Life-Cycle Costs of Selected Uniformed Health Professions (Phase II: The Impact of Constraints and Policies on the Optimal-Mix-of-Accession Model)

We computed life-cycle costs for physicians, dentists, and other selected health care professions. Specifically, we computed the cost to access them, train them to be fully qualified duty special-ists, and maintain them in staff utilization tours. We computed the cost per year of practice (YOP) as a fully trained specialist with emphasis on the cost per YOP at the completion of the initial active duty obligation and at the expected YOP. We found that training costs are substan-tial—8 to 49 percent over compensation costs for physicians depending on specialty and acces-sion source. Given these life-cycle costs, we’ve developed a model to determine the optimal mix of acces-sions to fill future billet requirements. The optimum depends crucially on the model’s con-straints, which include the required experience profile, in-house training requirements, and ac-cession constraints. The results indicate that the required experience profile affects the optimum for physicians more than any other constraint, whereas in-house training requirements are the biggest driver in the dentist model. Looking at the impact of pay on the optimum, we found that accession bonuses are modestly cost-effective for some specialties and that targeted special pay increases are more cost-effective than across-the-board increases.