Medical foster home is less costly than traditional nursing home care
Corresponding Author
Cari Levy MD, PhD
Denver-Seattle Center of Innovation at the Denver VA Medical Center, Denver, Colorado
Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora, Colorado
Correspondence
Cari Levy, MD, PhD, Rocky Mountain Regional Veterans Affairs Medical Center, 1700 Wheeling St, Aurora, CO 80045.
Email: Cari.Levy@VA.gov
Search for more papers by this authorEmily A. Whitfield PhD
Denver-Seattle Center of Innovation at the Denver VA Medical Center, Denver, Colorado
Search for more papers by this authorCorresponding Author
Cari Levy MD, PhD
Denver-Seattle Center of Innovation at the Denver VA Medical Center, Denver, Colorado
Division of Health Care Policy and Research, University of Colorado School of Medicine, Aurora, Colorado
Correspondence
Cari Levy, MD, PhD, Rocky Mountain Regional Veterans Affairs Medical Center, 1700 Wheeling St, Aurora, CO 80045.
Email: Cari.Levy@VA.gov
Search for more papers by this authorEmily A. Whitfield PhD
Denver-Seattle Center of Innovation at the Denver VA Medical Center, Denver, Colorado
Search for more papers by this authorAbstract
Objective
To compare the costs of Community Nursing Homes (CNHs) to Medical Foster Homes (MFHs) at Veteran Health Administration (VHA) Medical Centers that established MFH programs.
Data Sources
Episode and costs data were derived from VA and Medicare files (inpatient, outpatient, emergency room, skilled nursing facility, dialysis, and hospice).
Study Design
Propensity scores matched 354 MFH to 1693 CNH Veterans on demographics, clinical characteristics, health care utilization, and costs.
Data Extraction Methods
Data were retrieved for years 2010-2011 from the VA Corporate Data Warehouse, VA Health Data Repository, and the VA MFH Program through the VA Informatics and Computing Infrastructure (VINCI).
Principal Findings
After matching on unique characteristics of MFH Veterans, costs were $71.28 less per day alive compared to CNH care. Home-based and mental health care costs increased with savings largely attributable to avoiding CNH residential care. When average out-of-pocket payments by Veterans of $74/day are considered, MFH is at least cost neutral. Mortality was 12 percent higher among matched Veterans in CNHs.
Conclusions
MFHs may serve as alternatives to traditional CNH care that do not increase total costs with mortality benefits. Future work should examine the differences for functional disability subgroups.
Supporting Information
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Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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