Plan for the Reorganization of the Family Practice Program at Irwin ArmyCommunity Hospital Using a Managed Care Model

摘要

Irwin Army Community Hospital (IACH), Fort Riley, Kansas, has been selected asone of eleven sites to demonstrate the Gateway to Care , or 'Gateway', program for the Department of the Army (DA). Gateway is intended to accomplish several objectives, specifically these objectives are: (a) to improve access to medical care, (b) to implement a primary care delivery base, (c) to improve the quality of care, (d) to improve customer satisfaction, and (e) contain the rapidly escalating costs of medical care. These objectives will be accomplished through the use of managed care concepts. This represents a significant departure from the existing military health care system. As one of the test sites for the Army Gateway Program, IACH will be allowed to function more like a civilian Health Maintenance Organization (HMO). Under the Gateway program, primary care providers will become individual patient health care managers and 'gatekeepers of the health care system. Since IACH has an active Family Practice program, this service will become a focal point in the Gateway program. This paper analyzes the current Family Practice program at IACH to determine the best method to reorganize the program at IACH in a cost effective and operationally sound manner. A managed care model for the new program and a plan for its implementation are discussed.