Volume 53 | Number S3 | December 2018

Abstract List

Amy K. Rosen Ph.D., Todd H. Wagner Ph.D., Warren B. P. Pettey M.P.H., C.P.H., Michael Shwartz Ph.D., Qi Chen M.D., Ph.D., Jeanie Lo M.P.H., William J. O'Brien M.S., Megan E. Vanneman Ph.D., M.P.H.


To assess differences in risk (measured by expected costs associated with sociodemographic and clinical profiles) between Veterans receiving outpatient services through two community care () programs: the Fee program (“Fee”) and the Veterans Choice Program (“Choice”).

Data Sources/Study Setting

Administrative data from 's Corporate Data Warehouse in fiscal years () 2014–2015.

Study Design

We compared the clinical characteristics of Veterans across three groups (Fee only, Choice only, and Fee & Choice). We classified Veterans into risk groups based on Nosos risk scores and examined the relationship between type of outpatient utilization and risk within each group. We also examined changes in utilization of and in 14–15. We used chi‐square tests, t tests, and s to identify significant differences between groups.

Principal Findings

Of the 1,400,977 Veterans using in 15, 91.4 percent were Fee‐only users, 4.4 percent Choice‐only users, and 4.2 percent Fee & Choice users. Mean concurrent risk scores were higher for Fee only and Fee & Choice (1.9,  = 2.7; 1.8,  = 2.2) compared to Choice‐only users (1.0,  = 1.2) ( < .0001). Most users were “dual users” of both and in 14–15.


As care transitions from to , should consider how best to coordinate care with community providers to reduce duplication of efforts, improve handoffs, and achieve the best outcomes for Veterans.