[Federal Register Volume 74, Number 189 (Thursday, October 1, 2009)]
[Notices]
[Pages 50784-50785]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-23741]


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DEPARTMENT OF DEFENSE

Office of the Secretary


Military Health Risk Management Demonstration Project

AGENCY: Office of the Assistant Secretary of Defense for Health 
Affairs/TRICARE Management Activity, Department of Defense.

ACTION: Notice of a Military Health Risk Management demonstration 
project.

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SUMMARY: This notice is to advise interested parties of a Military 
Health System (MHS) demonstration project entitled ``Military Health 
Risk Management Demonstration Project''. This demonstration project, 
which will be available for participation by select non-Medicare 
eligible, retired TRICARE-eligible beneficiaries, and their family 
members, is designed to evaluate the efficacy of providing incentives 
to encourage healthy behaviors on the part of these MHS beneficiaries.

DATES: Effective Date: This demonstration will be effective from 
October 1, 2009, until February 28, 2012.

FOR FURTHER INFORMATION CONTACT: Dr. Barry Cohen, Director of 
Healthcare Operations--TRICARE Management Activity, 5111 Leesburg Pike, 
Suite 810, Falls Church, VA 22041-3206; telephone (703) 681-7515.

SUPPLEMENTARY INFORMATION:

A. Background

    Health Risk Management involves utilizing a self-reported health 
risk assessment to identify areas where TRICARE beneficiaries may be at 
risk to develop certain chronic illnesses. The questionnaire covers a 
wide range of lifestyle behaviors and health issues. In addition, 
physiological and biometric measures such as blood pressure, glucose 
level, lipids, nicotine use, and weight are also considered to aid in 
determining the overall level of risk for chronic disease. This 
demonstration project will assess the effects of providing incentives 
along with wellness programs and healthy behaviors and lifestyle 
practices among non-Medicare-eligible retired beneficiaries and their 
family members who are enrolled in TRICARE Prime.

B. National Defense Authorization Act (NDAA) for Fiscal Year 2009 
(FY09) Military Health Risk Management Directive

    Section 712 of the NDAA for FY09 requires the Department to develop 
a wellness assessment to be offered to beneficiaries enrolled in the 
demonstration project. The wellness assessment will incorporate 
nationally recognized standards for health and healthy behaviors, will 
be offered to determine a baseline assessment, and will be repeated at 
appropriate intervals. The wellness assessment will include a self-
reported health risk assessment, physiological, and biometric measures; 
including at least blood pressure, glucose level, lipids, nicotine use 
and weight. Non-Medicare-eligible retired beneficiaries of the MHS and 
their dependents who are enrolled in TRICARE Prime and who reside in 
the demonstration project service areas will be offered the opportunity 
to enroll in the demonstration project. The demonstration project will 
be conducted in at least three geographic areas within the United 
States where TRICARE Prime is offered. The area covered by the project 
will be referred to as the demonstration project service area. Programs 
will be developed to assist enrollees to improve healthy behaviors, as 
identified by the wellness assessment. For the purpose of conducting 
the demonstration project, monetary and/or nonmonetary incentives will 
be offered to enrollees to encourage participation in the demonstration 
project.

C. Description of Demonstration Project

    The Military Health Risk Management demonstration project will be 
conducted to evaluate whether monetary incentives in conjunction with 
wellness programs will encourage healthy behaviors among non-Medicare-
eligible retired beneficiaries and their family members who are 
enrolled in TRICARE Prime and reside in the demonstration project 
service areas. The duration of the project will be approximately 3 
years. There will be a monetary incentive award to enrollees for full 
participation in this project of an amount equivalent to 50 percent of 
the annual TRICARE Prime enrollment fee ($230/family or $115/
individual).
    For the purpose of this study, at least one demonstration project 
service area will encompass a military treatment facility (MTF), and 
the others will encompass areas supported exclusively by purchased 
care. The National Naval Medical Center, Medical Homes Program, 
Bethesda, MD, has been selected as the MTF demonstration project 
service area; the Designated Provider Programs at Martin's Point, 
Portland, ME, and CHRISTUS Health, Houston, TX, have been selected as 
the purchased care demonstration project service areas.

D. Implementation

    Each site will be responsible for identifying a cohort of retired 
beneficiaries and their family members who are enrolled in TRICARE 
Prime and are non-Medicare-eligible to participate in the 
demonstration. Following the enrollment period, the site will maintain 
the demographic, clinical, and other data required to evaluate the 
effectiveness of the demonstration. The

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service area sites will use a self-reported Health Risk Assessment 
(HRA) designed to screen and identify the participants' health risk 
factors and provide targeted interventions that help prevent, manage, 
and improve chronic conditions. They will perform all of the study 
participants' physiological and biometric measures, including at least 
blood pressure, glucose levels, lipids, nicotine use, and weight. The 
service area sites will schedule follow-up visits, encourage 
participants to take advantage of available online educational Web 
sites, and enroll in established wellness programs. They will also 
direct participants to retake the HRA/biometrics annually to reassess 
health behaviors and outcomes. A toll-free phone line will be available 
to answer questions regarding enrollment and monetary incentives from 
demonstration participants.

    Dated: September 25, 2009.
Patricia L. Toppings,
OSD Federal Register Liaison Officer, Department of Defense.
[FR Doc. E9-23741 Filed 9-30-09; 8:45 am]
BILLING CODE 5001-06-P