Impact of TriCare/Managed Care on Mirror Force Readiness


Name: Marilyn Ray

Rank: Col (ret.), USAF

Organization: Florida Atlantic University

Performance Site: 96th Medical Group, Eglin AFB, FL; TriCare Region 1, HQ, Washington, DC; TriCare Region 3, HQ, Fort Gordon, Georgia; TriCare Region 4, HQ,Keesler AFB, Mississippi

Year Published: 1998

Abstract Status: Final


United States Air Force mission readiness depends on a healthy Total Force and the response of the USAF Medical Service (Mirror Force). Managed care has become the norm in US health care. Although the transformation to a managed care system was expected to be completed by the year 2000, the system is in a constant state of change and evaluation. Cost management, health maintenance organizations (HMOs), and other health plans are defined as ΓÇÿmanaged care,' an aggressive cost-control effort by health care purchasers and insurers to limit health care spending and services and to advance a market-oriented, profit-driven system. The impact of managed care on mission readiness, retention of active and Reserve components, military medicine, and nursing is and will continue to be profound.Specific Aims: The purpose of this research was to conduct a phenomenological study of TriCare/managed care to: (a) explore the impact and the meaning of the experience on Total Force/Mirror Force mission readiness of the United States Air Force, and (b) elucidate how the initiation of managed care in military nursing is changing nursing practice.Long-Term Objectives:

    1. To respond to USAF/NC Chief, Brigadier General Linda Stierle's directive related to the "development of outcome studies to evaluate the impact of TRICARE..." and to include the evidence of the economics of health care (Stierle, 1996b, p. 3).
    1. To interpret the impact of TriCare/managed care on military nursing, clinical operations and Mirror Force.
    1. To lay the foundation for further development of evaluative studies.
    1. To contribute to the strategic planning and policy development of Air Force Medical Service Mirror Force.

Research Design and Data Analysis: A qualitative phenomenological study to interpret the meaning of TriCare/managed care was accomplished. By means of interviews and participant observation of human experiences and the organizational culture of a sample of active and Reserve personnel, readiness was explored as related to issues of health, health care benefits, and retention. One TriCare organizational region was examined in addition to civilian managed care environments. Data analysis was consistent with the tenets and research approaches of phenomenology. Thematic (interpretive meaning) analysis was done on all data. The results captured the meaning of the impact of TriCare/managed care on Total/Mirror Force readiness by identifying the strong role that economics is playing on Air Force active duty and Reserve forces' health and well-being.

Final Report is available on NTRL at: