Download or read book The TRICARE Managed Care Support Contracts an Analysis of the Bid Price Adjustment and Resource Sharing Mechanisms written by Robert R. Cox and published by . This book was released on 1996-12-01 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: This thesis analyzes the primary question: what are the unique characteristics of the military's TRICARE MCS contracts, and are they functioning sufficiently to achieve the objectives of the TRICARE Program? In answering this question, the bid price adjustment (BPA) and risk sharing mechanisms are analyzed. The TRICARE Program is compared to past Military health care programs, and the considerations which led to the inclusion of the bid price adjustment (BPA) and risk sharing mechanisms are examined.
Download or read book A Financial Analysis of Resource Sharing Agreements as Part of the TRICARE Managed Care Support Contracts written by Steven L. Hoeft and published by . This book was released on 1998-12-01 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: Escalating health care costs and base closures have forced the DoD to improve access to health care while maintaining quality, controlling costs, and increasing medical readiness. The response is a Tri-service managed care system called TRICARE. One mechanism utilized within the TRICARE Managed Care Support Contracts (MCSCs) is Resource Sharing. Resource sharing is a system to reduce the government's health care costs by recapturing the TRICARE workload This thesis explores if Resource Sharing Agreements (RSAs) are cost-effective and how they are being monitored and evaluated by the Lead Agent and MTFs. After conducting a literature review, interviews and performing data analysis, this thesis examined the reported cost analysis, retrospective analysis, and workload of RSAs in Health Services Region 10 as they are used under the MCSC for that region. A case study of RSAs, comparing forecasted and reported savings, was also conducted to understand RSAs and their role in controlling military health care costs. The analysis found that the RSAs are reducing government costs, but not at the predicted rate. This case study found that only 67 percent of the estimated government savings were realized. Decreasing workload is a key factor explaining this shortfall.
Download or read book Defense health care TRICARE resource sharing program failing to achieve expected savings report to the chairman and ranking minority member Subcommittee on Military Personnel Committee on National Security House of Representatives written by and published by DIANE Publishing. This book was released on with total page 42 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Government Estimates in the Tricare Managed Care Support Contracts written by Michael Evi Jonasson and published by . This book was released on 2001-08-01 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 1994, the Department of Defense (DoD) began a journey, to merge the Military Health System (MHS) with the concept of the Managed Care Support Contractor (MCSC). The DoD managed health care program, called TRICARE, includes the competitive selection of contractors to financially underwrite the delivery of civilian health care services with a uniform, stabilized benefit structure, triple option health benefit features, and a regionally-based health care management system. The goals of TRICARE are to maintain medical readiness, improve access to care, provide a secure quality health care benefit, provide a choice of health care options, and contain DOD health care costs. The Managed Care Support (MCS) contracts are fixed-price contracts, with risk-sharing features and a bid price adjustment process designed to periodically substitute projected/estimated health care costs with actual health care costs. MCS contracts are 5 1/2 year contracts, with a 6-month phase-in period prior to start-up of delivery of health care services, followed by 5 1-year option periods. This thesis will explore the bid price adjustment process within the MCS contract, and the Government's methodology used to project/estimate health care costs for use by offerors in the bidding process. Selected as an example for discussion is the Regions 3 and 4 MCS contract. This thesis explores whether the Government, in choosing and engaging a methodology for projecting/estimating health care costs, should have instead chosen another methodology or path; i.e., "the road not taken."
Download or read book An Evaluation of Resource Sharing Within Tricare s Managed Care Support Contracts written by Martin D. McCue and published by . This book was released on 1996-09-01 with total page 146 pages. Available in PDF, EPUB and Kindle. Book excerpt: To help reduce the overall cost of health care in the Military Health Services System, Managed Care Support Contracts include a provision known as Resource Sharing. Resource Sharing Agreements allow the contractor to provide personnel, equipment, or supplies to a military treatment facility to improve its capability to deliver health care. After reviewing civilian managed care programs, this thesis examines the Military Health Services System and its new managed care program known as TRICARE. Then the concept of Resource Sharing is examined and the process for identifying, evaluating, and using cost effective Resource Sharing Agreements is discussed. Case studies of different types of agreements are used to illustrate the complexity and importance of cost and workload estimates and key contract factors in understanding the agreements. The findings suggest that the contractor's and government's performance data and assumptions underlying the agreements should be continuously monitored to ensure the cost-effectiveness of the agreements.
