Congress is questioning a Defense Department plan to make military healthcare facilities share some of the risk of managed-care contracts.
House-passed defense budget legislation instructs the Pentagon to cancel plans to make military hospitals and healthcare facilities nationwide share with private-sector contractors some of the risk of managing care for military dependents and retirees under 65 enrolled in the military's Tricare managed-care plans.
Instead, the House urges that the risk-sharing arrangement-which calls for military healthcare facilities to receive capitated budgets to cover Tricare enrollees-be tested in just one region.
The Senate, meanwhile, wants to appoint a working group of military officials and managed-care experts to evaluate the risk-sharing arrangements. Then the plans could be implemented first in areas under two managed-care contracts, comprising 20 states in the Northeast, mid-Atlantic and Midwest, that are not yet covered by Tricare contracts.
If cost-effective in those states, the Senate recommends expanding risk-sharing agreements to the rest of the regions for which contracts already have been awarded.
The Defense Department already has signed Tricare contracts worth more than $8 billion over five years. The Pentagon expects to cover most of the 5.9 million eligible military dependents and retirees by the end of federal fiscal 1997.