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 2000-01-31 monographic deposited born digital 48 p. GA 1.13:HEHS-00-35 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-00-35 P0b002ee1803934dd f:he00035 DGPO 2010-08-12 2011-03-28 GAOREPORTS-HEHS-00-35 machine generated eng fdlp REPORT GAOREPORTS-HEHS-00-35 HEHS-00-35 Veterans benefits Retired military personnel Health care programs Health maintenance organizations Managed health care Eligibility criteria Health care services DOD Medicare Subvention Demonstration Program DOD Enrollment Eligibility Reporting System DOD TRICARE Program DOD Senior Prime Program Medicare Choice Program Medigap Medicare Program Letter Report HEHS Pursuant to a legislative requirement, GAO provided information on enrollment inthe Department of Defense's (DOD) pilot health maintenance organization (HMO) for military retirees, focusing on: (1) how successful the demonstration has been in enrolling eligible beneficiaries; (2) what influenced retirees to join DOD's pilot HMOs; and (3) what factors accounted for differences in enrollment rates across demonstration sites.<p/>GAO noted that: (1) in the first year of DOD's Medicare subvention demonstration, over one-fifth of Medicare-eligible military retirees in the demonstration areas enrolled in Senior Prime, DOD's HMO pilot for seniors, although enrollment rates differed markedly across the six demonstration sites; (2) two sites reached their enrollment targets and started putting applicants on a waiting list; consequently, the number of enrollees understates interest in the program at these two sites; (3) the demonstration allows retirees who turn age 65 after the demonstration's start to age-in--enroll in Senior Prime regardless of the site's enrollment limit--if they were enrolled until turning 65 in DOD's managed care plan for younger DOD beneficiaries; (4) slightly more retirees are aging-in than DOD had expected; (5) disenrollment rates are running at almost 5 percent per year demonstrationwide, relatively low compared with many other Medicare managed care organizations; (6) a retiree's recent use of the military health care system was a strong predictor of enrollment in Senior Prime--the greater the reliance on military health care in the previous year, the greater the likelihood of enrolling; (7) several related factors also influenced retirees' decisions: (a) satisfaction with previous health care; (b) knowledge of Senior Prime; and (c) convenience; (8) any potential expansion of DOD subvention would probably also tend to attract retirees with these characteristics, although they are a minority of all military retirees; (9) differences in site enrollment rates partly reflected the sites' different histories of serving retirees; (10) sites that had provided high levels of care to many older retirees had an advantage, since users who depended on military health care were more likely to choose Senior Prime; and (11) features of the local market and the site helped to shape individual enrollment decisions. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-00-35/html/GAOREPORTS-HEHS-00-35.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-00-35/pdf/GAOREPORTS-HEHS-00-35.pdf GAO/HEHS-00-35 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-00-35 Letter Report GAO/HEHS-00-35; Medicare Subvention Demonstration: Enrollment in DOD Pilot; Veterans benefits Retired military personnel Health care programs Health maintenance organizations Managed health care Eligibility criteria Health care services DOD Medicare Subvention Demonstration Program DOD Enrollment Eligibility Reporting System DOD TRICARE Program DOD Senior Prime Program Medicare Choice Program Medigap Medicare Program