Evaluation of the CHAMPUS Reform Initiative. (Record no. 597982)
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| 001 - CONTROL NUMBER | |
| control field | rnd000000000093794 |
| 003 - CONTROL NUMBER IDENTIFIER | |
| control field | RAND |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
| fixed length control field | 941103s1994 caua 000 0 eng d |
| 010 ## - LIBRARY OF CONGRESS CONTROL NUMBER | |
| LC control number | 92046776 |
| 020 ## - INTERNATIONAL STANDARD BOOK NUMBER | |
| International Standard Book Number | 0833015702 |
| 027 ## - STANDARD TECHNICAL REPORT NUMBER | |
| Standard technical report number | RAND/R-4244/6-HA |
| 035 ## - SYSTEM CONTROL NUMBER | |
| System control number | (Sirsi) a366892 |
| 037 ## - SOURCE OF ACQUISITION | |
| Terms of availability | $30.00 |
| 040 ## - CATALOGING SOURCE | |
| Original cataloging agency | CstmoR |
| Transcribing agency | CstmoR |
| 043 ## - GEOGRAPHIC AREA CODE | |
| Geographic area code | n-us--- |
| 050 00 - LIBRARY OF CONGRESS CALL NUMBER | |
| Classification number | UB403 |
| Item number | .S58 1994 |
| 100 1# - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Anderson, Mary E. |
| Relator term | author. |
| 245 10 - TITLE STATEMENT | |
| Title | Evaluation of the CHAMPUS Reform Initiative. |
| Number of part/section of a work | Vol. 6, |
| Name of part/section of a work | Implementation and operations / |
| Statement of responsibility, etc | Mary E. Anderson, Susan D. Hosek with Ellyn S. Bloomfield. |
| 264 #1 - PRODUCTION, PUBLICATION, DISTRIBUTION, MANUFACTURE STATEMENTS | |
| Place of production, publication, distribution, manufacture | Santa Monica, CA : |
| Name of producer, publisher, distributor, manufacturer | RAND, |
| Date of production, publication, distribution, manufacture | 1994. |
| 300 ## - PHYSICAL DESCRIPTION | |
| Extent | xiii, 78 pages : |
| Other physical details | illustrations ; |
| Dimensions | 28 cm |
| 336 ## - CONTENT TYPE | |
| Content Type Term | text |
| Content Type Code | txt |
| Source | rdacontent |
| 337 ## - MEDIA TYPE | |
| Media Type Term | computer |
| Media Type Code | c |
| Source | rdamedia |
| 337 ## - MEDIA TYPE | |
| Media Type Term | unmediated |
| Media Type Code | n |
| Source | rdamedia |
| 338 ## - CARRIER TYPE | |
| Carrier Type Term | online resource |
| Carrier Type Code | cr |
| Source | rdacarrier |
| 338 ## - CARRIER TYPE | |
| Carrier Type Term | volume |
| Carrier Type Code | nc |
| Source | rdacarrier |
| 500 ## - GENERAL NOTE | |
| General note | "National Defense Research Institute." |
| 500 ## - GENERAL NOTE | |
| General note | This is the sixth volume in a series of 6 reports from the CHAMPUS Reform Initiative evaluation. |
| 500 ## - GENERAL NOTE | |
| General note | This project "conducted ... by RAND's Health Sciences Program and Defense Manpower Research Center"--Preface. |
| 504 ## - BIBLIOGRAPHY, ETC. NOTE | |
| Bibliography, etc | Includes bibliographical references. |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc | Health care utilization and costs under managed care are evaluated in this report. As part of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) Reform Initiative (CRI) demonstration, conducted from 1988 to 1993 in California and Hawaii, this report includes estimates of the effects of CRI on utilization levels and costs for CHAMPUS beneficiaries. It also explores differences within CRI between beneficiaries who elected to enroll in CHAMPUS Prime, an HMO option offered by CRI, and those who did not enroll. The authors conducted two mail surveys of CHAMPUS beneficiaries, (beneficiaries include dependents of active-duty military personnel, and retired military personnel and their dependents) one shortly before CRI began and another two years later. They then compared data from both surveys in the eleven military hospital catchment areas with eleven matched control areas in different states. The authors found that for the average adult beneficiary, costs to the government were 9 percent higher with CRI. Compared to the non-CRI program, costs were 57 percent higher for Prime enrollees, whereas they were the same for non-enrollees. Prime enrollees' use of outpatient care accounted for almost all of the utilization increase in CRI. Active-duty spouses who enrolled did not change their military treatment facility (MTF) use, but they were more likely to augment their MTF care with civilian care. Retired enrollees were more likely to use both MTF care and civilian care. CHAMPUS inpatient utilization was lower in CRI, as is often the case in managed-care programs, whereas use of MTF inpatient services did not change significantly. These findings suggest that CRI was able to increase access, especially to civilian care, with an accompanying increase in costs. The evidence points to high utilization among Prime enrollees, especially for retired beneficiaries. First-dollar coverage in Prime increased the costs of care that would have been used even without CRI, thereby adding to the amount of care demanded. The cost containment features in CRI, such as utilization review, were not able to counteract the added costs in Prime and the higher administrative overhead for the program. |
| 530 ## - ADDITIONAL PHYSICAL FORM AVAILABLE NOTE | |
| Additional physical form available note | Also available on the internet via WWW in PDF format. |
| 588 ## - | |
| -- | Description based on print version record. |
| 610 10 - SUBJECT ADDED ENTRY--CORPORATE NAME | |
| Corporate name or jurisdiction name as entry element | United States. |
| Subordinate unit | Office of Civilian Health and Medical Program of the Uniformed Services. |
| 650 #0 - SUBJECT ADDED ENTRY--TOPICAL TERM | |
| Topical term or geographic name as entry element | Military dependents |
| General subdivision | Medical care |
| Geographic subdivision | United States. |
| 700 1# - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Hosek, Susan D. |
| Relator term | author. |
| 700 1# - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Bloomfield, Ellyn S. |
| Relator term | author. |
| 710 2# - ADDED ENTRY--CORPORATE NAME | |
| Corporate name or jurisdiction name as entry element | Defense Manpower Research Center. |
| 710 2# - ADDED ENTRY--CORPORATE NAME | |
| Corporate name or jurisdiction name as entry element | National Defense Research Institute (U.S.) |
| 710 2# - ADDED ENTRY--CORPORATE NAME | |
| Corporate name or jurisdiction name as entry element | Rand Corporation. |
| Subordinate unit | Health Sciences Program. |
| 710 1# - ADDED ENTRY--CORPORATE NAME | |
| Corporate name or jurisdiction name as entry element | United States. |
| Subordinate unit | Office of the Assistant Secretary of Defense (Health Affairs) |
| 856 41 - ELECTRONIC LOCATION AND ACCESS | |
| Link text | Online Access |
| Uniform Resource Identifier | <a href="http://www.rand.org/pubs/reports/R4244.6/">http://www.rand.org/pubs/reports/R4244.6/</a> |
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