Feasibility Analysis of Adopting Medicare's Mental Health Prospective Payment System for Tricare Beneficiaries Treated in Inpatient Psychiatric Facilities

摘要

This project will examine the feasibility of implementing Medicare's mental health prospective payment system (PPS) for Tricare beneficiaries treated in inpatient psychiatric facilities. Background information will be presented on both Tricare's current per diem system and Medicare's mental health PPS to facilitate a comparison of the systems. Specifically, a financial analysis will be performed to determine if the adoption of Medicare's mental health PPS can be a cost savings measure for the Department of Defense. This project will compare payments for mental diagnoses under the per diem system and PPS. The anticipated product of this project is a proposal to Tricare Management Activity, Aurora, CO to either implement Medicare's mental health PPS or to stay with the current system. The premise for adopting Medicare's mental health PPS would be to demonstrate potential for tangible cost savings over the current system. Should this project demonstrate the potential for little or no cost savings then the recommendation would be to reject Medicare's mental health PPS.