Data Sources

1. Data Sources Health Care Survey of DoD Beneficiaries (HCSDB) The HCSDB was developed by the TRICARE Management Activity to fulfill 1993 NDAA requirements and to provide a routine mechanism to assess TRICARE eligible beneficiary access to and experience with the Military Health System (MHS) or with their alternate health plans. Conducted continuously since 1995, the HCSDB was designed to provide a comprehensive look at beneficiary opinions about their DoD health care benefits (source: TMA Web site: www.tricare.osd.mil/survey/hcsurvey/). Note: “CAHPS” is no longer correct at this site. The HCSDB is composed of two distinct surveys, the Adult and the Child HCSDB, and both are conducted as large-scale mail surveys. The worldwide Adult HCSDB is conducted on a quarterly basis (every January, April, July, and October). The worldwide Child HCSDB is conducted once per year, from a sample of DoD children age 17 and younger. Both surveys provide information on a wide range of health care issues such as the beneficiaries’ ease of access to health care and preventative care services. In addition, the surveys provide information on beneficiaries’ satisfaction with their doctors, health care, health plan, and the health care staff’s communication and customer service efforts. The HCSDB is fielded to a stratified random sample of beneficiaries. In order to calculate representative rates and means from their responses, sampling weights are used to account for different sampling rates and different response rates in different sample strata. Beginning with the FY 2006 report, weights were adjusted for factors such as age and rank that do not define strata but make some beneficiaries more likely to respond than others. Because of the adjustment, rates calculated from the same data differ from past evaluation reports and are more representative of the population of TRICARE users. HCSDB questions on satisfaction with and access to health care have been closely modeled on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program. CAHPS is a standardized survey questionnaire used by civilian health care organizations to monitor various aspects of access to, and satisfaction with, health care. CAHPS is a nationally recognized set of standardized questions and reporting formats that has been used to collect and report meaningful and reliable information about the health care experiences of consumers. It was developed by a consortium of research institutions and sponsored by the Agency for Health Care Policy and Research (AHRQ). It has been tested in the field and evaluated for validity and reliability. The questions and reporting formats have been tested to ensure that the answers can be compared across plans and demographic groups. Because the HCSDB uses CAHPS questions, TRICARE can be benchmarked to civilian managed care health plans. More information on CAHPS can be obtained at https://www.cahps.ahrq.gov/default.asp. Results provided from the HCSDB are based on questions taken from the CAHPS Version 3.0 Questionnaire (for 2008 and part of 2009) and the CAHPS Version 4.0 Questionnaire. Rates are compared with the most recent benchmarks of the same version available at the beginning of the survey year. Appendix 129