Preview

Tricare Health Plans

Powerful Essays
Open Document
Open Document
3481 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Tricare Health Plans
TRICARE Health Plans is the replacement for CHAMPUS which was the provider of health care services for military dependents. TRICARE not only replaced CHAMPUS but its purpose was also to facilitate members with access to better health care. Unfortunately, TRICARE has gone through many changes and upheavals since its inception in 1997. First, they began by dividing the company into regions. Each member was placed into a region based on where the military member was stationed. If the member was stationed in Maryland then his family belonged to the East Region. Unfortunately, there were many problems with this plan. First, some military members and their families did not live in the same regions. Therefore, the families either had to travel long distances for care or had to fight for an out of region referral. Next, if the member and their family were in the process of moving from one duty station to another, they were in limbo. They still belonged to the original region and would not be transferred until the member was input into the new duty station 's database. This caused problems as it was virtually impossible for members to acquire a referral for emergency care during their move.
Essentially, TRICARE Health Plans is struggling to keep their customers happy. The attached report recommends a complete overhaul in the following areas: 1. organization design, 2. work design 3. management and leadership, 4. reversal and minimized power and organization politics, 5. quality assurance implementation, and 6. organization strategies. Based on current surveys, these changes would improve customer satisfaction and reduce lost profits due to high organizational turnover rates. Finally, TRICARE has taken several steps throughout their organization in order to ensure that their medical plans are more in line with the competitive medical health plans that are readily available.

Table of Contents

Cover Page



References: Office of the Assistant Secretary of Defense (Health Affairs) and the TRICARE Management Activity. (2005, December 30). U.S. Department of Defense Military Health System. Retrieved February 24, 2006, from http://www.tricare.osd.mil/ Office of the Assistant Secretary of Defense (Health Affairs) and the TRICARE Management Activity. (2005, December 30). U.S. Department of Defense Military Health System. Stakeholders ' Report. Retrieved February 24, 2006, from http://www.tricare.osd.mil/stakeholders/default.cfm Shortell, S. M. & Kaluzny, A. D. (2000). Health care management: Organization design and behavior (4th ed.). Delmar/Thomson Learning: Albany, NY. TriWest Healthcare Alliance. (n.d.) TRICARE Prime Remote Handbook. TriWest Healthcare Alliance. (2006, February 17). Challenge to aid families of deployed national guard, reserves off to good start. Retrieved February 26, 2006, from https://www.triwest.com/triwest/default.html

You May Also Find These Documents Helpful

  • Better Essays

    Managed Care

    • 1408 Words
    • 6 Pages

    Kleiner, B. H. (2012) Gives insight into conducted research to show how research of managed care has increasingly become a leading development in regards to the finances in managed health care. There have been many debates and, much confusion of the origins and, definition of managed care yet, the goals are to reduce costs, increase profits and, still provide quality services. The events that have led to managed care is due to constant changes within the health care management sectors as, all throughout history as, when the industries change there also is a need for change to meet the demands to finance managed care.…

    • 1408 Words
    • 6 Pages
    Better Essays
  • Satisfactory Essays

    Tricare standard is the basic tricare health care program out of the three options offering comprehensive health care coverage for eligible soldiers and family members not enrolled in tricare prime. Tricare extra is an option that requires you to choose a network provider within the tricare network it is the free for service option that gives beneficiaries the opertunites to see the tricare network providers, tricare extra is not available to active duty service members. Tricare prime is another health care option that is available to active duty service members (adsm) and their family members and certain other tricare eligible beneficiaries in specific areas in the u.s. called prime service areas…

