Defense Health Care

The Defense Department's (DOD) nationwide managed health care program--TRICARE--represents a sweeping reform of the $15 billion per year military health care system. TRICARE seeks to improve access to care and ensure high-quality, consistent health care benefits for the 1.7 million active-duty service members and some 6.6 million non-active-duty beneficiaries. It also seeks to preserve choice for non-active-duty beneficiaries by allowing them to choose whether to enroll in TRICARE Prime, which resembles a health maintenance organization; use a preferred provider organization; or use civilian health care providers under a fee-for-service arrangement. Despite initial beneficiary confusion caused by education and marketing problems, early implementation of the program is progressing consistent with congressional and DOD goals. Measures may be necessary now, however, such as gathering cost and access-to-care data, to help Congress and DOD better assess the program's future success. In addition, retirees, who make up half of those eligible for military health care, remain concerned about TRICARE's effect on their access to medical services.