Defense Health Care: Management Attention Needed to Make TRICARE More Effective and User-Friendly
Abstract
We are pleased to be here today to discuss the Department of Defense's(DOD) implementation of TRICARE-its managed health care program. After years of testing alternative health care delivery systems, DOD began restructuring its system into TRICARE in 1993. Today, over 8.1 million active-duty personnel, their dependents, and retirees are eligible to receive care in this $15.6 billion-per-year health care system. TRICARE was designed to improve beneficiaries' access to health care while maintaining quality and controlling costs in a time of military downsizing and budgetary concerns. Since TRICARE's inception, we have reported on the progress DOD has made in implementing TRICARE and the challenges that remain. Last June, TRICARE became a nationwide program when the last contract covering the Northeast became operational. As the program intended, many nonactive-duty beneficiaries have opted to enroll in the managed care option called TRICARE Prime. As of the end of last year, 70 percent of eligible active-duty family members and 23 percent of retirees under age 65 had enrolled in TRICARE Prime. However, several concerns we have raised in the past about operational issues continue to affect TRICARE's progress. My statement today will focus on four specific TRICARE issues: the extent to which (1) beneficiaries enrolled in TRICARE are getting timely access to health care, (2) claims for medical services are paid in a timely and accurate manner, (3) DOD and its contractors are identifying and mitigating fraud and abuse in TRICARE, and (4) DOD's pharmacy programs are cost-effective and consistently serve the needs of all beneficiaries.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 11, 1999
- Accession Number
- AD1106082
Entities
People
- Stephen P. Backhus
Organizations
- United States Government Accountability Office