The Department of Defense announced today the results of a recently-completed study by the Center for Naval Analyses/Institute for Defense Analyses (CNA/IDA) which point to increased satisfaction with military health care, especially since the implementation of Tricare, the Department of Defense's (DoD's) health care program.
"This is what we really expect to see as Tricare matures," said Dr. J. Jarrett Clinton, acting assistant secretary of Defense for Health Affairs. "We have great confidence in our military health personnel and our managed care support contractors, and we believe in their capabilities to successfully implement this program. While we have begun to see the fruits of our efforts, we are not complacent. There are many areas where we still need to work to make Tricare a health care benefit that more exactly meets the requirements of our readiness mission and exceeds the expectations of the beneficiaries we serve."
The study showed that the most significant increases in beneficiary satisfaction occurred in the areas of access and quality of care, particularly among Tricare Prime enrollees.
The percentage of all Tricare Prime enrollees who were satisfied with their access to care when needed in 1998 was 74 percent, compared to 63 percent "pre- Tricare." The percentage satisfied with the overall quality of care was 82 percent, compared to 73 percent before Tricare.
The CNA/IDA study is an ongoing, independent evaluation of Tricare that was congressionally directed. The new results reflect the experiences of beneficiaries in 1998 in Tricare Regions 3 (Southeast), 4 (Gulf South), 6 (Southwest), 7/8 (Central), 9 (Southern California), 10 (Golden Gate), 11 (Northwest), and 12 (Pacific). Regions with at least one full year under Tricare by the end of 1998 were included in the review. Region 11 was evaluated for the third time; Regions 3, 4, 6, and 9-12 for the second time; and Region 7/8 for the first time.
Access, quality and costs under Tricare were compared with estimates of what each would have been under the previous DoD health care benefit.
The new study found that government costs for the Tricare program were lower than they would have been under the previous health care benefit through the period that was reviewed.
The CNA/IDA review determined that out-of-pocket costs were lower for most active duty families, especially those enrolled in Tricare Prime with a military primary care manager. Costs were higher for Tricare-eligible retiree families -- averaging between $236-$381 more -- under the Tricare program. Out-of-pocket costs for Medicare-eligible families were only marginally higher under Tricare because most of these families continue to carry supplemental forms of private insurance. Additionally, the availability of Medicare Plus Choice health maintenance organizations in some regions provides a low-cost alternative to Tricare.
CNA/IDA's evaluation of data from TMA's Annual 1994-1998 Health Care Surveys of DoD beneficiaries demonstrated that in the regions studied, access to health care generally improved under Tricare. Beneficiaries enrolled at an MTF tended to report greater levels of satisfaction with access than those enrolled with civilian primary care managers.
Tricare beneficiaries reported that their use of preventive care generally increased, and their use of emergency rooms decreased. Their satisfaction with access to care when they needed it, their access to emergency and specialty care, and their access to telephone advice, all increased. Their satisfaction with the ease of making appointments increased, and their self-reported wait times for appointments decreased.
CNA/IDA measured Tricare quality, based on self-reported use of preventive care, against national standards for health-promotion and disease-prevention objectives specified by the U.S. Department of Health and Human Services in Healthy People 2000. Most of these goals were met, or nearly met, under Tricare. The report indicated the need for continued improvement on the rate at which military personnel use tobacco products.
In the area of claims filing, which is a primary cause of dissatisfaction with a health plan, the CNA/IDA evaluation determined that fewer people have to file claims under Tricare than under the old system. During the period of the study, Tricare beneficiaries were found to have to file claims more often and reported more problems per claim filed than those covered under national managed care plans. Tricare currently receives more than 32 million claims per year, and 96 percent of these are now processed within 30 days. Claims processing delays have plummeted during the past year as a result of a claims re-engineering initiative, and Tricare officials anticipate increasing beneficiary satisfaction in this area.
"We are pleased about the continued success of Tricare," said Clinton. "Standing up the Tricare program worldwide was a monumental undertaking, but the signs are clear that we are becoming the world-class health care system we set out to be. The CNA/IDA evaluation helps provide a compass to steer our course for the future."
The study is on the Web at http://www.defenselink.mil/pubs/tricare02202001.pdf .