Hidden Bibliographic Details
| Other authors / contributors: | Farley, Donna O.
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| ISBN: | 9780833059956
0833059955
1598751085
9781598751086
0833033174
9780833033178
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| Digital file characteristics: | text file PDF
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| Notes: | "Prepared for Medicare & Medicaid Services (CMS) and the DoD Tricare Management Activity (TMA)."
"RAND Health."
"MR-1580-CMS"--Page 4 of cover.
Includes bibliographical references (page 127).
Print version record.
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| Summary: | The Medicare-Department of Defense (DoD) Subvention Demonstration tested Senior Prime as a managed care approach for enhancing access to affordable health care for Medicare-eligible DoD beneficiaries. While Senior Prime achieved solid beneficiary participation and satisfaction, it also raised a difficult set of challenges involved in applying managed care to the DoD health care system. These challenges included financial issues such as establishing equitable capitation rates and an appropriate level-of-effort baseline, as well as management issues such as effective care management and administrative processes for health plan sites. The basic structures of TRICARE and the DoD health system, including separate management jurisdictions and hierarchical budgeting methods, contribute to the challenges by creating incentives that discourage delivery of cost-effective care. Military treatment facilities need to be motivated not only to provide excellent care but also to manage appropriateness of care and related costs. Although DoD has decided to discontinue the Senior Prime model, many of the lessons learned from this demonstration are applicable to any managed care program that DoD may contemplate in the future.
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| Other form: | Print version: Evaluation of the Medicare-DoD subvention demonstration. Santa Monica, CA : RAND, 2003 0833033174
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