Defense Health Care: More-Specific Guidance Needed for Assessing Nonenrolled TRICARE Beneficiaries' Access to Care
Abstract
DOD provides health care through TRICARE, its regionally structured health care program. In each of its regions (North, South, West), DOD has a TRO that oversees health care delivery. Beneficiaries who choose the TRICARE Prime option must enroll. Beneficiaries who do not enroll may obtain care under the TRICARE Standard, Extra, or Reserve Select options referred to as nonenrolled beneficiaries. Since TRICARE s inception in 1995, nonenrolled beneficiaries have complained about difficulties finding civilian providers who will accept them as patients. The National Defense Authorization Act for Fiscal Year 2008 mandated that GAO evaluate the processes, procedures, and analyses used by DOD to determine the adequacy of access to care for these beneficiaries. This report addresses the extent to which the TROs have assessed nonenrolled beneficiaries access to care. To conduct this work, GAO reviewed and analyzed relevant documentation and interviewed DOD officials, including officials in each of the TROs. In addition, GAO reviewed federal internal control standards for monitoring performance. GAO also interviewed officials from organizations representing military beneficiaries to discuss their perspectives on the TROs efforts. GAO recommends that DOD enhance existing guidance for the TROs to include more specificity on assessing nonenrolled beneficiaries access to care. DOD concurred with GAO s recommendation.
Document Details
- Document Type
- Technical Report
- Publication Date
- Apr 01, 2014
- Accession Number
- ADA599570
Entities
People
- Bonnie Anderson
- Danielle Bernstein
- Debra Draper
- Jacquelyn Hamilton
- Jeffrey Mayhew
- Laurie Pachter
Organizations
- United States Government Accountability Office