Health Care Surveys: Analysis and Presentation of Findings

Prepared for
U.S. Department of Defense, Defense Health Agency

TRICARE provides coverage to over 9 million active duty and retired service members and their dependents. Beneficiaries receive coverage under a wide array of TRICARE health plans and many beneficiaries also carry coverage from other plans such as Medicare, the Veterans Administration, and civilian health insurance. To monitor the performance of this complex health system, the Defense Health Agency (DHA) uses the Health Care Survey of Department of Defense Beneficiaries (HCSDB) and the TRICARE Standard Survey (TSS). These ongoing surveys monitor beneficiaries’ perceptions about their health status, use of health services and insurance, access to care, satisfaction with care, and attitudes toward and enrollment in TRICARE. Furthermore, family members of active duty personnel, retirees and their dependents, and inactive and retired reservists and their families increasingly rely on civilian providers for health care services. The TSS evaluates whether these beneficiaries have adequate access to civilian providers.

Mathematica is working with the DHA to facilitate the implementation of these surveys, providing various support services. These services include sample and questionnaire design, reporting and research, weighting for nonresponse, data analysis, database construction, and documentation. The results from the HCSDB are presented in TRICARE Beneficiary Reports, an interactive report card format developed by Mathematica. The Consumer Watch report is a quarterly summary we produce for each region and service, accompanied by an Issue Brief that uses HCSDB data to address important policy issues in the Military Health System. Mathematica also prepares yearly Consumer Watch reports that summarize results for numerous military hospitals and clinics and an annual report summarizing HCSDB’s national-level findings.

The results from the TSS are presented in annual reports and a series of briefings to TRICARE stakeholders and DHA senior leadership. The annual TSS report presents combined results on TRICARE Standard/Extra users’ access to care and health care providers’ acceptance of new Standard/Extra patients. Results are presented separately for TRICARE Prime Service Areas (PSAs), non-PSAs, and market areas selected by stakeholders for closer scrutiny, with additional focus on areas with Selected Reserve concentrations and on the effects of market characteristics.

The annual TSS briefings provide TRICARE leadership with useful information regarding the study questions, methodology, findings, and implications. The briefing slides include comparisons, with statistical significance testing, of current survey results to both external and internal benchmarks and to survey results from previous years. Beneficiary briefing slides show comparisons between PSAs and non-PSAs of Standard/Extra use, and access to primary care physicians, specialists, and mental health providers. Graphics highlight areas with high and low reported access to providers of different types. Provider briefing slides show comparisons by provider type and between PSAs and non-PSAs of awareness of TRICARE, of acceptance of new Standard/Extra patients, and of acceptance of new patients with other coverage. Graphics highlight areas with high and low acceptance rates by providers of different types.

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