United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office General Government Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1999-09-28 monographic deposited born digital 56 p. GA 1.13:GGD/HEHS-99-161 https://www.govinfo.gov/app/details/GAOREPORTS-GGD-HEHS-99-161 P0b002ee180377808 f:g399161 DGPO 2010-08-12 2011-03-24 GAOREPORTS-GGD-HEHS-99-161 machine generated eng fdlp REPORT GAOREPORTS-GGD-HEHS-99-161 GGD/HEHS-99-161 Health insurance Redundancy Health insurance cost control Health care programs Interagency relations Veterans benefits Retired military personnel DOD Senior Prime Program DOD TRICARE Program DOD Medicare Subvention Demonstration Program Letter Report GGD HEHS Pursuant to a legislative requirement, GAO provided information on the Department of Defense's (DOD) implementation of its Medicare Subvention Demonstration, focusing on: (1) progress in establishing the ground rules for program operation, receiving Health Care Financing Administration (HCFA) approval, attracting enrollment, and starting to deliver health services; (2) the useful practices and operational difficulties that emerged during program start-up; and (3) issues for the future.<p/>GAO noted that: (1) the start-up period of the Medicare Subvention demonstration was successful; (2) despite unanticipated delays, the six demonstration sites met the requirements for Medicare managed care plans, enrolled substantial numbers of beneficiaries, and began delivery of health care services by January 1, 1999; (3) the sites' experience in dealing with the difficulties that arose along the way has yielded valuable lessons and has also pinpointed issues that remain to be resolved; (4) while the successful start-up of the demonstration is encouraging, it will be some time before the results of its mature operation can be assessed; (5) establishing the ground rules for the demonstration took longer and the HCFA approval process was more demanding than anticipated; (6) as a result, the demonstration will cover 24 to 28 months of service rather than 3 years; (7) the initial demand for enrollment overall was not as great as expected, in part because retirees were wary of a temporary program and feared that they might be unable to obtain affordable supplementary insurance at the demonstration's end; (8) enrollment also reflected site-specific factors, such as prospects for getting space-available care at a military treatment facility (MTF) without joining Senior Prime, the breadth of services available at the MTF, and options for care elsewhere in the community; (9) preparing for the start-up of the demonstration brought some useful new senior health care and management practices to the MTFs, but also revealed operational difficulties; (10) the fact that this demonstration program operates within two bureacracies--DOD and HCFA caused--some points of strain; (11) being new to Medicare, demonstration sites had to devote substantial DOD staff and consultant time learning HCFA requirements; (12) the dual organizational structures within DOD carry with them the potential for conflict; (13) additionally, dual DOD and HCFA procedures may result in duplication of effort; (14) experience in the start-up phase of this demonstration raises issues for the future of this or other similar demonstrations; and (15) enrollees will need to know several months in advance of the end of this demonstration whether service will continue so that they can plan for their continued health care. https://www.govinfo.gov/content/pkg/GAOREPORTS-GGD-HEHS-99-161/html/GAOREPORTS-GGD-HEHS-99-161.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GGD-HEHS-99-161/pdf/GAOREPORTS-GGD-HEHS-99-161.pdf GAO/GGD/HEHS-99-161 https://www.govinfo.gov/app/details/GAOREPORTS-GGD-HEHS-99-161 Letter Report GAO/GGD/HEHS-99-161; Medicare Subvention Demonstration: DOD Start-Up Overcame; Health insurance Redundancy Health insurance cost control Health care programs Interagency relations Veterans benefits Retired military personnel DOD Senior Prime Program DOD TRICARE Program DOD Medicare Subvention Demonstration Program Public Law 105-33