ReportsReports are the most authoritative and most carefully considered products IDA publishes. They normally embody results of major protects which (a) have a direct bearing on decisions affecting major programs, (b) address issues of significant concern to the Executive Branch. the Congress and/or the public, or (c) address issues that have significant economic implications. IDA Reports are reviewed by outside panels of experts to ensure their high quality and relevance to the problems studied, and they are released I by the President of IOA. Group ReportsGroup Reports record the findings and results of IDA established working groups and panels composed of senior individuals addressing major issues which otherwise would be the subject of an IDA Report. IDA Group Reports are reviewed by the senior individuals responsible for the project and others as selected by IDA to ensure their high quality and relevance to the problems studied, and are released by the President of IDA. PapersPapers, also authoritative and carefully considered products of IDA, address studies that are narrower In scope than those covered in Reports. IDA Papers are reviewed to ensure that they meet the high standards expected of refereed papers in professional journals or formal Agency reports. Documents i IDA Documents are used for the convenience of the sponsors or the analysts (a) to record substantive work done in quick reaction studies, (b) to record the proceedings of conferences and meetings, (c) to make available preliminary and tentative results of analyses, (d) to record data developed in the course of an investigation, or (e) to forward information that is essentially unanalyzed and unevaluated. The review of IDA Documents is suited to their content and intended use.[The work reported in this document was conducted under contract MDA 903 89 C 0003 for 1 the Department of Defense. The publication of this IDA document does not indicate endorsement by the Department of Defense, nor should the contents be construed as reflecting the official position of that Agency.
ReportsReports are the most authoritative and most carefully considered products IDA publishes. They normally embody results of major projects which (a) have a direct bearing on decisions affecting major programs, (b) address issues of significant concern to the Executive Branch, the Congress and/or the public, or (c) address issues that have significant economic implications. IDA Reports are reviewed by outside panels of experts to ensure their high quality and relevance to the problems studied, and they are released by the President of IDA. Group ReportsGroup Reports record the findings and results of IDA established working groups and panels composed of senior individuals addressing major issues which otherwise would be the subject of an IDA Report. IDA Group Reports are reviewed by the senior individuals responsible for the project and others as selected by IDA to ensure their high quality and relevance to the problems studied, and are released by the President of IDA. PapersPapers, also authoritative and carefully considered products of IDA, address studies that are narrower in scope than those covered in Reports. IDA Papers are reviewed to ensure that they meet the high standards expected of refereed papers in professional journals or formal Agency reports. To interpret the requirements of the congressional tasking, IDA reviewed Section 712(a) of the National Defense Authorization Act for Fiscal Year 1993, 2 which states:The Secretary shall consider the cost-effectiveness of the initiative and the effect of the expansion of the initiative on the access of covered beneficiaries to health care and on the quality of health care received by covered beneficiaries.It is clear from the above language that our evaluation of the Uniformed Services Treatment Facilities (USTFs) must include a cost-effectiveness analysis and consider the impact of the managed-care plan on the access to and quality of health care.The USTF managed care plan is better known to beneficiaries and within DoD as the Uniformed Services Family Health Plan (USFHP). An analysis of the cost-effectiveness of the USFHP requires two components-an alternative system of care and a comparison of costs while holding effectiveness constant. The alternatives available to beneficiaries in The access of USFHP beneficiaries to health care in the event of program termination was addressed by a General Accounting Office (GAO) report, 5 which concludes:For beneficiaries, termination should not greatly affect their overall access to care, but they will likely experience increased out-of-pocket costs, and some may experience disruptions in the continuity of their care. Several private and community medical providers are located in and around the areas serving the USTFs, and beneficiaries would retain their eligibility for TRICARE, CHAMPUS, or Medicare-financed care, as well as DoD's direct care system, so termination should not affect access. Additionally, some beneficiaries have private insurance.In this report, we address access to care from the beneficiaries' ...
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