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 2007-07-31 monographic deposited born digital 36 p. GA 1.13:GAO-07-947 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-07-947 P0b002ee18038b798 f:d07947 DGPO 2010-08-12 2011-03-28 GAOREPORTS-GAO-07-947 machine generated eng fdlp REPORT GAOREPORTS-GAO-07-947 GAO-07-947 Children Community hospitals Differential pay Hospital care services Hospitals Managed health care Patient care services Payments Pediatrics Prospective payments DOD TRICARE Program Other Written Product A73693 Under the Department of Defense's (DOD) TRICARE health program, hospitals that treat primarily children--designated by DOD as children's hospitals--are paid differently from other types of civilian hospitals through a children's hospital differential payment. Representatives of children's hospitals state that payments for children's hospital services do not fully recognize the higher complexity of children's hospital patients. Acknowledging concerns over payments for children's hospital services, the National Defense Authorization Act for Fiscal Year 2006 directed GAO to study DOD's current system of payments to children's hospitals. This report examines (1) the effect of the differential on TRICARE's base payments to children's hospitals, (2) differences in diagnosis and complexity between TRICARE pediatric patients at children's hospitals and those at other hospitals, (3) the extent to which TRICARE payment differences across hospitals reflect differences in patient complexity, and (4) recent trends in TRICARE pediatric patients' use of children's hospital services. To do this, GAO analyzed pertinent TRICARE claims data for fiscal years 2003 through 2006 and interviewed relevant DOD officials and representatives of children's hospitals. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-07-947/html/GAOREPORTS-GAO-07-947.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-07-947/pdf/GAOREPORTS-GAO-07-947.pdf GAO-07-947 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-07-947 Other Written Product GAO-07-947; Defense Health Care: Under TRICARE, Children's Hospitals Paid More Than Other Hospitals After Accounting for Patient Complexity; Children Community hospitals Differential pay Hospital care services Hospitals Managed health care Patient care services Payments Pediatrics Prospective payments DOD TRICARE Program Volume 102 Page 2270 102 Stat. 2270 Volume 119 Page 3136 119 Stat. 3136 Public Law 100-463 Public Law 109-163