Chapter 8 provides references for further information about the Fee Basis program and data. Chapter 6 provides information about how to access the Fee Basis data, while Chapter 7 provides information about the rules governing Fee Basis care. Chapter 4 offers detailed information SAS Fee Basis data Chapter 5 provides detailed information about SQL Fee Basis data. Chapter 1 presents an overview of Fee Basis data in general Chapter 2 presents an overview of the variables in the Fee Basis data and Chapter 3 describes how SAS versus SQL forms of Fee Basis data differ. This guidebook describes characteristics of Fee Basis care data such as contents and missingness, and makes recommendations about its use for research purposes. This guidebook is intended to help researchers understand and use the National Fee Basis files, which come in both SQL and SAS formats. There is also a host of non-emergency surgery provided through Fee Basis mechanisms that may be of interest to researchers. Persons interested in studying care provided under the Choice Act may wish to explore the VACAA tables or the FBCS tables at VA Corporate Data Warehouse (CDW).įee Basis data will be most useful for studying conditions where contract care is common, such as home-based care and nursing care, and for determining typical non-VA charges for health care services (both charges and payments are reported) and comparing those to VA costs. 1 The Fee Basis files contain data for care received through the Choice Act, but in this guide, we do not distinguish for care provided under the Non-VA Medical Care program and that provided under the Choice Act. 2 Under the Choice Act, ten ($10) billion dollars has been allocated towards Non-VA Medical Care for eligible Veterans through 2017. 1 The Choice Act allows Veterans to receive health care through non-VA providers in the community if they are unable to schedule an appointment at their local VA within 30 days or by a date determined by their provider (“wait-time goals”), if they reside over 40 miles from a VA facility, or if they face an unusual or excessive burden in travelling to a VA facility. Passed in 2014 with bipartisan support in Congress, its purpose is to increase Veterans’ access to health care. The Choice Act represents one of the largest shifts in the organization and financing of healthcare in the Department of Veterans Affairs (VA) in recent years. Many veterans now have access to Non-VA medical care through the new Veterans Access, Choice, and Accountability Act (VACAA, or “Choice Act”). Non-VA Medical Care consumes a significant portion of VA spending indeed, contract costs (i.e., the cost of all things purchased from non-VA health care providers) accounted for approximately 11% of VA expenditures in fiscal year 2014. Payment for these types of care falls under the Non-VA Medical Care program. VA can also pay for hospice care for Veterans when the VA facility is unable to provide the needed care this happens frequently, as VA provides only inpatient-based hospice care and many Veterans may wish to receive hospice at home or in the community. In addition, VA may place a Veteran in a private or state-run nursing home when a bed in a VA nursing home is unavailable or if the nursing home is distant from the patient’s residence. As noted above, non-VA care may be authorized under the Non-VA Medical Care program when VA cannot offer needed care. VA can make payments to non-VA health care providers under many arrangements. Such care is called Non-VA Medical Care, or Fee Basis care. ![]() The Department of Veterans Affairs (VA) often pays providers in the community to provide care to Veterans when it is unable to provide such care itself (e.g., due to a lack of resources or delays in providing care), or when it is infeasible to do so (e.g., emergency care). ![]() Institutional Aspects of the Non-VA Medical Care System ![]() List of VA Economists and Researchers with Health Economic Interests.Measuring the Cost of a Program or Practice: Microcosting. ![]()
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