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Integrating Department of Defense and Department of Veterans Affairs Purchased Care
Carrie M. Farmer
Terri Tanielian
Christine Buttorff
Phillip Carter
Samantha Cherney
Erin L. Duffy
Susan D. Hosek
Lisa H. Jaycox
Ammarah Mahmud
Nicholas M. Pace
Lauren Skrabala
Christopher Whaley
其他書名
Preliminary Feasibility Assessment
出版
RAND Corporation
, 2019-02-15
主題
History / Military / United States
Medical / Health Policy
Medical / Public Health
Medical / Military Medicine
ISBN
1977401848
9781977401847
URL
http://books.google.com.hk/books?id=1Uj-vgEACAAJ&hl=&source=gbs_api
註釋
The U.S. Department of Defense (DoD) and U.S. Department of Veterans Affairs (VA) health systems provide services through a mix of direct care, delivered at government facilities, and purchased care, provided through the private sector, mainly by community-based providers who have entered into contracts with third-party administrators (TPAs). In the interest of expanding DoD-VA resource sharing that may lead to greater efficiencies and cost savings, the DoD/VA Joint Executive Committee is exploring options to integrate DoD and VA's purchased care programs. This preliminary feasibility assessment examined how an integrated approach to purchasing care could affect access, quality, and costs for beneficiaries, DoD, and VA and identified general legislative, policy, and contractual challenges to implementing an integrated purchased care program. An integrated approach to purchasing care is feasible under current legal and regulatory authorities, but policy changes may be needed - and the practicality of such an approach depends on the contract and network design. For example, legal/regulatory changes in how contracts are established would be required to achieve any real savings to the government. There are also differences in the populations served by TRICARE (DoD health care) and VA, particularly in terms of age and geographic location. Implementation would be further complicated by contractual differences in the TPA contracts for VA and DoD as they relate to network standards, provider payments, network participation requirements, and reporting requirements and incentive structures. As a result, there are significant uncertainties with respect to increased efficiency or cost savings for the government.