United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2000-08-31 monographic deposited born digital 40 p. GA 1.13:HEHS-00-172 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-00-172 P0b002ee18037f855 f:he00172 DGPO 2010-08-12 2011-03-23 GAOREPORTS-HEHS-00-172 machine generated eng fdlp REPORT GAOREPORTS-HEHS-00-172 HEHS-00-172 Military hospitals Armed forces abroad Health care services Foreign governments Health resources utilization DOD TRICARE Program Letter Report HEHS Pursuant to a congressional request, GAO reviewed the Department of Defenses (DOD) health care system in Europe and the Pacific, focusing on: (1) what DOD health care resources are available in Europe and the Pacific and what is their cost; (2) how does DOD integrate host nation care into its military health care system; (3) how does DOD ensure the quality of such care; (4) whether beneficiaries have adequate access to medical care; and (5) whether beneficiaries encounter obstacles when obtaining healthcare.<p/>GAO noted that: (1) DOD maintains in Europe and the Pacific an extensive system of 18 hospitals and 69 clinics providing primary and specialty care to about 500,000 beneficiaries in over 100 countries; (2) DOD spends about $1.1 billion annually to staff, operate, and maintain these overseas military treatment facilities (MTF); (3) most beneficiaries live near MTFs and receive their care from military physicians, although host nation providers and facilities are also used to augment MTF resources; (4) in Europe, MTFs have developed formal networks of English-speaking host nation providers to serve as referral specialists; (5) in the Pacific, MTFs have traditionally used less local care and have not developed formal provider networks; (6) Pacific MTFs, more so than those in Europe, rely on transporting patients between MTFs for specialty care; (7) beneficiaries living in remote areas hundreds of miles from MTFs particularly in the Pacific, provide DOD a major care challenge; (8) for such beneficiaries, DOD relies on various care sources, including Department of State health clinics and local health care, as well as on transporting patients to distant MTFs; (9) to improve services in the Pacific remote areas, DOD recently hired a contractor to arrange for and manage the care of beneficiaries living there; (10) DOD and the remote beneficiaries have given high ratings to this contractor's services; (11) to ensure host nation provider quality, DOD relies primarily on each country's licensing and credentialing requirements, as well as on limited inspections and monitoring by U.S. military physicians; (12) differences in language, culture, and health care practices between the U.S. and the Europe and Pacific Regions at times can cause frustrations and inconveniences for beneficiaries using host nation care; (13) using MTF and local providers, DOD has generally been able to ensure timely access to both primary and specialty care, however, specialty care is not always available within the 4-week TRICARE access standard, and local specialty providers are not available in all areas; (14) the medical systems in Europe and the Pacific face continuing challenges; (15) DOD believes that aircraft serving the aeromedical evacuation system may need to be replaced soon; (16) DOD is now seeking to expand local care options in some overseas locations and has begun reviewing alternatives for its aeromedical evacuation needs; and (17) DOD officials plan to review concerns about overseas screening and benefit portability. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-00-172/html/GAOREPORTS-HEHS-00-172.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-00-172/pdf/GAOREPORTS-HEHS-00-172.pdf GAO/HEHS-00-172 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-00-172 Letter Report GAO/HEHS-00-172; Defense Health Care: Resources, Patient Access, and; Military hospitals Armed forces abroad Health care services Foreign governments Health resources utilization DOD TRICARE Program