Characteristics and medication use of veterans in Medicare Advantage plans.

OBJECTIVES: To compare characteristics, health conditions, and medication acquisition patterns by fee-for-service (FFS) or Medicare Advantage (MA) plan enrollment status for Medicare-eligible veterans.

STUDY DESIGN: Retrospective analysis of all female and a random 10% sample of male veterans.

METHODS: Data were derived from the US Department of Veterans Affairs (VA) and Medicare administrative databases. Demographic, geographic, and RxRisk-V risk classes were ascertained in 2008. Medicare Part D enrollment, medication acquisition, and use of high-risk medications (HRMs) were examined in 2009. A veteran was classified as an MA enrollee if he or she was enrolled in an MA plan for at least 1 month in 2008-2009. Descriptive and regression analyses were conducted to compare veterans' characteristics and medication acquisition patterns by plan enrollment type controlling for veterans' characteristics.

RESULTS: Veterans who resided in urban settings and in the West or Northeast and who had co-payments for their VA medications had greater odds of enrolling in MA programs compared with their counterparts. MA-enrolled veterans were more likely to be dual (32.3% vs 7.0%) or Medicare-reimbursed (31.1% vs 14.5%) pharmacy users and less likely to be VA-only pharmacy users (29.4% vs 48.7%) than FFS enrollees. Higher proportions of MA-enrolled veterans received HRMs compared with those in the FFS sector (17.0% vs 14.3%).

CONCLUSIONS: Providers both inside and outside of the VA should consider that substantial information about the medication use of veterans may be unavailable in their healthcare systems' electronic records.