Return to
    Short Course


 TRICARE
     Sites


 Group 2
     members

  Return to
     OU  homepage

"The creators of the TRICARE program were probably fooled into thinking the benefits of TRICARE options would sell themselves to the military population. However, according to Rogers (1983), most innovations diffuse at a slow rate. Coleman, Katz, and Menzel (1966), found that people tend to resist medical changes and new innovations in treatment and care.

"Naval Hospital Twenty-nine Palms, Calif., has found this ‘face-to-face’ interaction to be the best way of informing people about the TRICARE options. In addition to the normal unit briefings, press releases, and handing out brochures and flyers, Naval Hospital Twenty-nine Palms requires all newly reporting personnel to the Marine Corps Air Ground Combat Center to check in through the hospital’s TRICARE Service Center or at the satellite service center in the Village Center, for a one-on-one TRICARE briefing."

Analysis:

     The communications theory model used for this project is Diffusion of Innovations with the main element being innovation (TRICARE), communicated through certain channels (brochures, booklets, briefings, video, press releases, etc.), over time (during the regional phase-in process), and among members of a social system (the military).

     This paper primarily focuses on a TRICARE pamphlet distributed to military retirees and sees if it follows the characteristics of innovations as stated by Rogers (1983) for a successful adoption of the innovation of TRICARE. This project will look at the TRICARE pamphlet distributed to retirees and do a systematic analysis using the five attributes of innovation as variables. The five attributes of innovation are (1) relative advantage, (2) compatibility, (3) complexity, (4) reliability (triability), and (5) observability. Will writing the new beneficiaries pamphlet following the five attributes of innovation bring about a better rate of adoption of TRICARE by military retirees? This project hopes to show that the theoretical perspectives of Diffusion of Innovations can bring about a better adoption rate among military retirees.

     Diffusion of Innovation fits the purpose of this research project because as stated by Rogers (1983) diffusion is a sort of social change, defined as the process by which alteration occurs in the structure and function of a social system (in this case the military). The creators of the TRICARE program were probably fooled into thinking the benefits of TRICARE options would sell themselves to the military population. However, according to Rogers (1983), most innovations diffuse at a slow rate. Coleman, Katz, and Menzel (1966), found that people tend to resist medical changes and new innovations in treatment and care. They concluded that people resist change in medical practice without regard for whether or not the change will be beneficial, because they resist change of new innovations in general. Coleman et al. (1966), point out there are examples throughout history to support this trend. For example, there was considerable resistance to Louis Pasteur’s vaccination ideas, but ultimately his ideas and innovations in the field led to the eradication or prevention of many infectious diseases.

     The adaptation of a new innovation is part of the diffusion process (Coleman et al., 1966). People are also more inclined not to accept the innovation readily if it doesn’t have an immediate impact on them. Innovations do not necessarily sell themselves (Rogers, 1983). For example, until a person is in need of medical care, they will not pursue the acceptance of the innovation of TRICARE until it becomes necessary for them to receive the care (Rogers, 1983). Diffusion is a social change in a social system, in this case TRICARE. If a person had not accepted the innovation and not signed up for the right type of care, they may be denied health care in a military system and forced to go to a public system.

     For any innovation there are five characteristics: relative advantage, compatibility, complexity, triability, and observability. The nationally available pamphlet that explains TRICARE to beneficiaries who are retirees, for example, fails in following the theory of diffusion of innovations because it fails to promote any advantages to the individuals of accepting the new system. The information in the pamphlet further alienates beneficiaries by comparing it to the old CHAMPUS system, which some people view as a failed medical system. This comparison shows compatibility, but to a system which people do not like. Furthermore, although TRICARE is a relatively easy to understand program, the pamphlet is worded in such a way that people perceive it to be difficult, therefore it has a high perceived complexity. Because people do not seek information on a medical innovation until they require care, the characteristic of triability is not possible. TRICARE did not allow people a trial visit first, they were simply presented with the innovation and asked to choose among its options without first trying any of them. This further leads the beneficiaries toward the road of non-acceptance. Finally, the results (observability) to which the TRICARE plan is successful is not visible to other beneficiaries.

     So if this is such a great way for health care to go, why do people resist TRICARE and why is there a perception of TRICARE as a worthless system? Research has found that mass media does have an effect on people, however, people’s attitudes and beliefs can best be attributed to their interaction on a face-to-face level with other people. Naval Hospital Twenty-nine Palms, Calif., has found this ‘face-to-face’ interaction to be the best way of informing people about the TRICARE options. In addition to the normal unit briefings, press releases, and handing out brochures and flyers, Naval Hospital Twenty-nine Palms requires all newly reporting personnel to the Marine Corps Air Ground Combat Center to check in through the hospital’s TRICARE Service Center or at the satellite service center in the Village Center, for a one-on-one TRICARE briefing. This gives eligible personnel a face-to-face education about the benefits of TRICARE and helps the individual make a choice that will best suit his or her family. This method of communication enables Naval Hospital Twenty-nine Palms to enjoy a TRICARE Prime enrollment rate of 76 percent of eligible active duty family members and 36 percent of eligible retirees for an overall enrollment rate of 63 percent, with 98 percent of those enrolled choosing the hospital as their Primary Care Manager. These figures are the highest in Navy medicine.

     This approach helps address the five characteristics of diffusion of innovations and helps beneficiaries to adopt the innovation faster than if they were left alone to chance and pamphlets. While the information put out by the TRICARE marketing office is good, it uses the wrong principles to get TRICARE as an innovation in health care accepted.