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 2001-10-31 monographic deposited born digital 94 p. GA 1.13:GAO-02-68 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-02-68 P0b002ee18039f18c f:d0268 DGPO 2010-08-12 2011-03-24 GAOREPORTS-GAO-02-68 machine generated eng fdlp REPORT GAOREPORTS-GAO-02-68 GAO-02-68 Health care costs Health care programs Managed health care Retirement benefits Retired military personnel DOD TRICARE Extra Program DOD TRICARE Prime Program DOD TRICARE Program DOD TRICARE Senior Prime Program DOD TRICARE Standard Program Medicare Choice Program Medicare Program Other Written Product A02387 In the Balanced Budget Act of 1997, Congress established a 3-year demonstration, called Medicare subvention, to improve access to Medicare-eligible military retirees for care at military treatment facilities (MTF). The demonstration allowed retirees to get their health care largely at MTF by enrolling in a Department of Defense (DOD) Medicare managed care organization known as TRICARE Senior Prime. During the subvention demonstration, access to health care for many retirees who enrolled in Senior Prime improved, while access to MTF care for some of those who did not enroll declined. Many enrollees said that, compared with their experience before Senior Prime, they were better able to get care when they needed it. In addition, they reported that access to doctors in general as well as care at MTF's improved. The results of enrollees' improved access and high utilization were mixed. Enrollees generally were more satisfied with their care than before the demonstration. However, the demonstration did not improve enrollees' self-reported health status. In addition, compared to nonenrollees, enrollees did not have better health outcomes, as measured by their mortality rates and rates of "preventable" hospitalizations. Moreover, DOD's costs of care were high, reflecting enrollees' heavy use of hospitals and doctors. These costs were significantly higher than Medicare's costs for comparable fee-for-service beneficiaries. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-02-68/html/GAOREPORTS-GAO-02-68.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-02-68/pdf/GAOREPORTS-GAO-02-68.pdf GAO-02-68 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-02-68 Other Written Product GAO-02-68; Medicare Subvention Demonstration: Greater Access Improved Enrollee Satisfaction but Raised DOD Costs; Health care costs Health care programs Managed health care Retirement benefits Retired military personnel DOD TRICARE Extra Program DOD TRICARE Prime Program DOD TRICARE Program DOD TRICARE Senior Prime Program DOD TRICARE Standard Program Medicare Choice Program Medicare Program Public Law 105-33 Public Law 106-398