| Abstract |
Health care now accounts for more than 14% of the U.S. gross national product and has become too expensive for society at large (Meltzer, Tyrell, Rich, & Wood, 1995). Consequently, managed health care is increasingly the norm.... (Meltzer, et al., 1995, p. 1147). Managed care programs, which stress factors relating to cost containment, cost efficiency, and management accountability either outside or within health maintenance organizations, have evolved in all sectors of the health care system. At the same time, both civilian and government health care organizations are dealing with the reduction of payments to hospitals and physicians, the quest for efficiency, limitations in Medicaid payments, and debates about types of payments for Medicare (Sharp, 1995). Now, both military and civilian health care organizations now challenged to meet operational goals in a climate of concern about access to health care and diminishing health care resources (Jennings & Borsch, 1994; Sharp, 1995; Masko, 1996). (References and Definition of Terms are listed in Appendices A and B respectively.) The military health care system is estimated to account for 25% of the Department of Defense (DOD) budget. In 1994, Public Law 103-160 was enacted to restructure this system (Nurse-Patient Relationship Patterns: An Economic Resource, Military Data, 1996). Currently, the military health care system is trying to embrace the best strategy to provide health care and while ensuring continuity of care for military families and beneficiaries. Regional military lead agents have been organized to provide for a capitation-based resource allocation approach. In addition, a triple-option managed care program called TRICARE (Prime, Extra, and Standard) was announced in 1994 by DOD to improve health care services and access to health care within a managed care environment (Masko, 1996). |
