Written by Lynn Goya

As more of the new national healthcare plan falls into place in 2011, people may not realize that it is modeled after a plan that has a 91 percent satisfaction rate among its members: U.S. veterans and their families.  The US Family Health Plan is a comprehensive healthcare plan available to over 100,0000 activated Guard and Reserve members, military retirees and their dependents through TRICARE Prime at select community-based hospitals and physician networks in the northeast, Texas and Washington state. 

US Family Health Plan members rated their satisfaction with their care dramatically higher than health care recipients in the civilian world.  In 2010, an independent study found that of the 4,781 military members surveyed on broad-based healthcare metrics scored, on a scale of 100, 28 points higher than those within the 224 other plans surveyed.

“Compared to the Quality Compass, US Family Health Plan members report significantly higher satisfaction with customer service, claims processing, how well their doctors communicate with them, the ability to get needed care, and get that care quickly,” says David Bahlinger, director of analytics and research for The Myers Group of Snellville, Ga., an NCQA-certified HEDIS survey vendor that administered the study of the health plan members. Only 62.7 percent of those in other health care plans report a high satisfaction with their care in the National Committee for Quality Assurance (NCQA) 2010 Quality Compass Report.

Mary Cooke, chairman of the US Family Health Plan Alliance, explained that:

 “We are committed to delivering high value to military beneficiaries and to the DOD by focusing on the needs of our members and engaging them in programs aimed at staying healthy. While we provide intensive disease management services to our members with multiple or chronic health conditions, through wellness and prevention programs, our goal is to inspire and engage our members to live healthy lifestyles today, and minimize their chances of developing chronic conditions years down the road. We’re proud that, for 16 years in a row, our members have validated through independent surveys that they are highly satisfied with their healthcare. But it’s never been about survey results for us — it’s about the people. We believe our military families deserve the best care we can provide — it’s that simple.” 

Other VA healthcare plans also consistently rate among the highest in patient satisfaction. The VA model of care and commitment to patient satisfaction inspired many of the details within the new healthcare law, although TRICARE did not offer dependent care up to age 26 until modifications were signed into law in December, 2010.

Key provisions that civilians will now benefit from through the Sept. 23, 2010 Patient Protection and Affordable Care Act (PPACA) that veterans have enjoyed for years include:

• Restrictions on annual limits, lifetime maximums, and high user cancellations;
• Denial of coverage for pre-existing conditions;
• Ban on lifetime caps.

Unlike civilians, however, veterans, active duty families and military retirees pay little in annual or monthly fees and pay nothing for medical care while active duty service members.