The uniformed services include the U. Army, U. Navy, U. Air Force, U. Marine Corps, U. Coast Guard, the Commissioned Corps of the U. TRICARE combines the health care resources of the uniformed services and supplements them with robust networks of civilian health care professionals, institutions, pharmacies, suppliers and other providers to provide access to high-quality health care services while maintaining the capability to support military operations and military readiness.
For the best browsing experience on www. The annual deductible is the same as for Tricare Extra, but both outpatient and inpatient care cost more. Tricare Prime appears to have the highest potential for providing comprehensive and fairly inexpensive coverage.
However, the Pentagon may have to limit the number of applicants it can accept. Further complicating matters, he said, is this fact: When it comes to receiving treatment in a military facility, military retirees—even those enrolled in Tricare Prime—will have a lower priority than active-duty dependents who are not enrolled. This means that retirees may have to use civilian providers. The ongoing process of base closure and realignment has also caused some uncertainty about continuing availability of military health care.
Additionally, both CHAMPUS- and Medicare-eligible beneficiaries in those areas can participate in either a retail pharmacy network or a mail-in pharmacy program. DoD just expanded the mail-in program to cover ten more Air Force bases and two Army posts. Neil M. Of major concern, said CBO, is the lack of control by lead agents. Ostensibly in charge of a region, lead agents will have little real authority over hospital commanders, who will still be controlled by their own service.
DoD plans to incorporate a utilization management program, similar to those found in private-sector managed-care plans, that will include prospective review, concurrent review, discharge planning, case management, and retrospective review. The CBO report pointed out, however, that decisions about use made by a military hospital commander will not be binding on the private contractor. Additionally, about thirty percent of eligible beneficiaries, some two million people, do not currently use military health care.
The Defense Department estimates that roughly 6. Almost all active-duty members and their families, totaling 4. Only about two-thirds of the three million military retirees and their dependents under age sixty-five use MTFs regularly.
About one-third of beneficiaries over age sixty-five, some 1. The Pentagon believes that Tricare will weather these difficulties. Capitated budgeting essentially allocates a fixed dollar amount on a per capita basis. DoD uses biannual surveys to estimate the number of beneficiaries who will use the military health-care system during a specific period, then determines payment amounts based on that estimated patient pool. At the same time that the Pentagon began developing its Tricare program, Congress directed DoD, through Section of the National Defense Authorization Act of Fiscal and Fiscal , to analyze the fundamental economic issues bearing on the size of the military medical system.
Specifically, Congress wanted to know whether it was cheaper to provide direct medical care to beneficiaries or to reimburse military beneficiaries for care obtained in the private sector. During the Cold War, those requirements called for a medical capacity that actually exceeded what it needed to provide day-to-day care for active-duty troops, leaving plenty of capability to care for non-active-duty beneficiaries.
Basing its findings on the current strategy of fighting two nearly simultaneous major regional conflicts, the Study found the wartime requirement greatly reduced.
Similarly, about half of the active-duty physicians projected to be available in FY would be needed to meet wartime requirements. The study pointed out that, if the Pentagon reduces its medical establishment to a size needed for wartime missions, it will also diminish its peacetime capability and force more beneficiaries from the direct-care system into CHAMPUS or Tricare. William J. Lynn, the Pentagon director of Program Analysis and Evaluation who presented the Study to Congress, said that the threshold issue is whether such a shift would reduce or increase DoD health-care costs overall.
Lynn attributed this advantage to five factors:. According to a Rand Corp. The Rand analysts also found a secondary effect: With expanded opportunity for free MTF care, those who had been using the system would do so more frequently. The demand effect would wipe out any cost advantage.
So pervasive and heated is the issue of military health care that the Commission on Roles and Missions of the Armed Forces also reviewed the situation. That seems to be the congressional view, as well. Skip to content. By Suzann Chapman. Beyond the Tricare Promise Tricare Prime appears to have the highest potential for providing comprehensive and fairly inexpensive coverage.
The chart at left shows the projected trend in the beneficiary population through Lynn attributed this advantage to five factors: MTFs provide care in more austere settings than civilian facilities do.
The military system, with some exceptions, is under less pressure to adopt unproven technologies, thereby slowing the pace of technology-driven cost growth. DoD has no financial responsibility when malpractice claims are upheld in court.
DoD is responsible for almost no indigent care. Because military physicians are salaried employees, they have less incentive to prescribe greater amounts of testing and treatment that may be of marginal benefit. Evidently, the debate still is wide open. Meanwhile, Tricare marches on.
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