Author: Donna FarleyPublisher:
ISBN:
Category : Health maintenance organizations
Languages : en
Pages : 72
Book Description
Evaluation Plan for the Medicare-DoD Subvention Demonstration
Author: Donna FarleyPublisher:
ISBN:
Category : Health maintenance organizations
Languages : en
Pages : 72
Book Description
Interim Report, Evaluation Plan for the Medicare-DoD Subvention Demonstration
Author: Donna O. FarleyPublisher:
ISBN:
Category : Medicare
Languages : en
Pages :
Book Description
beneficiaries have with automated appointment and customer service systems. In addition, DoD's health data system capabilities will need to be improved.
Evaluation of the Medicare-DoD Subvention Demonstration: Final Report
Author: Publisher:
ISBN:
Category :
Languages : en
Pages : 170
Book Description
The Centers for Medicare and Medicaid Services (CMS, formerly the Health Care Financing Administration) and the Department of Defense (DoD) have been testing the feasibility of making Medicare-covered health care services available to Medicare-eligible DoD beneficiaries through the TRICARE program (the managed care program of the Military Health Service) and military treatment facilities (MTFs). The vehicle used was the Medicare-DoD Subvention Demonstration, which was established by the Balanced Budget Act of 1997 (BBA). The goal of the demonstration was to implement cost-effective alternatives for care for this dually eligible population while ensuring budget neutrality, that is, neither CMS's nor DoD's total costs increase. The Secretaries of the Department of Health and Human Services and of the Department of Defense executed a Memorandum of Agreement that specified how the subvention demonstration was to be designed and operated. The Memorandum provided for an independent evaluation of the demonstration, which RAND conducted. This report describes the final results of the RAND evaluation.
Evaluation of the Medicare-DoD Subvention Demonstration
Author: Donna FarleyPublisher: Rand Corporation
ISBN: 9780833033178
Category : Business & Economics
Languages : en
Pages : 151
Book Description
Final review of the lessons learned from the Medicare-DOD Subvention Demonstration, which tested the feasibility of making cost-effective, Medicare-covered health care services available to Medicare-eligible DOD beneficiaries through the military TRICARE health insurance program and military treatment facilities.
Evaluation of the Medicare-dod Subvention Demonstration
Author: Publisher:
ISBN: 9780833059956
Category : Government employees' health insurance
Languages : en
Pages : 151
Book Description
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.
Medicare Subvention Demonstration
Author: United States. General Accounting OfficePublisher:
ISBN:
Category : Medicare
Languages : en
Pages : 44
Book Description
Interim Report
Author: Publisher:
ISBN:
Category : Medicare
Languages : en
Pages :
Book Description
The Health Care Financing Administration (HCFA) and the Department of Defense (DoD) are testing the feasibility of making Medicare-covered health care services available to Medicare-eligible DoD beneficiaries in the TRICARE program at military treatment facilities (MTFs). This report evaluates the early implementation of TRICARE Senior Prime at six MTFs, financed by subvention (the transfer of funds from HCFA to DoD). It finds that enrollment rates in Senior Prime were faster than in many private health plans and beneficiaries were generally pleased with their care. However, sites are having difficulties caused by the complexity of payment methods and by uncertainty over whether they will ever see Senior Prime revenues--even if DoD obtains net payments from HCFA after each year's reconciliation. If a larger Senior Prime program becomes a permanent part of TRICARE, the following policy issues must be addressed: (1) balancing interactions between the readiness mission and Senior Prime; (2) structuring and managing Senior Prime effectively; (3) creating the desired financial incentives; and (4) achieving effective clinical and cost performance. Lessons learned include the importance of effective introduction of the program and orientation of beneficiaries; early identification of enrollees with existing treatment requirements; the importance of coordination of intake activities and follow-up visits; and the difficulty many beneficiaries have with automated appointment and customer service systems. In addition, DoD's health data system capabilities will need to be improved.
The First Year of the Medicare-DoD Subvention Demonstration
Author: Medicare Subvention Demonstration
Author: United States. General Accounting OfficePublisher:
ISBN:
Category : Medicare
Languages : en
Pages : 40
Book Description
Medicare Subvention Demonstration
Author: United States. General Accounting OfficePublisher:
ISBN:
Category : Health maintenance organizations
Languages : en
Pages : 36
Book Description