    • 112 Words
    • 1 Page
    Satisfactory Essays
  • Better Essays

    Current numbers estimate about one-third of people meet the criteria for a substance abuse problem. As one would assume, the number for people in stressful situations is higher (Lande et al., 2011). “Substance abuse includes alcohol, tobacco, illicit drugs, and misuse of prescription drugs (Agency Group 09, FDCH Regulatory Intelligence Database, 2009)”. Military personnel have always bonded over a beer, a night out at the bar, and other forms of substance use, but recent studies have shown an increase in substance abuse problems. “A study of Army soldiers screened 3 to 4 months after returning from deployment to Iraq showed that 27 percent met criteria for alcohol abuse and were at increased risk for related harmful behaviors (“Substance Abuse among”, 2011)”. Not only have substance abuse problems increased in the last decade in returning soldiers, but they have increased in soldiers before and during deployment as well. Before they are deployed, while they are deployed, and after returning from deployment, substance abuse is a real concern and extensive measures should be taken to prevent and treat substance abuse in military personnel…

    • 1855 Words
    • 8 Pages
    Better Essays
  • Better Essays

    Porter-O 'Grady, T., & Malloch, K. (2007). Managing for success in health care . St. Louis, MO: Mosby.…

    • 1182 Words
    • 3 Pages
    Better Essays
  • Good Essays

    Managed care

    • 906 Words
    • 4 Pages

    Managed health care is a system of health care delivery managed by a company aiming mainly at quality/value cost effective services provided to patients. It has been introduced with an intention to avoid paying for unessential facilities and services directly to physicians. It helps in forming an intermediate between patients and physicians in such a way that health insurance organizations pay the physicians from the premiums paid by patients to insurers for the services provided. This helps in monitoring how cost effectively the services are utilized. It is not to be mistaken as health care delivery at discounted prices. It’s goal is to provide quality care at affordable prices by restricting patient’s choice of physicians and physicians limiting their fees. People who seek care in America are mostly enrolled in health care plans such as health maintenance organizations(HMOs) and preferred provider organizations(PPOs).The less common plan people are enrolled in is point-of-service(POS) which has features of both HMO and PPO.HMO provides integrated and preventive care services to voluntarily enrolled families with low premiums within the network of doctors and hospitals that belong to the organization. It requires to select a primary care physician(PCP) who serves as a personal doctor to provide all basic health care services. PCPs include family physicians and internal medicine physicians. Some HMOs consider pediatricians(for children), gynecologists(for women) as PCPs. Before seeing a specialist or for a diagnostic service, it is required to obtain a referral from PCP(“gatekeeper”). If an outside specialist is chosen or referral is not obtained before seeing a specialist, no coverage for services is rendered by HMO. All or most of the cost for the care must be taken care by the individual. In contrast to HMO, with a PPO it is not necessary to select a single doctor as policy holder’s PCP nor is it necessary to…

    • 906 Words
    • 4 Pages
    Good Essays
  • Better Essays

    Managed Care

    • 3374 Words
    • 14 Pages

    There are so many problems with our society's health care. Everyone wants to find a…

    • 3374 Words
    • 14 Pages
    Better Essays
  • Better Essays

    Managed Care

    • 1382 Words
    • 6 Pages

    Millions of individuals live in the United States of America, and they all need effective, affordable and accessible health care coverage and services. Within decades, the scope and cost of health care has changed dramatically with increased complexity and significance to the healthcare market. The purpose of this paper is to analyze the managed care industry and examine how organizations try to control costs.…

    • 1382 Words
    • 6 Pages
    Better Essays
  • Powerful Essays

    Amspar Business Project

    • 4791 Words
    • 20 Pages

    Lt Col J Taylor, Senior Medical Officer and Liz Thurley RGN for their time and…

    • 4791 Words
    • 20 Pages
    Powerful Essays
  • Better Essays

    “For over 60 years, Centers for Disease Control and Prevention (CDC) has been dedicated to protecting health and promoting quality of life through the prevention and control of disease, injury, and disability,” (CDC, 2012, p. 1). The organization has a focus of decreasing the health and economic disadvantages of the principal reasons of demise and incapacity through diverse programs, thus safeguarding an extended, prolific, vigorous life for people, (CDC, 2012). This paper will expound on The Centers for Disease Control and Prevention and it is enhancement to the fundamental operations of the health system, the unambiguous methods that the association affect the health care system, and the roles, responsibilities, competencies, and skills of the agency workers, (CDC, 2012).…

