Final Evaluation Report for Uniformed Services Family Health Plan Continuous Open Enrollment Demonstration

by Michael Schoenbaum, Katherine M. Harris, Gary Cecchine, Melissa A. Bradley, Ana Suarez, Terri Tanielian, C. Ross Anthony


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The National Defense Authorization Act for Fiscal Year 2000 established the authority for a demonstration program under which eligible military retirees and their dependents would be permitted to enroll in the Uniformed Services Family Health Plan (USFHP) at any time, rather than during a designated 30-day period each spring. The USFHP Continuous Open Enrollment demonstration was conducted at three of the seven USFHP sites, beginning in early 2000. This book assesses the likely impact of continuous open enrollment on beneficiaries, the DoD, and other stakeholders. The authors interviewed USFHP and DoD staff and other key participants involved in rate-setting negotiations, visited each demonstration site, conducted focus groups with enrolled and eligible non-enrolled beneficiaries, and analyzed data on enrollment patterns. The evaluation found no apparent drawbacks for beneficiaries of the continuous open enrollment policy, nor any evidence that it increased enrollment in USFHP. For beneficiaries under age 65, the authors found that a de facto policy of continuous open enrollment already exists because beneficiaries may enroll in TRICARE Prime and then transfer to USFHP at any time. Finally, the authors expect the financial risk to the DoD to be minor, mainly because the current system of calculating payment rates places most risk from adverse selection on the USFHP. The authors recommend that the continuous open enrollment policy be extended to all USFHP sites and be made permanent.

Table of Contents

  • Chapter One


  • Chapter Two


  • Chapter Three

    Purpose of Evaluation

  • Chapter Four


  • Chapter Five


  • Chapter Six


  • Appendix A

    Intended Analyses of Health Care Use and Costs

  • Appendix B

    Organization and Delivery of Care at USFHP Demonstration Sites

  • Appendix C

    Medicare Managed-Care Market in USFHP Demonstration Sites

  • Appendix D

    USFHP Marketing

  • Appendix E

    Sample USFHP Focus Group Recruitment Letter, Enrollees

  • Appendix F

    Sample USFHP Focus Group Recruitment Letter, Non-Enrollees

  • Appendix G

    Sample USFHP Focus Group Confirmation Letter, Enrollees

  • Appendix H

    Sample USFHP Focus Group Confirmation Letter, Eligibles

  • Chapter I

    USFHP Enrolled Focus Group Interview Guide

  • Appendix J

    Maps of Demonstration Areas

This research was conducted within RAND's National Defense Research Institute.

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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