Accession Number : ADA324270

Title :   The Dual Eligible Beneficiary Population: An Analysis of The Treatment of Medicare/DoD Eligible Patients at Tripler Army Medical Center.

Descriptive Note : Final rept. Jul 95-Jul 96,

Corporate Author : ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATI ON

Personal Author(s) : Hendee, Michael N.

PDF Url : ADA324270

Report Date : 13 MAY 1996

Pagination or Media Count : 80

Abstract : The Department of Defense has developed a comprehensive managed care program known as TRICARE. The goals of this program are to increase efficiency and cost-effectiveness of CHAMPUS and direct care services through established networks of high-quality civilian providers and hospitals, and improving beneficiary services by providing enhanced access to care. An issue that has Spurred many a debate is that of access to care for the dual eligible Medicare/DoD population. Currently, there is no mechanism for this beneficiary population to enroll in TRICARE. It is estimated that as space available care decreases in the Military Treatment Facilities, they will have to seek care on their own in the civilian sector. A goal of DoD is to be authorized nationwide as a Medicare reimbursable provider, a policy known as Medicare Subvention. Under Medicare Subvention, DoD will be given funding to provide care to Medicare eligible beneficiaries who want to continue to receive care under the Military Health Services System. This policy is currently under review in Congress. The purpose of this project was to present a utilization and demographic analysis of the Medicare/DoD eligible population for Tripler Army Medical Center. In addition, two reimbursement methodologies, a prospective payment and capitation system, were applied to review the revenue that could have been generated for FY 1994 and 1995 if Medicare Subvention were passed. This project will serve as a baseline for further analysis if and when Medicare Subvention becomes a reality.

Descriptors :   *COST EFFECTIVENESS, *MILITARY MEDICINE, *CIVILIAN POPULATION, *MEDICAL SERVICES, *HEALTH CARE FACILITIES, MILITARY PERSONNEL, CONGRESS, DEPARTMENT OF DEFENSE, MILITARY FACILITIES, DEMOGRAPHY, POPULATION, ACCESS, HOSPITALS.

Subject Categories : Economics and Cost Analysis
      Medicine and Medical Research
      Medical Facilities, Equipment and Supplies

Distribution Statement : APPROVED FOR PUBLIC RELEASE