Tricare Health Plans

TRICARE Health Plans is the replacement for CHAMPUS which was the provider of health care services for military dependents. TRICARE not only replaced CHAMPUS but its purpose was also to facilitate members with access to better health care. Unfortunately, TRICARE has gone through many changes and upheavals since its inception in 1997. First, they began by dividing the company into regions. Each member was placed into a region based on where the military member was stationed. If the member was stationed in Maryland then his family belonged to the East Region. Unfortunately, there were many problems with this plan. First, some military members and their families did not live in the same regions. Therefore, the families either had to travel long distances for care or had to fight for an out of region referral. Next, if the member and their family were in the process of moving from one duty station to another, they were in limbo. They still belonged to the original region and would not be transferred until the member was input into the new duty station's database. This caused problems as it was virtually impossible for members to acquire a referral for emergency care during their move.

Essentially, TRICARE Health Plans is struggling to keep their customers happy. The attached report recommends a complete overhaul in the following areas: 1. organization design, 2. work design 3. management and leadership, 4. reversal and minimized power and organization politics, 5. quality assurance implementation, and 6. organization strategies. Based on current surveys, these changes would improve customer satisfaction and reduce lost profits due to high organizational turnover rates. Finally, TRICARE has taken several steps throughout their organization in order to ensure that their medical plans are more in line with the competitive medical health plans that are readily available.

Table of Contents

Cover Page 1

Executive Summary 2

Table of Contents 3

Body

Introduction 4

Organization Design 5

Work Design 6

Management versus Leadership 7

Power and Politics 9

Quality Assurance 9

Organizational Strategies 11

Conclusion and Recommendations 13

References 15

TRICARE Health Plans: Final Project

Introduction

The company I have chosen to work for is TRICARE Health Plans. This company is the insurance provider for military and their families. Several years ago, the U.S. Department of Defense came to the conclusion that it was cheaper and more efficient to utilize contracted civilians to provide health services for military members and their families. Due to the overwhelming costs of maintaining military clinics and hospitals combined with the shortages of qualified staff, the United States Government made the decision to close many of the Military Treatment Facilities and contract a civilian company to provide health care insurance that would be governed by the Department of Defense.

TRICARE has had many learning curves to overcome. In the beginning, the contractors were not prepared to handle the amount of members that serve the United States Military. Also, they were unprepared for the multitude of health issues that were plaguing the families. One such issue was the Gulf War Syndrome which the United States Government was attempting to cover up. Over the years, their service to members has improved but has a long way to go in order to compete with some of the private health insurance plans that are available. Many families who have major health issues find it more convenient to pay for private health insurance. This also allows for those families to get care without going through the bureaucracy and red tape that surrounds TRICARE's policies.

However, not all has been lost. TRICARE is striving to succeed in providing optimal care for their members. They have taken the initiative to enact new policies and benefits that allow for members to see many private and local physicians and dentists. This has had a great impact on how TRICARE is being perceived not only by their members but also the surrounding communities.

Organization Design

According to Shortell and Kaluzny (2003), organization design is the way the building blocks of an organization are arranged in order to ensure improved effectives and capacity (p. 275). The building blocks are authority, responsibility, accountability, information, and rewards. All of these affect both the internal stakeholders and the external stakeholders of an organization. To ensure profitability and overall employee satisfaction, the organization design must meet the needs of the organization.

In TRICARE's infancy stage, they struggled with the design process. Their views of change were not made important