Download or read book TRICARE Managed Care Support Contracts written by United States. Congress. House. Committee on Armed Services. Subcommittee on Military Personnel and published by . This book was released on 2001 with total page 270 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Department of Defense Appropriations for 1999 written by United States. Congress. House. Committee on Appropriations. Subcommittee on National Security and published by . This book was released on 2002 with total page 636 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Department of Defense Authorization for Appropriations for Fiscal Year 2001 and the Future Years Defense Program written by United States. Congress. Senate. Committee on Armed Services and published by . This book was released on 2000 with total page 498 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Defense Health Care written by United States. General Accounting Office and published by . This book was released on 1997 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Defense Department's (DOD) nationwide managed care program, called TRICARE, is intended to improve the access of military personnel and their families to health care while maintaining quality and controlling costs. DOD has entered into seven multistate managed care support contracts with civilian health care entities. Resource sharing is an important cost-saving aspect of these partnerships. To share resources, the contractor supplements the capacity of a military hospital or clinic by providing civilian personnel, equipment, and supplies. DOD estimates that resource sharing could save about $700 million over five years for these contracts. However, GAO found that DOD and the support contractors will realize only about five percent of the $700 million in projected savings. Problems impeding progress on resource-sharing agreements have included the lack of clear program policies and priorities, uncertainty about cost effects on military hospitals, lack of financial rewards for the hospitals entering into such agreements, and changes in military hospital capacities after contractors developed bids. DOD has revised policies, improved training and analytical tools, and taken other steps to promote resource sharing under the contracts, but so far these efforts have not brought needed results.
Download or read book Department of Defense Appropriations for 1999 Personnel quality of life issues written by United States. Congress. House. Committee on Appropriations. Subcommittee on National Security and published by . This book was released on 2002 with total page 644 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book TRICARE Administrative Prices in the Northwest Region May be Too High written by United States. General Accounting Office and published by . This book was released on 1997 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt: GAO reviewed the Department of Defense's (DOD) TRICARE program, focusing on whether TRICARE managers in the Northwest Region had taken advantage of DOD's contractual authority to adjust administrative prices to correspond with a large health care price decrease. GAO noted that: (1) the largest contract change to date in the Northwest Region, modification P00008, effective February 1, 1995, reduced the health care price by a total of $169 million, 33 percent, over the five option periods; (2) the reduction was calculated to reflect lower baseline population and military treatment facility utilization estimates; (3) despite a 33-percent reduction in health care prices, TRICARE contracting officers did not propose a second action to reduce administrative support prices; (4) TRICARE managed care services (MCS) contracts do not require that health care price reductions automatically trigger a corresponding reduction in the administrative support prices, nor do contracts require the reasons administrative prices are not reduced; (5) while administrative price adjustments are not part of the bid price adjustment process, administrative support price adjustments are not precluded under the federal acquisition regulation (FAR) changes provisions; (6) because modification P00008 was issued under the authority of FAR section 52.243-1, it is a change order that allows TRICARE Support Office (TSO) contracting officers to adjust administrative support prices; (7) while health care costs are not directly linked to administrative support costs in existing TRICARE MCS contracts, there is a clear relationship between the two; (8) the Defense Contract Audit Agency and Lead Agent officials told GAO that a 33-percent reduction in health care price should have been accompanied by a reduction, perhaps proportionally smaller, in the administrative support price or, at minimum, TSO contracting officers should have conducted further analysis to determine the extent to which an administrative support price reduction was warranted; (9) had TRICARE contracting officials applied the contractor's administrative support rates to the reduced health care prices in modification P00008, administrative support prices might be as much as $25 million less over the 5 years of the contract; (10) this projection, moreover, is at the upper range of potential savings because administrative support costs would likely not decrease in the same proportion as health care costs; and (11) nevertheless, renegotiating administrative support prices would not only give DOD valuable information on the true cost of administrative services in the Northwest Region, but also would ensure DOD pays fair and reasonable prices for these services.
