Summary

In response to a congressional request, GAO analyzed the implications of imposing a user fee for outpatient visits to Department of Defense (DOD) medical treatment facilities by non-active-duty beneficiaries.

GAO estimated that, if DOD had imposed a $5 user fee in fiscal year 1984, it could have generated net revenue of between $231 million and $467 million for the 5-fiscal-year period 1984 to 1988, depending on the work load unit on which the fee was imposed. DOD believes that a user fee would cause work load shifts from DOD to the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). There were no data to precisely determine what user fee at DOD facilities would be comparable to the charge CHAMPUS beneficiaries pay. GAO believes that imposing a user fee on non-DOD uniformed service facilities should be considered in structuring a user fee program, because if a fee were to be imposed only at DOD facilities, beneficiaries could use the other uniformed service facilities to avoid paying a fee.