MHS Beneficiary Self-Reported Assessment of the Adequacy of the TRICARE Standard Network - Issue Brief

Objective: A special study using Health Care Survey of DoD Beneficiaries (HCSDB) data to assess beneficiary acceptance of, or challenges with, accessing network providers.

Results: Beneficiaries covered by Standard/Extra are more likely to rate their health care highly than their health plan. The proportion giving their health plan a rating of 8 or above is 57 percent, which is below the NCBD benchmark, while the proportion rating their health care 8 or above now matches the benchmark at 76 percent. Like other TRICARE groups, the proportion of Standard/Extra beneficiaries who say they have a personal doctor is lower than the NCBD norm, in this case 83 percent, compared to 90 percent, as shown in Figure 13. The proportion who say they have no difficulty finding a personal doctor, also lies below the norm. Sixty-two percent report no difficulty in finding a personal doctor, compared to 67 percent in the NCBD. Eighty percent give their personal doctor a high rating, which exceeds the benchmark rate. Access to specialized care does not present particular problems for Standard/Extra users. Eighty-nine percent report no delays awaiting approval and 76 percent report no problems in seeing specialists, similar to civilian standards. The proportion giving their specialists high ratings is 79 percent, also similar to the NCBD benchmark. Standard/Extra users rate claims handling and customer service below civilian norms. The proportion that reports claims are usually or always handled correctly and the proportion reporting that claims handling is usually or always on time are both slightly below the civilian standard. The proportion reporting no problem with the customer service line is substantially below the benchmark. Cancer screening results show that Standard/Extra users receive Pap smears at a lower rate than the HP2010 goal, while mammography rates exceed that goal. Mammography rates and the prenatal screening rate were the same in 2003 and 2005, while Pap smear rates showed a slight decline.

Status: Complete

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