washingtonscene Pays Doctor
2018 $100 2019 $102 2020 $103 2021 $105 2022 $106 2023 $108 2024 $109 2025 $111 2026 $113 2027 $114 2028 $116
* TRICARE
Patient Pays*
$25 $26 $28 $29 $31 $32 $34 $36 $38 $39 $42
Cost Share 25%
26% 27% 28% 29% 30% 31% 32% 33% 35% 36%
If adjusted by annual National Health Expenditures index (5.2 percent a year) as the FY 2017 budget proposes.
means your cost share (20 percent of al- lowed charges for active duty families; 25 percent for retirees) has risen slowly as well. But what if your payment is switched to a flat fee that is adjusted subsequently at the rate of 5.2 percent a year, as envi- sioned in the defense budget proposal? At that rate, your cost would double in about 11 years — much faster than Medi- care and TRICARE payments to doctors have grown. Let’s assume your doctor bill is $100.
Your TRICARE Standard cost share as a retiree under 65 today is 25 percent of that, or $25. That’s exactly the flat fee the new budget proposals envision for an in-network primary care visit in 2018. But how would that change over time? Let’s assume your $100 Medicare/ TRICARE payment to the doctor grows at 1.5 percent a year — which is faster than it actually has grown in the past. In 10 years, the TRICARE payment to the doctor would be $116, but your $25 flat fee would have grown to $42 — and instead of paying 25 percent of the doctor bill, your share would be 36 percent.
Patient
No matter what you think of the initial fee changes, the biggest potential effect of these proposals, if enacted, might be how much faster they would escalate your health care costs over 20 to 30 years. Suffice to say, time would not be on your side from that perspective.
VA Budget Boost
Draws Attention The FY 2017 budget supports more transformational change.
T
he VA fared well in the adminis- tration’s proposed FY 2017 budget. The $182.3 billion budget represents
nearly an 86-percent increase in the VA’s budget since 2009. This builds on VA Secre- tary Bob McDonald’s MyVA transformation initiative, which aims to make the depart- ment’s health and benefits systems more responsive to veterans and their families. Much of the VA’s budget — $103.6 billion
— covers veterans’ disability compensation and pensions. For the first time, thanks to Congress’ new statutory mandate, the VA’s budget includes $103.9 billion in advance appropriations for 2018, largely to protect veterans’ payments from stopping should the government shut down. The remaining $78.7 billion funds
mostly health care programs and ser- vices, an almost 5-percent increase from this year. The budget also includes $70 billion for medical advance appropria- tions in 2018. Some lawmakers are skepti- cal about the VA’s growing cost and doubt the department will be able to fix system- ic problems that remain. “This budget request is almost double
the VA budget in 2009, and since then, the VA has been plagued by scandals and mis- management and has consistently proven its inability to use its existing resources,”
*on the web: Inim voluptat elit utpating ex etuerci eu feum eum aliquating ese feugait APRIL 2016 MILITARY OFFICER 39
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