Sent in by Veterans News and Information Services
By Douglas J. Gillert
WASHINGTON -- Reports from DoD's oldest TRICARE region show a
high level of success in controlling costs, improving access and
maintaining quality.
A survey of more than 10,000 DoD health care beneficiaries in
TRICARE Region 11 -- Washington, Oregon and part of Idaho --
measured the delivery of health care to some 340,000
beneficiaries between 1994 and 1998. TRICARE began in the area
in 1993. Dr. James Sears, TRICARE Management Activity executive
director, called the survey "all good news."
"In a time when there's significant inflation in health care
costs, they found no increase in cost to the government or
beneficiaries," Sears said. At the same time, the survey
reported that Region 11 medical providers maintained high
quality standards. "There's even a plus-up in perception [among
survey respondents] of quality," he said.
In terms of access, improvements were noted in several
categories, Sears said. "They're getting their primary care when
they need it, they're getting preventive services they need and
they aren't using the ER as much. Not having to go to the ER to
get their primary urgent or acute care is a sign of a healthy
system.
Sears said he's particularly pleased with Region 11
beneficiaries' increased reliance on preventive health services.
"That's a major goal we're after -- to keep people healthy so
they don't have to use health care services as much," he said.
CNA Corp. and the Institute for Defense Analyses conducted the
Region 11 survey and will perform similar surveys in all regions
over a four-year period, Sears said. Congress mandated the
study, which looks at "before" and "after" data to determine
TRICARE's impact on military health care. Although the survey
measured just one region, Sears said it reflects what he expects
to find in every region.
"It's the same program we have put in place across the country,"
he said. "As the survey reaches all the other regions over the
next two years, we anticipate similar results. There's no reason
to think this program would be any less successful in other
regions."
Next on tap for the survey this spring are regions 3
(Southeast), 4 (Gulf South), 6 (Southwest), 9 (Southern
California), 10 (Golden Gate) and 12 (Pacific), and a second
look at Region 11. Regions 7 and 8 (Central) will be surveyed in
2000 and Regions 1 (Northeast), 2 (Mid-Atlantic) and 5
(Heartland) will follow in 2001.
Outcomes from the Region 11 survey "are in the direction we want
them to be," Sears said. "But we've got a lot of feelers out to
learn how the program is doing. This study is just one of them."
Annual and monthly customer surveys help Sears and his staff
learn about and solve problems in the TRICARE system. "Most of
the changes we're making, where we're placing new or additional
emphasis, are based on feedback we're getting from these
multiple channels," he said. "We're using this information to
improve the current structure and future contracts."
What this and other surveys tell Sears is that TRICARE is doing
well where it has matured, in Southern California, for example.
"We just have no negative noise level of any significance from
the places where TRICARE has been in place and operating for
awhile," he said.
In Southeast, Gulf South and some other newer regions, problems
that existed a year ago have been corrected, he said. "We had
problems with claims, networks and appointments. As of today,
however, their networks are developed, they're paying claims and
their telephone issues are history."
Sears said the same types of "hiccups" occur in every regional
startup, and a similar maturing process eventually smoothes out
the wrinkles. The Central region matured rapidly, he said, and
he expects the Northeast, Mid-Atlantic and Heartland regions to
improve quickly.
TRICARE has met with similar success overseas, an area perceived
to be a medical care trouble spot in the early 1990s, according
to Air Force Maj. Brian Hurley, senior health analyst for
military health systems operations at TRICARE. Surveys, he said,
detected few claims turnaround problems and found high patient
satisfaction with health care access and quality.
But surveys aren't the only tool DoD's using to gauge the health
of health care. TRICARE management discusses health care issues
regularly with the Military Coalition, a 5-million-member group
of 26 military support associations, and the 3-million-member
Military/Veterans Alliance. Sears has conducted meetings with
the services' senior enlisted representatives to uncover and fix
health care problems of enlisted members and their families. And
Rudy de Leon, undersecretary of defense for personnel and
readiness, has started conducting regional town hall meetings
with medics and patients.
TRICARE is accomplishing all it was designed to do, but that
doesn't mean it can't be improved, Sears said. "We want to
continue showing improvement in every area, keeping costs down
and ensuring every beneficiary, whether active duty or retired
or family member, has quick access to quality care."
A recent survey of TRICARE patients was "all good
news," says Dr. H. James Sears, TRICARE Management Activity
executive director
American Forces Press Service
