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Alternatively, if VA-outsourced dialysis veterans are systematically less complex, then building additional VA capacity and patient access to more VA-based dialysis may improve continuity of VA care and reduce VA expenditures on outsourced dialysis care without compromising patient survival outcomes.
VA expenditures for "buying" outsourced dialysis are high and increasing relative to "making" dialysis treatment within its own system.
ACGs (14) are another widely used risk adjustment measure for expenditure analyses and have been applied in VA expenditures analyses (6, 15).
DCGs were originally developed to predict Medicare expenditures, are the most widely implemented risk adjuster in payment settings (9), and have predicted total VA expenditures better than other risk adjusters (15).
These findings suggest the need for VA to consider Veterans' access to care, long-term savings in VA expenditures, and optimal patient outcomes in its strategy for delivering dialysis services.
Similar(55)
Third, non-VA expenditures and VA outpatient pharmacy expenditures were not available and may have underestimated our power.
Outpatient VA pharmacy and non-VA expenditures were excluded.
The purpose of this analysis was to compare VA utilization and expenditures of veterans receiving primary care at CBOCs and VAMCs in FY00 and FY01.
VA utilization and expenditure data were drawn from the VA's system-wide cost accounting system.
While overall outpatient dialysis expenditures for VA dialysis increased 10% between 1993 and 2003, payments for VA-outsourced dialysis grew 348% (from $13.5 M to $60.7 M) during the same period [ 7].
The RxRisk was developed to predict primary care visits, hospitalizations, and expenditures in VA and managed-care populations (3, 6, 13, 15); this study used the RxRisk tailored to the VA population (RxRisk-V) (24).
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