A retrospective, longitudinal study of Veterans enrolled in VA care in the year before and year after enrollment in Medicaid among 7,249 nonelderly Veterans with serious mental illness ( SMI ), substance use disorder ( SUD ), posttraumatic stress disorder ( PTSD ), depression, or other BHC s. Data Collection/Extraction Methods Utilization and VA reliance (proportion of care received at VA ) for BH outpatient and inpatient services in unadjusted and adjusted analyses. Principal Findings In adjusted analyses, we found that overall Veterans did not significantly change their use of VA outpatient BH services after Medicaid enrollment. In beta‐binomial models predicting VA BH outpatient reliance, veterans with SMI ( IRR = 1.38, p < .05), PTSD ( IRR = 1.62, p < .01), and depression ( IRR = 1.36, p < .05) had higher reliance than veterans with other BHC s after Medicaid enrollment. Conclusions While veterans did not change the amount of VA outpatient BH services they used after enrolling in Medicaid, the proportion of care they received through VA or Medicaid varied by BHC .