Medicare subvention : a case analysis of reimbursement issues affecting TRICARE Senior Prime at Naval Medical Center, San Diego

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Authors
Breier, David N.
Subjects
Advisors
Doyle, Richard B.
Date of Issue
1999-12
Date
December, 1999
Publisher
Monterey, California: Naval Postgraduate School
Language
en_US
Abstract
Medicare-eligible military beneficiaries have experienced difficulty accessing the Military Health System. To help alleviate this problem, a three- year demonstration project known as Medicare Subvention has been implemented creating a Department of Defense Health Maintenance Organization called TRICARE Senior Prime (TSP). This research determined the financial impact of TSP at Naval Medical Center, San Diego (NMCSD). The financial analysis includes an examination of inpatient and outpatient costs and revenues for Fiscal Year (FY) 1999. The results of this research show that TSP indirectly caused a net reduction. in operating costs at NMCSD in FY 1999 of $ 1.5 million or one percent of the operating budget. The program caused revenues to decline by causing a 20 percent reduction in admissions for non-TSP beneficiaries with other health insurance. Proportionally larger cost reductions resulted from this decrease in non-TSP admissions that outweighed increases in TSP admissions.
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Thesis
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Format
x, 68 p.;28 cm.
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Distribution Statement
Approved for public release; distribution is unlimited.
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