The military provides health services to dependents and retirees both through the on-base military health system—Military Treatment Facilities (MTFs), and through the private health care system—CHAMPUS (Civilian Health and Medical Plan for the Uniformed

PREFACE The military provides health services to dependents and retirees both through the on-base military health system—Military Treatment Facilities (MTFs), and through the private health care system—CHAMPUS (Civilian Health and Medical Plan for the Uniformed Services). Because the average cost per visit has been estimated to be less in the MTFs, it has been suggested that increasing MTF staffing levels might draw into the MTFs patients who otherwise would use CHAMPUS, thereby decreasing total military health expenditures. This report addresses this assumption. The report uses data on variation in staffing levels between FY 1988 and FY 1992 to generate estimates of the effects of increasing MTF staffing on the utilization of MTF care and on the utilization of CHAMPUS care. Two considerations are examined that might diminish the projected cost savings. First, increased staffing levels may yield a less-than-proportional increase in patients served. Second, with better care available in the MTFs, total utilization may increase. The findings of this study will be of special interest to government and other agencies concerned with the efficient use of resources in the military health care system.-v