Defense Health Care: DOD's Managed Care Program Continues to Face Challenges

GAO discussed the Department of Defense's (DOD) TRICARE managed health care program. GAO noted that: (1) regional program officials are concerned that the program's administrative structure does not provide sufficient authority and control over funds and personnel because these resources are controlled by the military services; (2) although DOD believes it has sufficiently promoted interservice cooperation to improve program delivery, lead agents will still have to overcome historic inter-service rivalries; (3) DOD has implemented several procedural changes to combat the many problems it has experienced in obtaining civilian health care services; (4) although DOD is developing an integrated, automated medical information system to support a wide range of hospital functions, military hospital officials are concerned that these information systems may not be available by the time the program is implemented in their regions; (5) program beneficiaries may not have full or equitable access to care because lower cost health care options may not be available in all areas and enrollment in the low cost-sharing options may be limited; (6) there is insufficient information to predict whether the program will be cost-effective; and (7) DOD has not developed a plan for evaluating the program's cost-effectiveness or compliance with legislative cost-neutral requirements.