Introducing Value-Based Purchasing into TRICARE Reform.

Area of Science:

• Health Services Research
• Health Policy
• Managed Care

Background:

• TRICARE, the U.S. Department of Defense health program, was established in the 1980s.
• It covers care in military facilities and through civilian providers.
• Current legislative discussions focus on updating TRICARE's managed care strategy.

Purpose of the Study:

• To provide historical context for TRICARE's managed care approach.
• To examine recent value-based purchasing innovations by private insurers and Medicare.
• To evaluate reform proposals and suggest an alternative approach for TRICARE.

Main Methods:

• Historical analysis of TRICARE's evolution.
• Review of innovations in private and Medicare value-based purchasing.
• Evaluation of existing TRICARE reform proposals.

Main Results:

• TRICARE's current strategy is rooted in 1980s managed care concepts.
• Private insurers and Medicare are increasingly adopting value-based purchasing to improve care value (cost and quality).
• Two reform proposals for TRICARE were assessed.

Conclusions:

• TRICARE requires modernization to align with current healthcare trends.
• An alternative reform approach blending existing proposals is presented.
• The proposed approach aims to enhance the value of healthcare for TRICARE beneficiaries.