Accession Number : ADA259584


Title :   Defense Health Care: Champus Mental Health Demonstration Project in Virginia


Corporate Author : GENERAL ACCOUNTING OFFICE WASHINGTON DC HUMAN RESOURCES DIV


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a259584.pdf


Report Date : Dec 1992


Pagination or Media Count : 17


Abstract : This report responds to your request that we examine the Contracted Provider Arrangement managed care demonstration project for mental health services currently being conducted in the Tidewater, Virginia, area by the Department of Defense (DOD) for beneficiaries of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). CHAMPUS beneficiaries in several Virginia cities, including Norfolk, Portsmouth, and Newport News, participate in the project. For a fixed-price ($31.2 million in fiscal year 1992), the project's contractor is responsible for authorizing, arranging, and paying claims for mental health care services to CHAMPUS beneficiaries who seek care in the project area. In November 1991, the Tidewater area media began reporting allegations that the project's contractor was denying needed care for CHAMPUS beneficiaries to increase its profits under the fixed-price arrangement. Subsequently, your Subcommittee held a hearing on the project in April 1992. At the conclusion of the hearing, you asked us to provide a report (1) identifying the extent of cost-savings achieved under the project and explaining how these savings were achieved and (2) describing the extent to which DOD oversight and contractor controls have been sufficient to ensure that CHAMPUS beneficiaries have access to quality treatment.


Descriptors :   *COSTS , *MENTAL HEALTH , *MEDICAL SERVICES , *SAVINGS , *INSURANCE , FAMILY MEMBERS , MENTAL DISORDERS


Subject Categories : Administration and Management
      Economics and Cost Analysis
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE