Defense Health Care

The Defense Department's (DOD) managed care program, known as TRICARE, is intended to improve beneficiaries' access to health care while controlling costs in the military's $15.5 billion health care system. Under TRICARE, medical care for more than 8.2 million beneficiaries is coordinated and managed on a regional basis by using military hospitals and clinics, supplemented by contracted civilian services. This testimony discusses (1) DOD's progress in implementing TRICARE; (2) whether DOD is adequately assessing TRICARE's effects on military health care access, quality, and cost; and (3) the implications for TRICARE of ongoing and proposed changes in the military health care system itself.

GAO noted that: (1) TRICARE was established in an era of military downsizing and rapidly escalating DOD health costs; (2) it was envisioned as a way to maintain beneficiary access to high-quality care while containing costs; (3) designing and implementing TRICARE to achieve these objectives, however, has proven to be a complex and difficult undertaking involving many stakeholders, including Congress, the individual services and their many facilities and contractors, and the more than 8 million beneficiaries of the military health care system; (4) DOD has taken steps to improve the program as it has evolved, but much remains to be done before TRICARE becomes the smooth-running and beneficiary-friendly endeavor envisioned by its developers; (5) moreover, many questions concerning its cost-effectiveness and ability to meet beneficiary access and quality of care concerns are still to be answered; (6) in addition to operational difficulties, TRICARE is likely to continue to be implemented amid many changes that could profoundly affect not only the program but the entire military health care system; and (7) the result of the continuing evolution of TRICARE and the collective effects of these individual changes on it remain to be seen.