Survey Gauges TRICARE's Impact on Health Care
By Douglas J. Gillert
American Forces Press Service
WASHINGTON, Oct. 1, 1996 Sixty percent of patients surveyed in the Pacific Northwest say they're satisfied with the care they get under TRICARE.
The TRICARE Marketing Office conducted the telephone survey of 1,180 TRICARE Prime enrollees in Region 11 (Washington, Oregon and northern Idaho) to measure satisfaction levels 11 months after DoD launched the managed care plan there. A contractor, Market Metrics, helped develop the survey and analyze responses.
Similar surveys are planned for Regions 6, 9, 10 and 12 this fall and winter, according to Air Force Maj. William Slauson, assistant director of TRICARE marketing. "For each survey, we'll talk to 1,5002,000 Prime enrollees to find out if TRICARE is doing what it's supposed to do," he said. Results of the surveys will be announced early next year, he said. He said he hopes to eventually survey all 12 TRICARE regions.
Respondents included 418 active duty service members, 508 adult active duty dependents, 101 military retirees and 153 adult retiree dependents. They answered questions ranging from their level of knowledge about TRICARE to quality and access to care.
About half those polled said they fully understand TRICARE Prime, DoD's health maintenance organization plan. Active duty service members are automatically enrolled in the plan; it is optional for their family members, and for retirees and their eligible family members. Retirees pay an annual enrollment fee ($230 for one or $460 for two or more). Enrollees are assigned to a primary care manager for the bulk of their health care. In some cases, they may be assigned to a civilian primary care manager contracted by TRICARE.
"The more enrollees know about Prime or have experienced it, the more likely they are to like it," Slauson said.
When asked to compare their access to care before and after they enrolled in Prime, a third reported Prime "vastly improved" access, while 15 percent said access declined. Enlisted respondents and those who had visited their primary care manager reported the biggest improvement.
Respondents also reported improved access to primary and specialty care, and a significant minority reported shorter office waiting times and better continuity of care.
Those assigned to civilian primary care managers or referred to a civilian specialist were more likely to note improved access.
Quality of care is as good or better under TRICARE, according to the survey. The biggest improvements are associated with specialty care. Fortyfive percent of those contacted who saw a civilian specialist and 35 percent who visited a military specialist reported quality improvements.
Only one in four enrollees contacted used TRICARE contractorprovided nurse adviser telephone lines. Those who did, however, rated the service highly, and more than half said the call saved a trip to an emergency room or physician.
Respondents said TRICARE's tollfree information lines are slow, but they gave operators and TRICARE representatives at military medical facilities high marks for courtesy and explaining how the program works. On the other hand, they rated the helpfulness and courtesy of reception staffs at military facilities much lower than those at civilian primary care facilities.
Four out of five said they plan to reenroll in TRICARE Prime, and only 5 percent said they'll switch options. Seventytwo percent of active duty dependents who made a copayment to a civilian physician think Prime's copayments are reasonable; 46 percent of those who haven't made a copayment agree.
More than onethird of retirees and their dependents polled don't like paying annual enrollment fees. However, those retirees who paid for civilian care before TRICARE Prime was available were happiest with the annual fee. Less than a third said the annual fee caused them serious financial hardship.
Slauson said the surveys will help his office improve TRICARE education programs and provide DoD with valuable information for improving delivery of health care under TRICARE.