Defense Health Care: TRICARE Progressing, but Some Cost and Performance Issues Remain

Thank you for the opportunity to discuss the Department of Defense's (DOD) implementation of its nationwide managed health care program - TRICARE. The changes embodied in the TRICARE program represent a sweeping reform of the $15 billion per year military health care system. Among TRICARE's goals are to improve access to care and ensure high-quality, consistent health care benefits for the 1.7 million active-duty Service personnel and some 6.6 million nonactive-duty beneficiaries. It also seeks to preserve choice for nonactive-duty beneficiaries by giving them the option of enrolling in TRICARE Prime, which is like a health maintenance organization; using a preferred provider organization called TRICARE Extra; or using civilian health care providers under a fee-for-service arrangement like the current CHAMPUS program. Another system goal is to contain DOD's health care costs. We have reported several times over the past 9 years on DOD's efforts to reform the military health care system and on the evolving development of TRICARE. Now that TRICARE is well into implementation in some areas of the country and beginning to be implemented in others, we appreciate this chance to discuss what is occurring as the program moves from the drawing board toward becoming a real part of the lives of the people served by military health care.