Download or read book Defense Health Care written by United States. General Accounting Office and published by . This book was released on 1997 with total page 23 pages. Available in PDF, EPUB and Kindle. Book excerpt: To help contain health care costs, the Department of Defense (DOD) in 1993 initiated TRICARE, its nationwide managed health care program for military personnel. By mid-1998, DOD expects to have implemented seven TRICARE managed care support contracts at an estimated cost of $17 billion. Since the award of the first TRICARE contract in 1994, 357 change orders have been made to the five TRICARE contracts now in place. Cumulatively, these change orders have increased tasks and overall costs. DOD has settled 134 of the orders at a cost of about $336,000. DOD estimates costs for the 223 orders that are yet to be settled at $38 million. However, DOD's initial cost estimates differ markedly from contractor estimates. GAO found that although there have been many change orders, DOD has not adequately managed the process. For example, rather than separately budgeting for the costs of individual change orders, DOD has used funds budgeted for other Defense Health Program activities to pay for them--an approach that could potentially create a need for supplemental funding. In addition, DOD's initial cost estimates for new orders have not been sound. As a result, DOD has not developed a reliable estimate of the total federal liability for the contract changes.
Download or read book TRICARE MANAGED CARE SUPPORT CONTRACTS LESSONS LEARNED HEARING H A S C NO 107 17 COMMITTEE ON ARMED SERVICES HOUSE OF REPRESENTATIVES written by and published by . This book was released on 2003* with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Defense Health Care Acquisition Process for Tricare s Third Generation of Managed Care Support Contracts written by U.s. Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-07-27 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: " DOD provides certain health care services through its TRICARE Program, which complements the health care services provided in military treatment facilities. DOD acquires these health care services through MCSCs with private sector companies. As of October 1, 2013, DOD's Defense Health Agency is responsible for awarding, administering, and overseeing TRICARE's MCSCs. Prior to this date TMA handled these duties. DOD's health care costs have more than doubled from $19 billion in fiscal year 2001 to its fiscal year 2014 budget request of more than $49 billion. Senate Report 112-173, which accompanied a version of the National Defense Authorization Act for Fiscal Year 2013, cited concerns with the growth of DOD's health care costs and identified private sector health care contracts as an area for potential savings and efficiencies. The Senate report mandated that GAO review DOD's process for acquiring TRICARE's MCSCs. This report examines: (1) TMA's acquisition process to award TRICARE's third generation MCSCs; (2) the extent to which issues were raised in the bid protests involving these MCSCs, including identifying any common themes; and (3) lessons learned from the acquisition process to award these MCSCs and how these lessons may be used in future acquisitions.
Download or read book Defense Health Care written by United States Government Accountability Office and published by Createspace Independent Publishing Platform. This book was released on 2017-12-16 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: Defense Health Care: Acquisition Process for TRICARE's Third Generation of Managed Care Support Contracts
Download or read book The Managed Care Contracting Handbook written by Maria K. Todd and published by CRC Press. This book was released on 2009-03-26 with total page 334 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care contracting is a process that frustrates even the best administrators. However, to ignore this complexity is to do so at your own expense. You don‘t necessarily need to bear the cost of overpriced legal advice, but you do need to know what questions to ask, what clauses to avoid, what contingencies to cover ... and when to ask a lawyer
Download or read book Defense health care acquisition process for TRICARE s third generation of managed care support contracts written by and published by . This book was released on 2014 with total page 33 pages. Available in PDF, EPUB and Kindle. Book excerpt: DOD provides certain health care services through its TRICARE Program, which complements the health care services provided in military treatment facilities. DOD acquires these health care services through MCSCs with private sector companies. As of October 1, 2013, DOD's Defense Health Agency is responsible for awarding, administering, and overseeing TRICARE's MCSCs. Prior to this date TMA handled these duties. DOD's health care costs have more than doubled from $19 billion in fiscal year 2001 to its fiscal year 2014 budget request of more than $49 billion. Senate Report 112-173, which accompanied a version of the National Defense Authorization Act for Fiscal Year 2013, cited concerns with the growth of DOD's health care costs and identified private sector health care contracts as an area for potential savings and efficiencies. The Senate report mandated that GAO review DOD's process for acquiring TRICARE's MCSCs. This report examines: (1) TMA's acquisition process to award TRICARE's third generation MCSCs; (2) the extent to which issues were raised in the bid protests involving these MCSCs, including identifying any common themes; and (3) lessons learned from the acquisition process to award these MCSCs and how these lessons may be used in future acquisitions. GAO reviewed relevant federal statutes, regulations, policy documentation, and the bid protest decisions for TRICARE's third generation MCSCs. GAO also interviewed TRICARE officials about the acquisition process and lessons learned.
