Uniformed Services Treatment Facilities: Hearing Before the Military Personnel and Compensation Subcommittee of the Committee on Armed Services, House of Representatives, One Hundredth Congress, Second Session, Hearing Held September 28, 1988 |
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accidents active duty administrators Admiral Thunman advisory agreements allies Army Assistant basic BATEMAN beneficiaries budget burdensharing BYRON Center CHAMPUS Clark Air Base CNET committee concerns conducted Congress cost effective courses Department of Defense develop DODDS schools DODDS system Ernst & Whinney evaluation fiscal forces GAINER going hearing hospitals individual initial inpatient instruction issue Japan Japanese Lehowicz look Madam Chairman managed care Marine Medicare military families military health military spouses NATO NAVAL Navy Office operational outpatient overseas Pacific panel parents patients payment percent personnel Philippines physician plans principal problem procedures question recommendations recruit recruit training reimbursement responsibility safety school system Secretary of Defense Services Treatment Facilities specific stateside subcommittee Subic Bay teachers Thank tion Training Command training instructors unduplicated user Uniformed Services Treatment United USTF program USTF's Wyman Park
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Page 23 - WOULD DO SO IN TERMS OF ROLES AND MISSIONS RATHER THAN STATIC INDICATORS SUCH AS REAL BUDGETARY GROWTH OR THE RATIO OF DEFENSE SPENDING TO GNP. FOR ITS PART, THE UNITED STATES PLEDGED IN 1981, TO PROVIDE IN THE NORTHWEST PACIFIC, A NUCLEAR UMBRELLA, OFFENSIVE PROJECTION FORCES AS NECESSARY, AND A CONTINUED PRESENCE IN THE REPUBLIC OF KOREA. IN THE SOUTHWEST PACIFIC AND INDIAN OCEANS, THE UNITED STATES SAID IT WOULD MAINTAIN THE NUCLEAR UMBRELLA. FINALLY, WE PLEDGED TO PROVIDE PROJECTION FORCES AND...
Page 30 - Hummel, jr., Deputy Assistant Secretary of State for East Asian and Pacific Affairs Mr.
Page 53 - USTF beneficiaries is less than receiving comparable care under CHAMPUS or Medicare. Put simply, we are confident that, if we closed our doors tomorrow and all of our patients were suddenly required to find care in the community under the CHAMPUS or Medicare programs, the cost to the government of paying for those services would be much Higher than the present cost of providing these services through the USTFs. QUALITY OF CARE...
Page 52 - In addition, in the typical unmanaged fee- forservice environment, physicians face incentives to provide more services than necessary. In contrast, USTFs provide a package of services for a fixed price to the government for each patient. Some of our agreements provide that these payments cover both in-patient and out-patient services. In other cases, DOD has preferred to apply USTF payments only to out-patient services. In such cases, USTFs bill CHAMPUS and Medicare for inpatient services. However,...
Page 43 - Reimbursement to such facilities is required to be "based upon medical and dental care costs in the area in which (a) facility . . . is located." (PL 98-94 $1252(f); 42 USC S248(c).) Initially, Congressionally authorized participation agreements were negotiated and managed by the Department of Health and Human Services (HHS) as a natural extension of that agency's prior management of the PHS direct care system. The agreements provided for reimbursement...
Page 45 - ... and establish different reimbursement methodologies, (2) required DOD to conduct a study of the cost-effectiveness and quality of the program, particularly as compared to CHAMPUS, and (3) extended the USTF designation to December 31, 1987. DOD renegotiated the participation agreements with the USTFS in 1984. The new agreements standardized most of the processes and procedures used by the USTFs and established different reimbursement mechanisms based on Medicare and Blue Cross/ Blue Shield prevailing...
Page 60 - ... additional utilization plus inflation costs in excess of the increase in FEHBP rates. This fixed payment mechanism is intended to encourage efficient patient care management by utilizing a combination of incentives and quality assurance standards. For USTFs, fixed per capita reimbursement has meant that we must manage the provision of care to our patients essentially as if we were health maintenance organizations (HMOs) . However, DOD's fixed payment reimbursement mechanism entails substantially...
Page 47 - Phase data indicates that the USTF program was as cost-effective as CHAMPUS in providing care to military beneficiaries during fiscal Years 1983 and 1984." For the Operational Phase, BAH found that •the USTF program was more cost-effective than CHAMPUS in providing care to military beneficiaries during the period from October 1. 1984 through June 30. 1986...
Page 52 - PROGRAM COST-EFFECTIVENESS Several studies have evaluated the costs of USTF health care prior to FY 1987 and found the USTF program to be cost-effective in comparison to CHAMPUS and Medicare on a per patient basis with utilization rates at or below the CHAMPUS and Medicare programs. In 1987, DOD commissioned a consulting firm (Booz, Allen and Hamilton) to undertake the comparative cost-effectiveness study mandated by Congress in 1983. The study evaluated the USTFs during two distinct phases...
Page 5 - He cannot shut himself off from the other welfare agencies of the community; he must know what they are doing, why they are doing it, and how to cooperate with them.