Quality and Equity of Care in the Veterans Affairs Health-Care System and in Medicare Advantage Health Plans

This article compares the quality of care provided to seniors through the Veterans Affairs (VA) health care system and Medicare Advantage plans. In the mid-1990s, the VA improved the quality of its care and outperformed private sector health care plans in studies, but little is known about whether this quality improvement persisted through the 2000s.

The authors conducted a cross-sectional comparison analysis on data from 2000 through 2007, including 293,554 observations from VA medical centers and 5,768,573 observations from Medicare Advantage plans. They compared the two systems across 12 quality measures.

Key Findings:

  • The VA consistently outperformed Medicare Advantage plans, achieving higher scores across all 12 quality measures collected in the final year of the study.
  • The VA provided significantly more equitable care across socioeconomic levels than the Medicare Advantage plans.

This research strongly suggests that the VA has succeeded in its efforts to improve the quality and equity of its care. The authors speculate that the VA’s strong chronic disease management, salaried payment structure and integration of health care facilities may contribute to the VA’s high quality ratings.