US Family Health Plan: Providing High Quality, Cost Effective

Healthcare to Military Beneficiaries

By: Marshall Bolyard, Executive Director, US Family

Health Plan, CHRISTUS Health

US Family Health PlanBackground & Historical

Perspective

Origins1981:• PL 97-34 transferred ten US Public Health

Service (PHS) hospitals and clinics to private, not-for-profit healthcare entities

• PL 97-99 designated these former PHS facilities as Uniformed Services Treatment Facilities (USTFs)

Origins1989:• Congress requests the development of a

managed care delivery system1993:• US Family Health Plan is born1997:• USTFs become designated providers and

made a permanent part of the MHS

Alliance of Designated Providers

Model, Measures & Reasons for Success

Model• Managed care / coordinated care• Capitation• Fully at risk• Commercial & Medicare population• Access to government prices for

pharmacy

MeasureThe best measure of our success is the

consistently high levels of patient satisfaction

Member Satisfaction87%85.5% 87.7% 86% 88.6% 86.1%

62%57% 56.7% 59.3% 61.8% 61.3%

0102030405060708090

100

2000 2001 2002 2003 2004 2005

USFHPHMOs

Comparison to national averages for member satisfaction with HMOs(all percentages = proportion highly satisfied, rating plan 8 through 10 on a scale from 0 to 10, where 10 is the best possible plan)

Reasons for Success

Prime contributors to high rate of acceptance:• Population based care• Provider based care• Full risk for care• Care Management & Disease Management• Primary Care Manager• Customer Focus

Why this Model is a Good Model for the American Healthcare

System

Summary

• Intimacy between patient and provider• Focus on population health, not

fragmented care• Patient centric• Members for life