Accession Number : AD1024448


Title :   Analysis of Private Sector Care Reform Authorities and Savings


Descriptive Note : Technical Report,01 Aug 2015,30 Sep 2016


Corporate Author : Institute for Defense Analyses Alexandria


Personal Author(s) : Bishop,James M ; Whitley,John E ; Wu,Linda ; Wu,Kevin Y ; Burns,Sarah K


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/1024448.pdf


Report Date : 01 Dec 2016


Pagination or Media Count : 166


Abstract : Budgetary pressures facing the Military Health System (MHS) have necessitated the consideration of various cost-saving reform options. This paper reviews past savings efforts within a strategic framework for MHS reform, identifying reform of the Department of Defense (DoD)s contracts for private sector care as a key neglected reform area. Current DoD contracting practice is out of step with civilian trends in healthcare. We estimate that incentivizing the insurance carriers (TRICARE contractors) who administer the program to adopt value-based purchasing (VBP) methods could save somewhere between $400 million and $1.5 billion annually under the most comprehensive approach (savings are larger if also applied to Medicare-eligible population). These savings are similar in magnitude to those achieved by DoD's proposals to raise cost shares, but would be generated by improving efficiency through better incentive structures rather than cutting benefits. We also examine how VBP incentives can be introduced into the contracts. We find that the TRICARE contracts should be restructured in a manner that increases competition between contractors in a given geographic market, increases contractor risk-bearing, and improves the contractors flexibility in negotiating with the delivery system.


Descriptors :   TRICARE , contracts , delivery of health care , military medicine , health services , health care , cost reductions , contractors , patient care management , PRIVATIZATION , Insurance


Subject Categories : Medicine and Medical Research
      Administration and Management


Distribution Statement : APPROVED FOR PUBLIC RELEASE