TRICARE Plus: A Cost, Capacity and Enrollment Analysis

Abstract

This study looks at the TRICARE Plus (TP) impact on the cost of primary care (PC) within the Naval Hospital Pensacola (NHP) catchment area by determining current costs and NHP s TRICARE Prime enrollment capacity. Recommended TRICARE Plus options are provided based on NHP s and the Military Health System (MHS) costs and capacity. NHP s fiscal year 2001 (FY01) PC capacity was nearly 50 percent, which equated to over 45,000 unfilled visits. NHP s and the MHS PC costs in FY01 for the Pensacola catchment area were $17,357,609 and $23,753,608 respectively. Increasing enrollment will reduce these costs. Over 28,000 eligible beneficiaries in the Pensacola catchment area are not enrolled in TRICARE Prime at NHP. Recapturing a portion of these beneficiaries could result in $2.25 million savings for the MHS and decrease the cost of a NHP PC visit to $44. Specific enrollment strategies will determine actual savings. It is recommended that NHP recapture all Active Duty Dependents (ADD) currently enrolled in the Civilian Provider Network (CPN) while actively enrolling TRICARE Plus eligibles. By FY06, ADD Civilian Prime Network recaptures should increase NHP s TRICARE Prime enrollment nearly 4500. Additionally, TRICARE Plus enrollment could increase by over 3000. Estimated annual cost savings for NHP and the MHS would be $90 thousand and $2.25 million respectively.

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Document Details

Document Type
Technical Report
Publication Date
May 01, 2002
Accession Number
ADA420994

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  • Michael L. Haney

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  • Academy of Health Sciences

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