The Impact of Health Reform on Purchased Care Access: National Health Reform and Modernization of the Military Health System Study
Abstract
This document outlines the RAND National Defense Research Institutes assessment of the impact of a key aspect of reform in the broader U.S. health care system: the Affordable Care Acts coverage expansion. The analysis estimated how an influx of newly insured patients through the coverage expansion may change the way that civilian providers choose to interact with TRICARE enrollees. RANDs approach for this analysis combined data from the Defense Health Agency (DHA), publicly available data sources, and projections of health insurance coverage in 2016 from the RAND COMPARE microsimulation model to predict how physicians decisions to treat TRICARE enrollees will change over time. This research culminates in lists and maps of counties where civilian physicians are most likely to face financial incentives to substitute newly insured patients for current TRICARE patients. We found that about 7 percent of current TRICARE visits are delivered by a community provider who could face financial incentives after the Affordable Care Acts coverage expansion to replace their current TRICARE patients with the newly insured. Our work is one indicator of potential future TRICARE access concerns rather than an exact prediction of providers decisions. The goal of this study is to highlight the potential impacts of the coverage expansion on TRICARE in aggregate and for specific geographic regions and physician specialties. One potential use of the results presented in this study is to flag regions and physician specialties where access to purchased care should be monitored more closely over time by DHA and TRICARE managed care support contractors.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2017
- Accession Number
- AD1085304
Entities
People
- Andrew W. Mulcahy
- George E. Hart
- Italo A. Gutierrez
- Melony E. Sorbero
- Tadeja Gracner
- Teague Ruder
Organizations
- RAND Corporation