Defense Health Care

The National Defense Authorization Act for Fiscal Year 1994 requires GAO and the Congressional Budget Office (CBO) to evaluate the agreements entered into between the Defense Department (DOD) and the Uniformed Services Treatment Facilities to provide health care to members of the military. This report discusses (1) the health care services available through the Uniformed Services Treatment Facilities under the agreements compared to the health care services available through other components of the military health care delivery system, the beneficiary cost-sharing requirements of the Facilities compared to those of the other components of the military health care delivery system, and the costs and other implications of terminating the agreements before their expiration. CBO will be issuing a separate report discussing the cost effectiveness of the agreements and the impact of the agreements during their four-year term on DOD's budget and expenditures for health care programs.

GAO found that: (1) USTF health care services are equivalent to those established under the TRICARE Prime Program and are greater than those available under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), TRICARE Extra, and at nearby military facilities; (2) the USTF program requires less beneficiary cost sharing than TRICARE or CHAMPUS, but more than direct care systems; (3) the costs of terminating USTF agreements before they expire vary among the government, beneficiaries, and USTF; (4) the impact of early termination on the government depends on the cost-effectiveness of the USTF Program; (5) DOD could face costly litigation brought by USTF if it terminates the agreements for reasons other than those specified by statute or in the agreements; (6) although beneficiaries would be able to access health care services through TRICARE, CHAMPUS, Medicare, direct care systems, or private health insurance if the USTF program were terminated, their costs would likely increase and some could experience disruptions in service; and (7) the impact of terminating the USTF program would vary by facility and the extent to which each facility depends upon USTF program revenue.