MTF Refill Mail Service Initiative Pilot: Fiscal Year 2003 Report

The TRICARE Management Activity (TMA) asked CNA to evaluate the joint DoD/VA pilot study for mailed refill services. The pilot program addressed the ability of Military Treatment Facilities (MTFs) to interface with the VA’s automated Consolidated Mail Outpatient Pharmacy (CMOP) system to process refills. This program—the MTF Refill Mail Order Service (MRMS) pilot—offered DoD beneficiaries an option to receive mailed refills from the CMOP at no copay. Some additional potential benefits included freeing up MTF staff to concentrate on clinical and cognitive duties, patient safety, and customer service for beneficiaries. Based on the pilot program, MTF use of the CMOP system was technically feasible, beneficiary acceptance was high, and MTF staff were supportive of the initiative. Estimating response at 50 percent, we project that a nationwide program might send 9.35 million DoD refills to the CMOP system, at a net cost of about $8.6 million attributed to the TRICARE For Life accrual fund and $10.9 million attributed to the Defense Health Program. Costs might be covered by a combination of cutting pharmacy staff as refills shift to the CMOP, recapture from retail pharmacy and TMOP, cost-avoidance based on accrual fund reimbursement rates, or adding a CMOP copay.