Summary: The Defense Department's (DOD) nationwide managed care program, called TRICARE, is intended to improve the access of military personnel and their families to health care while maintaining quality and controlling costs. DOD has entered into seven multistate managed care support contracts with civilian health care entities. Resource sharing is an important cost-saving aspect of these partnerships. To share resources, the contractor supplements the capacity of a military hospital or clinic by providing civilian personnel, equipment, and supplies. DOD estimates that resource sharing could save about $700 million over five years for these contracts. However, GAO found that DOD and the support contractors will realize only about five percent of the $700 million in projected savings. Problems impeding progress on resource-sharing agreements have included the lack of clear program policies and priorities, uncertainty about cost effects on military hospitals, lack of financial rewards for the hospitals entering into such agreements, and changes in military hospital capacities after contractors developed bids. DOD has revised policies, improved training and analytical tools, and taken other steps to promote resource sharing under the contracts, but so far these efforts have not brought needed results.
