Research for DOD

The TRICARE program is designed to provide for the health care needs of those on active duty, their family members, and retirees and their family members. TRICARE is a complicated health care system with several different parts. One key component is Prime, the managed care portion of the Defense Health Plan (DHP). One must enroll in Prime in order to receive care under it; however, other options for receiving care do not require enrollment. This study responds to tasking from the Under Secretary of Defense (USD) for Personnel and Readiness concerning the feasibility of an enrollment system for the DHP. Under Prime, enrollment is a requirement for receiving care. In a limited sense, enrollment is not only possible but currently under way. We believe, however, that the more important question and one posed under the tasking is whether universal enrollment is feasible. As we'll show, Prime pertains to a relatively important and growing part of the beneficiary population that relies on military treatment facilities (MTF)-military clinics and hospitals-for health care. The other user of the MTFs rely on space-available care. These people don't have to enroll to use military healthcare providers or facilities; they use the NTFs for care when there is sufficient capacity.

In a previous study, CNA analysts used data from past DoD A-76 competitions to construct a model of savings and projected the potential savings from additional DoD Commercial Activities (CA) competitions. In this paper, we use an alternative approach for estimating savings from future Dod CA competitions. We estimate two separate bidding equations - one for the in-house team bid and another for the minimum contractor bids - along with an equation for baseline cost. Based on these estimated equations, one could then indirectly project future savings in the A-76 inventory as the difference between predicted baseline cost and the predicted winning bid. Using the new approach, we project an annual savings of $6 billion if the entire 1995 DoD CA inventory were competed under A-76 rules.

In 1955, the Office of Management and Budget (OMB) implemented a policy known as the Commercial Activities (CA) Program. This program enables the private sector to compete with government organizations in providing goods and services when it is appropriate and economical to do so. The objective is to promote an efficient support structure through competition. This research memorandum is part of a CNA-initiated research effort examining the DoD Commercial Activities program. Most of our previous research has examined the Navy CA program. This paper presents the results of all completed DoD comprehensive A076 competitions between 1978 and 1994.

As part of the Outsourcing Options study, N4 asked CNA to look across the services and DoD agencies to evaluate different practices and lessons learned in implementing A-76 procedures. Earlier work suggested that big savings are possible if the Navy chooses to start large-scale competitions. Since OMB is revising - rather than withdrawing - its A-76 policies, CNA focused on how the process could be streamlined to maximize savings. In this brief, we first review the evidence of competition savings found across DoD. We then discuss what role senior Navy leadership can play in easing implementation, as well as specific ways to streamline the process. We also suggest best contracting practices. Finally, we touch on employee transition issues.