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Cost of Veteran Coronary Artery Bypass Grafting: Veterans Health Administration Versus Community Care

Jake L Cotton1, Adnan Syed2, Danielle Abbitt3

  • 1Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado; Department of Surgery, Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, Colorado; Denver Seattle Center of Innovation, Rocky Mountain Regional Veteran Affairs Medical Center, Aurora, Colorado.

The Journal of Surgical Research
|October 2, 2025
PubMed

Insights

Coronary artery bypass grafting (CABG) surgery costs were similar between Veterans Health Administration (VHA) and community hospitals initially. However, VHA CABG procedures were found to be less expensive after adjusting for factors like length of stay, highlighting efficient care delivery.

Area of Science:

  • Health Services Research
  • Cardiovascular Surgery
  • Health Economics

Background:

  • The Veterans Health Administration (VHA) community care program funds veteran healthcare in community settings.
  • Rising costs in community care necessitate cost comparisons with VHA care.
  • Limited comparative cost data exists for procedures like coronary artery bypass grafting (CABG) between VHA and community hospitals.

Purpose of the Study:

  • To compare the costs of coronary artery bypass grafting (CABG) surgery performed within the VHA versus community care hospitals.
  • To identify potential cost efficiencies in VHA-funded cardiac procedures.

Main Methods:

  • A retrospective cohort study of veterans undergoing CABG between October 2018 and September 2020.
  • Data collected from VHA and community care hospitals within Veteran Integrated Service Network 19.
  • Index hospitalization costs were analyzed using VHA databases.

Main Results:

  • 361 veterans underwent CABG, with 54% in VHA and 46% in community hospitals.
  • Initial median costs were similar: VHA $122,213 vs. community $112,923 (P=0.23), despite longer VHA postoperative stays.
  • After controlling for factors like length of stay, VHA CABG was significantly less expensive (P=0.007).
  • No differences were observed in index hospitalization metrics or 30-day outcomes.

Conclusions:

  • Coronary artery bypass grafting (CABG) is less expensive within the VHA compared to community care when accounting for relevant factors.
  • Ongoing evaluation of community care costs is crucial for VHA funding efficiency and program sustainability.
Abstract

Keywords:
Coronary artery bypassCost analysisHealth EconomicsHealth care costsHealth policyThoracic surgeryVeterans

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