    • 1704 Words
    • 7 Pages
    Better Essays
  • Good Essays

    About Tricare

    • 595 Words
    • 3 Pages

    Military medical care for active duty members of uniformed service and their families date back to the 1700’s. In 1884 Congress directed that “medical officers of the Army and contract surgeons shall whenever possible attend the families of the officers and soldiers free of charge.” Powers (2008). Following were great strides made to provide maternity care, infant care, psychiatric care, and care for surviving family members of a deceased sponsor. By the 80’s there was two ways for military personnel, retirees, and family member to receive health care. Tricare/CHAMPUS was now in full effect. Service members received treatment at the medical facilities and retirees and family members were seen on a space available status. Family members and retirees also had the option of using Civilian Health and Medical Program Uniformed Services (CHAMPS), which provides government subsidized care from civilian providers.…

    • 595 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    Comparison Hmos and Ppos

    • 1662 Words
    • 7 Pages

    The transformation of medical marketplace has major implications between two surging managed care plans. Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) examine research gaps, tradeoffs between financial and administrative barriers, and participation has fueled undesirable outcomes for both plans. Furthermore, employers, consumers, and providers seem to know what it is they do not want from their managed care plans, the options they have within these plans are not always clear. Evidence suggests that a comparison of two managed care plans can be utilized when examining health care benefits. “It is also related to the fact that PPO participation growth resulted from flight from the undesirable features of the HMO and widespread skepticism about the value of managed care, rather than from a migration to the attractive features of the PPO.” (Hurley, Strunk, and White, 2004) It focuses on the design of these two managed care plans Health Maintenance Organizations (HMO), and Preferred Provider Organizations (PPO). This article with describe the similarities and differences between these two managed care plans. The reasons that impact the decisions made to choose any particular health care plan. In addition, there are significant differences between HMOs and PPOs and the plans they offer, controlling for organizational and community factors, characteristics of health care plans, and human resources (HR) managers control costs. The article will promote innovations, discuss provider incentives, and facilitate patient satisfaction practices.…

    • 1662 Words
    • 7 Pages
    Powerful Essays
  • Better Essays

    Evolution of Managed Care

    • 1519 Words
    • 7 Pages

    Tufts Managed Care Institute. (1998). A brief History of Managed Care. Retrieved on August 25, 2010, from http://www.thci.org/downloads/BriefHist.pdf…

    • 1519 Words
    • 7 Pages
    Better Essays
  • Better Essays

    The complete Hospice Team; Social worker, CNA, Pastoral Care, Bereavement Services, RN/ Case Manager and Volunteers will all work together to achieve this goal by beginning teaching at time of admission. The Hospice team will all work together in order to make sure that the patient will die comfortably in their home with their family by their side and will do this without returning to the hospital. .We will provide the family with all of the information and support they will need in order to feel comfortable in keeping their loved one at home without returning them to the hospital. They will have access to a nurse 24 hours a day/7 days a week through our Triage line and will be reminded at each visit to use this form of communication in order to prevent re-hospitalization.…

    • 1147 Words
    • 4 Pages
    Better Essays
  • Good Essays

    “Patient Safety. Validity of Selected AHRQ Patient Safety Indicators Based on VA National Surgical Quality Improvement Program Data” (2009) by Romano, Mull, Rivard et.al is a comparative study in which the NSQIP data at VAMC’s during fiscal year 2001 is merged with AHRQ Patient Safety…

    • 807 Words
    • 4 Pages
    Good Essays
  • Powerful Essays

    acetone

    • 9648 Words
    • 49 Pages

    9. James, T. Tweedy, M.S, CHCM, CHSP. (2nd ed.). (2005). Healthcare Hazard Control and Safety Management, 275-301…

    • 9648 Words
    • 49 Pages
    Powerful Essays