Geographic Variation in Appointment Wait Times for US Military Veterans.

Importance: Timely access to medical care is an important determinant of health and well-being. The US Congress passed the Veterans Access, Choice, and Accountability Act in 2014 and the VA MISSION (Maintaining Systems and Strengthening Integrated Outside Networks) Act in 2018, both of which allow veterans to access care from community-based clinicians, but geographic variation in appointment wait times after the passage of these acts have not been studied.

Objective: To describe geographic variation in wait times experienced by veterans for primary care, mental health, and other specialties.

The persistence of medicare advantage spillovers in the post-Affordable Care Act era.

Spillovers can arise in markets with multiple purchasers relying on shared producers. Prior studies have found such spillovers in health care, from managed care to nonmanaged care populations-reducing spending and utilization, and improving outcomes, including in Medicare. This study provides the first plausibly causal estimates of such spillovers from Medicare Advantage (MA) to Traditional Medicare (TM) in the post-Affordable Care Act era using an instrumental variables approach.