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