DEFENSE HEALTH CARE: Access to Care for Beneficiaries Who Have Not Enrolled in TRICARE's Managed Care Option
Abstract
TMA and its MCSCs use various methods to evaluate access to care, and according to TMA and MCSC officials, the resulting measures indicate that nonenrolled TRICARE beneficiaries access to care is generally sufficient and that access problems appear to be minimal. Among methods used by TMA to evaluate access to care are its recently implemented civilian provider survey and an annual beneficiary health care survey. The survey of civilian providers, which includes network and nonnetwork providers, is designed to measure access to care by identifying how many civilian providers are willing to accept nonenrolled TRICARE beneficiaries as new patients. The first round of this survey, implemented in 2005, focused on 20 states and found that 14 percent of civilian providers were not accepting new patients from any government or commercial health plan. Of those accepting new patients, about 80 percent would accept nonenrolled TRICARE beneficiaries as new patients. In addition, the results of each of TMA s annual beneficiary health care surveys for 2003 through 2005 show that nonenrolled TRICARE beneficiaries satisfaction with access to care was similar to satisfaction reported by participants in commercial health plans. TMA and the TROs also receive anecdotal information through beneficiary feedback, and, according to these officials, complaints about access to care are infrequent. Each of the MCSCs also has its own methods of monitoring access to care, including analyzing provider and beneficiary locations as part of their responsibility for ensuring sufficient network capacity for all TRICARE beneficiaries residing in locations with civilian provider networks. While the MCSCs methods were not designed specifically to evaluate access for nonenrolled TRICARE beneficiaries, they do provide helpful information that allows the MCSCs to monitor the availability of both network and nonnetwork civilian providers for this population. According to MCSC officials, their measures indic
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 01, 2006
- Accession Number
- ADA475151
Entities
People
- Marcia G. Crosse
Organizations
- United States Government Accountability Office