A financial analysis of resource sharing agreements as part of the TRICARE Managed Care Support Contracts

Abstract

Escalating health care costs and base closures have forced the DoD to improve access to health care while maintaining quality, controlling costs, and increasing medical readiness. The response is a Tri-service managed care system called TRICARE. One mechanism utilized within the TRICARE Managed Care Support Contracts (MCSCs) is Resource Sharing. Resource sharing is a system to reduce the government's health care costs by recapturing the TRICARE workload This thesis explores if Resource Sharing Agreements (RSAs) are cost-effective and how they are being monitored and evaluated by the Lead Agent and MTFs. After conducting a literature review, interviews and performing data analysis, this thesis examined the reported cost analysis, retrospective analysis, and workload of RSAs in Health Services Region 10 as they are used under the MCSC for that region. A case study of RSAs, comparing forecasted and reported savings, was also conducted to understand RSAs and their role in controlling military health care costs. The analysis found that the RSAs are reducing government costs, but not at the predicted rate. This case study found that only 67 percent of the estimated government savings were realized. Decreasing workload is a key factor explaining this shortfall.