Most members of Tricare, the Defense Department's managed care health plan, are satisfied with the quality of their health care, according to an independent study
released last week. The study, conducted jointly by the Center for Naval Analyses and the Institute for Defense Analyses, showed that 74 percent of Tricare beneficiaries were satisfied with their access to health care in 1998, compared with a 63 percent satisfaction rate before Tricare was adopted in 1994. Tricare offers three health care packages that include different benefits, copayments and deductibles. Most of the satisfied customers are enrolled in the Tricare Prime program, in which members have a primary care manager that maintains their medical records and coordinates their care. The Center for Naval Analyses and the Institute for Defense Analyses evaluate Tricare annually and submit a joint report to Congress each December. Data from 1999 and 2000 are not yet available, the Defense Department said. Congress passed legislation in 1996 directing the Defense Department to conduct an ongoing, independent evaluation of Tricare. The managed health care system costs the Defense Department $16 billion per year and covers more than 8.2 million active-duty personnel, retirees and their dependents. The analysis tracks data from surveys from fiscal years 1994 to 1998, concluding that access to health care improved under Tricare and that the government's costs were lower than they would have been under Defense's traditional health care plan, theCivilian Health and Medical Program Uniformed Service (CHAMPUS). CHAMPUS, an insurance program that covers supplemental care from civilian doctors for military dependents and retirees, can be used separately or along with Tricare. Although total costs under Tricare were $318 million lower in fiscal 1998 than costs in 1994, the price of prescription costs increased by over $200 million in the eight health service regions evaluated. Out-of-pocket costs were also lower for most active-duty families under Tricare, although costs for Tricare-eligible retirees and their dependents were higher under the system. "While we have begun to see the fruits of our efforts, we are not complacent. There are many areas where we still need to work to make Tricare a health care benefit that more exactly meets the requirements of our readiness mission and exceeds the expectations of the beneficiaries we serve," said Dr. J. Jarrett Clinton, acting assistant secretary of Defense for Health Affairs at the Defense Department. Fewer people had to file claims under Tricare in fiscal 1998 than in fiscal 1994, with a 10 percent reduction in the rate of claims. Although costs are down slightly from 1994 to 1998, the report's authors acknowledge that it is too soon to see an overall trend in lower costs under Tricare. The fiscal 2001 Defense Authorization bill
contains several key reforms
to the health care system. One provision eliminates co-payments for active-duty members and their dependents, except for co-payments on prescription drugs, beginning in April 2001. Another provision provides permanent lifetime Tricare eligibility to Medicare-eligible military retirees and their family members, expected to start in October 2001.