The Department of Defense (DOD) provides health care through TRICARE--a regionally structured program that uses civilian contractors to maintain provider networks to complement health care provided at military treatment facilities (MTF). In 2004, DOD implemented extensive changes to its TRICARE contracts and regional structure. A committee report accompanying the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 directed GAO to provide information on implementation issues for (1) the new TRICARE contracts and (2) the new regional structure. This report also provides information on the new management tools used to assess (3) contractors' performance and (4) program performance at the MTF and regional levels.
Recommendations for Executive Action
|Department of Defense||1. As DOD considers what further investments are warranted for managing referrals and authorizations, the Secretary of Defense should direct the Assistant Secretary of Defense for Health Affairs to determine comprehensive costs for the development and nonavailability of the Enterprise Wide Referral and Authorization System as well as the costs being incurred to develop a solution.|
|Department of Defense||2. To facilitate the TROs' oversight of regional health care delivery, the Secretary of Defense should direct the Assistant Secretary of Defense for Health Affairs to clearly define the TROs' contract oversight roles and responsibilities as they relate to other TRICARE Management Activity offices.|
|Department of Defense||3. To facilitate the TROs' oversight of regional health care delivery, the Secretary of Defense should direct the Assistant Secretary of Defense for Health Affairs to establish protocols for how TROs are to collaborate with the military services' MTFs.|