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In 1997, Congress directed the Health Care Financing Administration (HCFA) and the Department of Defense (DoD) to conduct a demonstration to test the feasibility of establishing Medicare managed care plans within the DoD TRICARE health benefits program for beneficiaries who are eligible for both DoD and Medicare health insurance coverage. The legislation was intended to expand access to military health care services for dually eligible beneficiaries while maintaining budget neutrality. This report focuses on one model being tested in the demonstration, called TRICARE Senior Prime. It presents the results of RAND's evaluation of the first year of operation at six demonstration sites.

Table of Contents

  • Chapter One


  • Chapter Two

    The Medicare-DoD Subvention Demonstration

  • Chapter Three

    Evaluation Methods and Data

  • Chapter Four

    Enrollment Demand

  • Chapter Five

    Early Effects of Senior Prime on Service Use

  • Chapter Six

    Early Financial Effects of Senior Prime

  • Chapter Seven

    Status of the Demonstration Sites

  • Chapter Eight

    Discussion of Findings and Issues

  • Chapter Nine

    Selection of Military Treatment Facilities for Senior Prime

  • Appendix A

    Evaluation of the DoD-Medicare Subvention Demonstration

  • Appendix B

    FY96 – FY98 RAND Data Documentation

  • Appendix C

    Teleconferences with the Demonstration Sites

  • Appendix D

    DoD Medical Treatment Facilities – Not Participants in the Subvention Demonstration

This research was conducted within RAND Health.

This report is part of the RAND Corporation Monograph report series. The monograph/report was a product of the RAND Corporation from 1993 to 2003. RAND monograph/reports presented major research findings that addressed the challenges facing the public and private sectors. They included executive summaries, technical documentation, and synthesis pieces.

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