![]() ![]() In addition to care delivered through Military Treatment Facilities (MTFs), the MHS provides care in the private sector using the TRICARE benefit. The MHS serves approximately 9.6 million beneficiaries, of whom approximately 17% are active-duty service members from every military branch, with the remainder being nonactive-duty dependents and retirees, representative of the US population. The MHS is unique in the United States in that it offers universal health coverage with no or low premium and low or no copayments. Little is known about how a consumer would choose a health plan if cost was not an option such as in the Military Health System (MHS). 3, 4 As cost is a major component of health insurance in the United States, most of the literature looking at choice of a health plan is linked to cost. Apart from cost, consumers look for plans with choice of providers and high-quality primary care and specialty physicians. 2, 3 Evidence shows consumers are generally looking for a cost-benefit trade-off, specifically when it comes to premiums, deductibles, and maximum out-of-pocket spending caps. However, variability in both cost and quality and between health plans can make it difficult for beneficiaries to make an informed choice when given the opportunity. 1 Health insurance is usually obtained through employment, government sponsored programs, or the Health Insurance Marketplace established under the Affordable Care Act. In the United States, continuous health insurance is critical to ensure access to care and positive health outcomes. This evaluation of TRICARE beneficiaries explores how to motivate high-quality value-based care in a traditionally fee for service system. ![]() Four overarching themes emerged: (I) patient choice (II) access to care (III) quality of care and (IV) cost. The majority were women, above age 40, had a master's degree, a sponsor in the US Army and of senior officer rank. We interviewed a total of 20 TRICARE Prime and Select beneficiaries. We conducted inductive thematic analysis to determine key areas of concern. ![]() Using social media platforms, we recruited TRICARE Prime and Select beneficiaries to participate in key informant interviews from October to December 2022. We developed a semistructured interview guide by adapting a framework established by Klinkman to assess factors in choosing a health plan. We sought to identify how to recruit TRICARE beneficiaries into new pilot programs challenged by low recruitment. Little is known about how a consumer would choose a health plan if cost was not an option such as in the Military Health System. ![]()
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