Research Brief
Expanding Access to Mental Health Counselors Under TRICARE
Jul 22, 2009
Expanding Access to Mental Health Counselors
Evaluation of the TRICARE Demonstration
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TRICARE, the program through which military health system beneficiaries access health care services, provides coverage for most medically necessary mental health care delivered by qualified providers. Federal legislation in 2001 required the Department of Defense to conduct a demonstration project involving expanded access under TRICARE to a particular type of mental health service provider — the licensed or certified mental health counselor (LMHC). Under the demonstration, LMHCs could provide services to covered beneficiaries without physician referral or adherence to physician supervision requirements, both of which are otherwise required. This report describes and presents findings from RAND Corporation’s evaluation of the demonstration. The authors present detailed findings, based on surveys and interviews with various stakeholders, on the demonstration’s impact on health care utilization, cost, and outcomes of health care services. The authors examine and compare pre-demonstration and post-demonstration data, and compare results from military catchment areas that participated in the demonstration and catchment areas that did not participate but were studied for comparison purposes.
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Table of Contents
Chapter One
Introduction
Chapter Two
Evaluating the Impact of the Demonstration: Implementation, Objectives, Framework, and Methods
Chapter Three
Impact on Beneficiaries
Chapter Four
Impact on Providers
Chapter Five
Impact on TRICARE
Chapter Six
Implication of Findings, Caveats, and Conclusions
Appendix A
Demonstration Materials
Appendix B
Evaluation Tasks and Methods
Appendix C
Beneficiary Survey: Background and Survey Instrument
Appendix D
Beneficiary Survey: Supplemental Data Tables
Appendix E
Administrative Claims Data: Supplemental Data Tables
Research conducted by
The research described in this report was sponsored by the Office of the Secretary of Defense (OSD). The research was conducted jointly by RAND Health’s Center for Military Health Policy Research and the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center supported by the OSD, the Joint Staff, the unified commands, and the defense agencies.
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