An Evaluation of Resource Sharing Within Tricare's Managed Care Support Contracts

An Evaluation of Resource Sharing Within Tricare's Managed Care Support Contracts

Author: Martin D. McCue

Publisher:

Published: 1996-09-01

Total Pages: 146

ISBN-13: 9781423583011

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To help reduce the overall cost of health care in the Military Health Services System, Managed Care Support Contracts include a provision known as Resource Sharing. Resource Sharing Agreements allow the contractor to provide personnel, equipment, or supplies to a military treatment facility to improve its capability to deliver health care. After reviewing civilian managed care programs, this thesis examines the Military Health Services System and its new managed care program known as TRICARE. Then the concept of Resource Sharing is examined and the process for identifying, evaluating, and using cost effective Resource Sharing Agreements is discussed. Case studies of different types of agreements are used to illustrate the complexity and importance of cost and workload estimates and key contract factors in understanding the agreements. The findings suggest that the contractor's and government's performance data and assumptions underlying the agreements should be continuously monitored to ensure the cost-effectiveness of the agreements.


A Financial Analysis of Resource Sharing Agreements as Part of the TRICARE Managed Care Support Contracts

A Financial Analysis of Resource Sharing Agreements as Part of the TRICARE Managed Care Support Contracts

Author: Steven L. Hoeft

Publisher:

Published: 1998-12-01

Total Pages: 100

ISBN-13: 9781423554936

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Escalating health care costs and base closures have forced the DoD to improve access to health care while maintaining quality, controlling costs, and increasing medical readiness. The response is a Tri-service managed care system called TRICARE. One mechanism utilized within the TRICARE Managed Care Support Contracts (MCSCs) is Resource Sharing. Resource sharing is a system to reduce the government's health care costs by recapturing the TRICARE workload This thesis explores if Resource Sharing Agreements (RSAs) are cost-effective and how they are being monitored and evaluated by the Lead Agent and MTFs. After conducting a literature review, interviews and performing data analysis, this thesis examined the reported cost analysis, retrospective analysis, and workload of RSAs in Health Services Region 10 as they are used under the MCSC for that region. A case study of RSAs, comparing forecasted and reported savings, was also conducted to understand RSAs and their role in controlling military health care costs. The analysis found that the RSAs are reducing government costs, but not at the predicted rate. This case study found that only 67 percent of the estimated government savings were realized. Decreasing workload is a key factor explaining this shortfall.


Code of Federal Regulations

Code of Federal Regulations

Author:

Publisher:

Published: 2017

Total Pages: 1284

ISBN-13:

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Special edition of the Federal Register, containing a codification of documents of general applicability and future effect ... with ancillaries.