Research for Military Benefits

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The Implications of Universal Enrollment for the DOD Health Care System
June 1, 2000
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.
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Pharmacy Options For DOD Medicare-Eligible Retirees
February 1, 2000
The Navy's Bureau of Medicine and Surgery asked CNA to examine several alternative pharmacy plans that would extend prescription coverage to the DOD 65+ Medicare-eligible population. The specific pharmacy plans examined fall under three general categories. After paying an enrollment fee, beneficiaries may receive prescriptions (1) through mail order, (2) at the military treatment facility (MTF) or mail order, or (3) at retail pharmacies or through mail order. This research memorandum describes these options and the costs to DOD for each.
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FCC Baseline Subsidy Analysis
January 1, 1999
The DON is seeking to maximize the availability of child-care spaces within the available funding by adjusting the subsidies paid for different types of childcare. Military childcare is provided either in Child Development Centers (CDCs) or through the Family Child Care (FCC) program in private homes or bases. PDASN(M&RA) asked CNA to take a quick look at the subsidy program. The purpose of the study is to establish a baseline for FCC use and cost in the DON, with particular attention to initiatives to subsidize FCC. Recommendations include improving routine data collection and reporting, instituting regular parent and provider surveys, giving subsidies only to 0-3 year olds, and setting subsidies in line with local markets. In addition, we considered what an evaluation plan to monitor the effectiveness of FCC subsidies should include. Part of the report includes a suggestion for a follow-on study that would implement the evaluation plan. DTIC AD-B242825
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Options for Improving Access to Health Care for Retirees
September 1, 1998
CNA was asked to determine the costs of extending three different types of benefits to the Medicare-eligible population. The first options would extend the National Mail Order Pharmacy (NMOP) program. The second option is to offer the DOD Medicare-eligible beneficiaries enrollment in the Federal Employee Health Benefits Program (FEHBP). The third option is to offer a Medicare supplemental insurance package sponsored by DOD. The three plans offer different sets of benefits and a wide variation in cost. The least expensive plan is the NMOP, costing about $267 million. The most expensive plan would be to offer FEHBP, costing DOD about $1.6 billion. In the middle of these two plans is our proposed Medigap subsidy in which DOD could design and offer its own unique Medigap plan covering core benefits. It would cost around $600-$650 million.
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Assessing the Accuracy of MEPRS Data Collection
March 1, 1991
CNA developed a method for comparing CHAMPUS and medical treatment facility (MTF) inpatient costs that uses Medical Expense and Performance Reporting System (MEPRS) data to calculate the MTF cost per admission for a category of care. However, a lack of reliable MTF data on cost per admission is a major obstacle to the application of the methodology. This research memorandum provides MTFs with a detailed description of procedures used to identify and correct problems with MEPRS data collection at Naval Hospital, Portsmouth.
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Is There Such A Thing As Overall Satisfaction With Military Life? A Factor Analysis of Marine Corps Data
February 1, 1988
This research contribution attempts to determine the number of dimensions in which satisfaction with military life should be measured. The analysis used a correlation matrix of satisfaction measures for Marine respondents to the 1985 DOD Member Survey and performed a standard factor analysis on that matrix. Three distinct dimensions of Marine satisfaction, having to do with personal fulfillment in the military, military family stability, and military fringe benefits, were identified.
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Retention Costs of the GI Bill and the Draft: New Evidence from the Navy's Enlisted Force
May 1, 1987
Drawing upon new data from the Navy's enlisted force, this study estimates the effect on military reenlistment rates of several major policy variables: eligibility for the Vietnam-era G.I. Bill, draft-pressure at the original enlistment point, and the amount of formal training given to enlistees in their first term. These specific effects are all shown to be substantially adverse, even after statistic controls have been established for other key determinants of military retention.
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Costs and Benefits of Training and Experience
January 1, 1985
On-the-job training continues throughout the careers of enlisted men in the Navy. This kind of experience-induced training entails no formal training costs, but it requires payment of higher wages and benefits due more senior individuals. This paper examines where the balance is between the costs and benefits of such training.
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Projecting the Retention of Navy Careerists
April 1, 1984
This report quantifies the link between civilian job growth and military retention for Navy enlisted personnel. The magnitude of this effect is identified--at both the first and second re-enlistment decision points--for highly technical ratings and for ratings which are not highly technical. The effect that future civilian job growth will have on the chances that Navy personnel will reenlist or leave is then projected, using occupational forecasts for the next decade provided by the Bureau of Labor Statistics.
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Retention And Career Force Quality
March 1, 1984
Previous studies have examined the factors that influence first-term retention. This analysis expands on prior work to investigate the impact of these factors on retention and the quality of personnel retained. We find that the aggregate pay elasticity is approximately 2 (which is similar to that found in earlier analyses), but that this result masks substantial differences in the pay responsiveness of different personnel. Upper mental group personnel displayed a pay elasticity in excess of 3, whereas personnel in the lower groups had an elasticity of approximately 1. Thus, pay increases improve the quality of the career force as well as increasing the number of personnel retained. Conversely, if Navy pay lags behind civilian earnings, the decline in retention is compounded by a decrease in quality. Upper mental group personnel seemed to be more sensitive to changes in the civilian unemployment rate as well. There is a significant relationship between advancement and retention. The effect is stronger than that expected from the related pay increase. It seems to indicate that advancement can be an effective and selective retention tool.
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