FALLS CHURCH, VA –
The Department of Defense announced the selection of new TRICARE Managed Care Support contractors for the North, South and West TRICARE regions in the United States July 13.
This is the third generation of TRICARE managed care support contracts. The contracts are worth an estimated $55.5 billion over the base and five options periods. Transition from the current contracts is scheduled to begin immediately, while the start of health care delivery under the new contracts is projected to be April 1, 2010. The transition will occur during the base period and health care delivery will begin with the first option.
The TRICARE West region retains its current contractor, TriWest Healthcare Alliance Corp. The selected contractors in both North and South are new.
Aetna Government Health Plans, Hartford, Conn., is selected for the North Region, where Health Net Federal Services is the current contractor. UnitedHealth Military & Veterans Services, Minnetonka, Minn., is selected for the South Region, where Humana Military Healthcare Services is the current contractor.
TRICARE Management Activity is the Defense Department activity, which administers the health care plan for 9.4 million service members, retirees and their families worldwide. MCS contractors provide health, medical and administrative support services to eligible beneficiaries in each of the three TRICARE regions within the United States.
"We expect all of our managed care support contractors to provide top quality health care and the highest possible customer satisfaction," said Ellen Embrey, who is the acting director of TMA and is also performing the duties of the assistant secretary of defense for health affairs. "Delivering quality health care to our nation's heroes and their families is our number one priority - with a special emphasis on our wounded warriors."
"Our military hospitals and clinics continue to be at the center of our health care delivery system," said TMA Deputy Director Rear Adm. Christine Hunter. "At TRICARE we are fully committed to augmenting that system with high quality care for all beneficiaries."
Although two new contractors have been selected, the three-region structure in the United States and all of the TRICARE benefit options offered under the current contracts remain the same.
The Third Generation of TRICARE Contracts, or T-3, feature financial incentives to encourage exceptional customer service; high quality care; detection of fraud, waste and abuse; increased electronic claims processing; better program management, improved preventive care and cost savings. To apply these incentives fairly, TRICARE has improved methods to measure and assess network provider, beneficiary and military treatment facility commander satisfaction.
As with the current contracts, the new contracts require prime service areas around Military Treatment Facilities and Base Realignment and Closure sites. Under T-3, some prime service areas may be discontinued, and as a result some beneficiaries will no longer be offered the Prime option. These beneficiaries still retain TRICARE coverage under the Standard or Extra plans. TRICARE Standard is the most flexible of the TRICARE options and is available everywhere. TRICARE Extra is a discount given to TRICARE Standard beneficiaries when they use a TRICARE network provider. Officials remind beneficiaries both TRICARE Prime and Standard are excellent options with high satisfaction rates.
"TMA and all the managed care contractors are dedicated to making a smooth transition with minimal impact on beneficiaries," said Admiral Hunter. "We will ensure that key information flows to all of our beneficiaries and stakeholders, in particular those affected by the changes in contractors or providers."