Defense Health Care. Obstacles in Implementing Coordinated Care.
GENERAL ACCOUNTING OFFICE WASHINGTON DC HUMAN RESOURCES DIV
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Challenges which the Department of Defense DOD faces in restructuring its health care system to managed care include 1 significant budget constraints as the size of the military forces is reduced, 2 building a consensus of support among various parties for managed care, and 3 making key operational decisions in the face of little data from the Departments demonstration projects. GAO believes that DOD should reconsider certain features of its Coordinated Care program to address the following problems differences in cost-sharing by enrollees depending on whether they are directed to military facilities or private network providers for their medical care, higher levels of cost-sharing by enrollees compared to those in health maintenance organizations, and use of negative incentives to encourage enrollment such as eliminating nonenrollees access to military health facilities. GAO believes that DOD should reconsider the range of beneficiary cost-sharing options available for Coordinated Care including 1 instituting small charges for care provided to beneficiaries in military facilities and 2 a system of beneficiary premiums. DOD should postpone its plans to lock out nonenrollees from military health care facilities.
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