CHAMPUS psychiatric inpatient savings: military management versus contractor, the Fort Polk experience.

Inpatient psychiatric costs were a significant part of the CHAMPUS bill at Bayne Jones Army Community Hospital. With implementation of Gateway to Care, a case management program was developed for intervention. In May 1993, Foundation Health Federal Services Inc. began a modified CHAMPUS Reform Initiative program providing an opportunity to retrospectively analyze two methods of managed care. Civilian hospital inpatient admissions for both programs during fiscal year (FY) 1993 were compared to corresponding periods in FY 1992. Under the case management program, admissions were reduced by 67%, occupied bed days by 74%, and costs by 76%. Under the Foundation Health Program, admissions were reduced by 13%, occupied bed days by 15%, and total costs by 42%. Both methods achieved savings over standard CHAMPUS. In spite of constraints that Foundation Health did not have, the case management program appeared to be more effective, demonstrating that a managed health care program directed by the hospital commander can significantly reduce costs.