LEADER 00000cam 2200565Ii 4500 001 ocn171566261 003 OCoLC 005 20170927053019.7 006 m o d 007 cr ||||||||||| 008 070914s2003 caua ob 000 0 eng d 019 855305048 020 9780833059956|q(electronic bk.) 020 0833059955|q(electronic bk.) 027 RAND/MR-1580-CMS 035 (OCoLC)171566261|z(OCoLC)855305048 037 22573/ctt5hw3|bJSTOR 040 YDXCP|beng|epn|erda|cYDXCP|dUBY|dNRU|dOCLCQ|dCOO|dOCLCO |dCUI|dOCLCQ|dOCLCA|dJSTOR|dOCLCQ|dOCLCO|dOCLCQ|dOCLCA |dUAT|dEBLCP|dOCLCQ|dCUS|dMERUC|dOCLCQ 043 n-us--- 049 CKEA 050 4 RA412.3|b.E936 2003 082 04 353.690973|a368.426008697097|a368.4260086970973 245 00 Evaluation of the medicare-dod subvention demonstration : |bfinal report /|cDonna O. Farley [and others]. 264 1 Santa Monica, Calif. :|bRand,|c2003. 300 1 online resource (1 online report (xxxiv, 151 pages)) : |billustrations 336 text|btxt|2rdacontent 337 computer|bc|2rdamedia 338 online resource|bcr|2rdacarrier 500 "Prepared for Medicare & Medicaid Services (CMS) and the DoD Tricare Management Activity (TMA)." 500 "RAND Health." 500 "MR-1580-CMS"--Page 4 of cover. 504 Includes bibliographical references (page 127). 505 0 Introduction -- Evaluation Methods and Data -- Senior Prime Implementation and Market Entry -- The Beneficiary's Perspective: Enrollment Demand and Perceptions of Senior Prime -- Early Effects of Senior Prime on Costs and Service Use -- Implications for Broader Use of an MTF- Based Option -- Appendix A: RAND Process Evaluation Questions for Initial Site Visits -- Appendix B: Template for Site Visit Agenda -- Appendix C: RAND Process Evaluation Questions for Mid-Demonstration Review -- Appendix D: FY96-FY98 RAND Data Documentation. 520 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. 588 0 Print version record. 610 10 United States.|bDepartment of Defense|xOfficials and employees, Retired|xMedical care|xFinance. 650 0 Government employees' health insurance|zUnited States |xFinance. 650 0 Medicare. 650 0 Retired military personnel|xMedical care|zUnited States |xFinance. 650 0 Health maintenance organizations. 650 0 Managed care plans (Medical care)|zUnited States|xFinance. 650 7 MEDICAL|xHealth Policy.|2bisacsh 651 0 United States|xArmed Forces|xMedical care. 700 1 Farley, Donna. 776 08 |iPrint version:|tEvaluation of the Medicare-DoD subvention demonstration.|dSanta Monica, CA : RAND, 2003 |z0833033174|w(DLC) 2002036969|w(OCoLC)51053445 914 ocn171566261 994 92|bCKE
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