The impact of the elimination of Facility Not Available (FNA) waivers
Ransom, Kimberly A.
Doyle, Richard B.
Lamar, Steven R.
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This thesis examines the impact of the elimination of 'Facility Not Available' (FNA) waivers. Naval Reserve facilities could previously waive, as 'FNA,' any portion of the periodic physical examination not locally available. The Navy eliminated the authority to use FNA waivers in February 1994. The objective of this thesis was to identify the impact of FNA waiver elimination on periodic physical examination cost, effectiveness and delivery methods. It begins by describing the periodic physical examination and the Naval Reserve physical examination delivery system. Three methodologies were used to do this: interviews of key personnel, a literature review, and analysis of retrospective data from the Naval and Marine Corps Physical Evaluation Board (PEB) and the Commander of the Naval Reserve Force (CNRF). Then the impacts of FNA waiver elimination were examined using a survey which resulted in the review of 81,699 medical records and periodic physical examination delivery and cost data from 199 Naval Reserve facilities (98 percent of the Naval Reserve). This thesis found that FNA waiver elimination was an extremely successful change in health care policy for the Naval Reserve. Periodic physical examination costs were increased and the methods used to deliver examinations were changed. However, these impacts are justified because of the dramatic increase in periodic physical examination effectiveness achieved due to FNA waiver elimination.
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