Health Care in the Military. Feasibility and Desirability of a Health Enrollment System

摘要

This study concludes that the HES concept is not feasible today but would be feasible given the changes discussed in the report especially the replacement budget, the reinsurance plan, and successful completion of appropriate data and information systems. The authors cannot draw final conclusions on the eventual desirability of an HES. While the incentive structures of an HES and the ability to manage the health care system better both offer great promise for improvements in cost and quality of care, only a demonstration offers the opportunity to observe how outcomes vary under different program designs. Specifically, a controlled demonstration can provide information including: (1) Would patient enrollment match the projections. Would differential premiums or health allowances be needed to balance supply and demand for Military Treatment Facilities (MTF) services. What are the readiness training consequences of actual enrollments. (2) How much efficiency gain would arise from the new incentives. (3) How would patients use medical care under an HES environment in MTF. How would medical practice patterns change (if at all). and (4) Are currently available models adequate to project enrollment or new data and models needed.