Evaluation of the CHAMPUS Reform Initiative

Volume 2, Beneficiary Access and Satisfaction

by Elizabeth M. Sloss, Susan D. Hosek


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Beneficiary access to and satisfaction with medical care under managed care are evaluated in this report. As part of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) Reform Initiative (CRI) demonstration, conducted from 1988 to 1993 in California and Hawaii, two new options were offered: an enrollment option similar to a health maintenance organization (called CHAMPUS Prime), and an option to obtain medical care at a lower cost through networks of civilian physicians and hospitals similar to a preferred provider organization (called CHAMPUS Extra). The authors conducted two mail surveys of CHAMPUS beneficiaries (beneficiaries include dependents of active-duty military personnel, and retired military personnel and their dependents), one shortly before CRI began and another two years later. They then compared data from both surveys in the eleven military hospital catchment areas in California and Hawaii with eleven matched control areas in other states. The authors concluded that beneficiaries who enrolled in CHAMPUS Prime had better access to and higher levels of satisfaction with medical care than beneficiaries in the control sites. Those in the demonstration sites who did not enroll, however, reported levels of access and satisfaction very similar to those in the control sites.

Table of Contents

  • Chapter 1


  • Chapter 2

    Evaluation Methods

  • Chapter 3


  • Chapter 4


  • Appendix A

    Access and Satisfaction Questions Used in the CRI Beneficiary Surveys

  • Appendix B

    Derivation of the 18-Item General Satisfaction Battery from a 50-Item General Satisfaction Battery

  • Appendix C

    Internal Consistency and Item Discrimination of the General Satisfaction Scales

  • Appendix D

    Relationship Between Encounter-Specific Satisfaction Items and Their Total

  • Appendix E

    Statistical Methods Used in Analysis

  • Appendix F

    Baseline Levels of Access and Satisfaction in Demonstration and Control Sites

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