Association between self-reported health and reliance on Veterans Affairs for health care among Veterans Affairs enrollees

Abstract: The Department of Veterans Affairs (VA) is the largest integrated health care system in the US. However, most enrollees (80%) have other health insurance. Veterans’ selective use of VA health care creates an immense challenge for VA leadership, the scale of which is relatively unknown. The VA allocates substantial resources to improve equitable access, prevent suicides, and provide transparency on hospital quality by analyzing VA-provided and VA-purchased care. These analyses will be inaccurate if patient health and reliance on the VA are linked, especially as the VA expands its role as a payer of care and the recently passed PACT Act brings in younger veterans, who are more likely to have private health insurance. This study investigated whether VA reliance was associated with self-reported health, a predictor of health outcomes, and whether this association varied for individuals with different types of outside insurance using a nationally representative survey.