To examine the effect of the Department of Veterans Affairs’ (VA) Program of Comprehensive Assistance for Caregivers (PCAFC) on total VA health care costs for Veterans.
VA claims.
Using a pre‐post cohort design with nonequivalent control group, we estimated the effect of PCAFC on total VA costs up through 6 years. The treatment group included Veterans ( = 32 394) whose caregivers enrolled in PCAFC. The control group included an inverse probability of treatment weighted sample of Veterans whose caregivers were denied PCAFC enrollment ( = 38 402).
May 2009‐September 2017.
Total VA costs pre‐PCAFC application date were no different between groups. Veterans in PCAFC were estimated to have $13 227 in VA costs in the first 6 months post‐PCAFC application, compared to $10 806 for controls. Estimated VA costs for both groups decreased in the first 3 years with a narrowing, but persistent and significant, difference, through 5.5 years. No significant difference in VA health care costs existed at 6 years, approximately $10 000 each, though confidence intervals reflect significant uncertainty in cost differences at 6 years.
Increased costs arose from increased outpatient costs of participants. Sample composition changes may explain lack of significance in cost differences at 6 years because these costs comprise of early appliers to PCAFC. Examining 10‐year costs could elucidate whether there are long‐term cost offsets from increased engagement in outpatient care.
