Research for Effectiveness

The U.S. Navy Surgeon General tasked the Center for Naval Analyses to evaluate the TRICARE demonstration project. This demonstration is an attempt to coordinate health care for the medical-eligible military population of 300,000 in the Tidewater area of Virginia. When TRICARE matures, it will integrate a series of military treatment facilities, a preferred provider network, and a health maintenance organization, under joint service management. The evaluation consists of a comparison of several measures of effectiveness, before and after TRICARE implementation. We will be comparing Tidewater with two other regions: southern California, which is under CRI (a managed care program), and North Carolina, which is under standard CHAMPUS. The evaluation will take about three years to complete. In the meantime, we have collected baseline data for Tidewater and the comparison sites. The purpose of this paper is to present the findings of the baseline analysis of access to, and satisfaction with, health care during the pre-implementation period. This is not an evaluation of TRICARE. The results will be helpful in interpreting subsequent changes in the components of the program after TRICARE implementation.

In a previous research, we showed how the Navy can cut the cost of carrier Aviation Consolidated Allowance Lists (AVCALs) by as much as 26 percent without cutting readiness by implementing Readiness-Based Sparing (RBS). The RBS method of selecting inventory allowances is different from the current Demand-Based Sparing (DBS) method in that it links supply resources to aircraft readiness at least cost. Our earlier RBS work prompted the Navy to conduct an at-sea test of an RBS AVCAL on USS AMERICA. The Navy asked us to perform the analysis and report the results. In this memorandum, we analyze how well AMERICA's new RBS AVCAL supported the airwing during its 1993-94 deployment and report our findings. We summarize the results of our analysis and the aviation support lessons we learned. We discuss how RBS AVCALs fit into the Integrated Logistics Support (ILS) system, present our analysis approach, and describe our analysis of mission capable rates, maintenance operations, and cannibalization actions.

In this report, we examine the question of where the Navy's depot maintenance should be done. In FY 1992, the Department of the Navy spent $7.5 billion on depot maintenance, and most of that work was done at naval depots. Now that the workload is declining, however, the Department of the Navy and the Department of Defense are looking at the possibility of doing more of that work at private facilities.

As part of the study Managing the Enlisted Marine Corps in the 1990s, CNA analyzed success patterns of Marines making lateral moves. Each of these Marines retrains in a primary military occupational specialty different from the original one. The Marine Corps currently has no basis for judging the success of Marines initiating lateral moves. Our analysis of historical data provides planners with information to help judge the efficiency of these moves. We will first describe the Marine Corps manpower planning and how lateral moves fit into this planning. We then consider the costs of selective reenlistment bonuses versus lateral moves. Finally, we provide statistical analysis of historical data on lateral moves. Our analysis of lateral moves focuses on the following considerations: (a) patterns of successful completion of a lateral move; (b) the promotion and attrition experience of Marines who have made lateral moves relative to their cohorts; and (c) experience in the Marine Corps compared with performance of occupation-related tasks.