Final Evaluation Report for Uniformed Services Family Health Plan Continuous Open Enrollment Demonstration
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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
Introduction
Chapter Two
Background
Chapter Three
Purpose of Evaluation
Chapter Four
Methods
Chapter Five
Findings
Chapter Six
Conclusions
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
Research conducted by
This research was conducted within RAND's National Defense Research Institute.
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