Compensation Commission cites US Family Health Plan as Important Example of Population Health Management for DOD

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Arlington, VA – The Final Report of the Military Compensation and Retirement Modernization Commission calls the U.S. Family Health Plan (“USFHP”) “An important example” of how to use “nonprice tools to manage patient care.” The commission recommends the US Family Health Plan continue to be among the health care choices available to military families in a new OPM-administered program.

“The Commission has reaffirmed USFHP as a provider of high quality care that improves health and keeps people out of the hospital,” said Jim Schweiter, Chief Executive Officer for US Family Health Plan Alliance. “The Commission’s recognition of USFHP as an example of care management practices that the rest of TRICARE should emulate is very gratifying.”

“Population health management is the direction of future medical care in the United States. We are pleased that the Commission recognized this trend as it considered the future of the TRICARE health benefit,” said David Howes, president of Martin’s Point Health Care, a US Family Health Plan member and chair of the Alliance’s board of directors. “The Commission also recognized the value of the US Family Health Plan in using tools to avoid inpatient admissions, prevent readmissions and shorten hospital stays. The US Family Health Plan is renowned for providing high quality health care to beneficiaries. As everyone familiar with this plan knows, patient satisfaction among its members has long been among the highest in the Department of Defense health care system.”

In its report, the Commission recognized the USFHP program for its use of “population health” managed care techniques which include “disease management, wellness, and better coordination of care.” The commission report notes that compared to TRICARE Prime, USFHP participants, have 33 percent fewer inpatient days and 28 percent fewer emergency room visits than other TRICARE Prime enrollees.

The commission commended USFHP for “identifying high-risk patients, managing complex cases, keeping chronic diseases under control, and promoting wellness and preventative services.” As a result of the success of the USFHP program’s managed care techniques, the Commission recommended that the program continue in the new system of care proposed in its report.

About the US Family Health Plan

The US Family Health Plan is among the health care choices for eligible beneficiaries of the Department of Defense’s TRICARE Prime program. Health care is provided to active-duty family members, including activated National Guard and Reserve family members, and retirees and their family members. Care is provided through large, local civilian health care networks of primary care physicians, hospitals and affiliated specialists. Patients choose a primary physician who provides and coordinates care and referrals to specialists and hospitals. The US Family Health Plan Alliance is the association that represents the collective interests of the regional USFHP networks in interactions with Congress, the Department of Defense, and the private sector.

Contact: Jim Schweiter,

US Family Health Plan Alliance
Jim.Schweiter@usfhp.com

US Family Health Plan Reduces Need for Emergency Care and Hospitalization

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The sponsoring organizations of the US Family Health Plan program, highly experienced providers of high quality health care in the Military Health System, have successfully reduced the need for care in two key and costly areas.

The US Family Health Plan is a TRICARE Prime option that focuses on keeping patients well by identifying disease risk early, taking the necessary interventions, and coordinating services through a primary care manager. This managed care approach ensures care is provided in the most clinically appropriate, least expensive, and safest setting.

“The managed care approach used by the US Family Health Plan gives patients the care they need when and where they need it so that they stay as healthy as possible. We do everything we can to optimize patient wellness and to achieve positive long term health outcomes,” said David Howes, M.D., president and chief executive officer of Martin’s Point Health Care, one of the six US Family Health Plans.

According to an independent actuarial analysis, when compared to the TRICARE Prime program as a whole, adult US Family Health Plan members under age 65 spent 33 percent less time in the hospital and visited the emergency room nearly 25 percent less often than other adult Prime members. Thus, US Family Health Plan members utilize inpatient and emergency care less frequently than other TRICARE Prime beneficiaries. Importantly, US Family Health Plan member patient satisfaction rates continue to be among the highest in the nation and among Department of Defense beneficiaries.

“The US Family Health Plan program continues to demonstrate that its innovations, high quality primary and specialty medical care, and attention to customer service add value to the Military Health System,” said Henry J. “Jim” Schweiter, chief executive officer of the US Family Health Plan Alliance. “It is a privilege for the Designated Providers of the US Family Health Plan to serve our uniformed services families. They have sacrificed a great deal for our country.”

About the US Family Health Plan:

An integral part of health care provided to uniformed services dependents and retirees since 1981, the US Family Health Plan program is part of the Military Health System, offering the TRICARE Prime benefit in 16 states and the District of Columbia. The US Family Health Plan was the first and remains the only true population health/managed care model in the Military Health System. The six fully accredited, community-based health care systems, known as designated providers, include Brighton Marine Health Center, Christus Health, Johns Hopkins Health Care, Martin’s Point Health Care, Pacific Medical Centers, and St. Vincent Catholic Medical Centers.