United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2001-04-30 monographic deposited born digital 32 p. GA 1.13:GAO-01-513 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-513 P0b002ee18038a4fe f:d01513 DGPO 2010-08-12 2011-03-28 GAOREPORTS-GAO-01-513 machine generated eng fdlp REPORT GAOREPORTS-GAO-01-513 GAO-01-513 Contract modifications Contract oversight Defense cost control Funds management Health care programs Managed health care Defense Health Program DOD Change Management Process DOD Defense Reform Initiative DOD Future Years Defense Program DOD Military Health Services System DOD TRICARE Program Medicare Program Other Written Product A00796 Under TRICARE, the Department of Defense's (DOD) managed care program, military-operated hospitals and clinics are supplemented by contracted civilian services. Since the inception of TRICARE, DOD has made numerous modifications to these contracts via contract change orders. Since July 1997, when (GAO) reported that DOD was taking steps to improve its change order process, a backlog of change orders has continued to grow. In this report, GAO evaluated (1) the status of the change order backlog and how DOD addressed it, (2) factors that contributed to the growth of the backlog, and (3) DOD's new initiative to improve the change order process. As of June 30, 2000, the number of change orders issued had almost tripled, while the number of unsettled change orders had more than doubled since July 1997. Despite recommendations to devote high-level attention to managing improvements to the change order process, this was not done. Until recently, none of TRICARE Management Activity's (TMA) numerous initiatives effected much improvement to the process or reduced the backlog. The current small backlog is the result of recent concerted effort, not better management over time. TMA's new Change Management Process (CMP) appears to address many of TMA's problems with change orders. However, past initiatives have made similar promises and delivered little when they were abandoned or eclipsed by higher priorities. The high volume of change orders now or soon to enter the new CMP makes it imperative that TMA management closely monitor the process to prevent future backlogs. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-513/html/GAOREPORTS-GAO-01-513.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-513/pdf/GAOREPORTS-GAO-01-513.pdf GAO-01-513 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-513 Other Written Product GAO-01-513; Defense Health Care: Continued Management Focus Key to Settling TRICARE Change Orders Quickly; Contract modifications Contract oversight Defense cost control Funds management Health care programs Managed health care Defense Health Program DOD Change Management Process DOD Defense Reform Initiative DOD Future Years Defense Program DOD Military Health Services System DOD TRICARE Program Medicare Program Public Law 106-398