Consortium on Chronic Illness: Improving Health Care Experiences and Quality of Care among Military Health System Beneficiaries Living with Chronic IllnessObjective: The purpose of this study is to facilitate research on complex chronic illness of MHS beneficiaries by developing a cooperative program of health care research with the Consortium on Complex Chronic Illness, Quality and Equity. The inaugural program of study under this task order is to use MHS data to provide comparative reports on prevalence and strategies for effective treatment of 8 chronic illnesses selected from the IOM “priority areas”: Asthma, Severe mental illness, Diabetes, Stroke, Hypertension, Tobacco dependence, Major depression and Ischemic heart disease. The objectives were to: Compare TRICARE patients with VA, Medicaid and Commercial Insurance; Assess frequency of key adverse events (i.e., hospitalization, readmission); Calculate average per person annual expenditures; and, Conduct more in-depth analysis of one condition, diabetes.
Results: While TRICARE patients had a relatively high prevalence of hypertension, tobacco dependence and asthma compared to other patient populations studied, TRICARE often achieved superior results in managing care while controlling program costs. For the eight conditions studied and when compared to the care of veterans within the VHA, Medicaid enrollees in five states, and a large national sample of commercial insurance enrollees, TRICARE performed well on a number of indicators: 1. TRICARE had the lowest hospitalization rates and among the lowest costs of care for patients with hypertension., 2. Across all seven conditions among which readmission rates were assessed, TRICARE readmission rates were consistently among the lowest. 3. TRICARE also achieved superior performance on providing regular eye exams for diabetic patients. Expenditures varied significantly across populations for all conditions studied. For all disease cohorts, except diabetes and ischemic heart disease, TRICARE total average annual per person expenditures were either the lowest or were similar to the VHA. With the exception of IHD, TRICARE had drug expenditures that were either similar to or lower than the VHA or the commercially insured.