New TRICARE Regional Managed Care Support Contractors Selected

FALLS CHURCH, VA – The Department of Defense (DoD) announced today the selection of new TRICARE Managed Care Support (MCS) contractors for the North, South and West TRICARE regions in the United States.

This is the third generation (T-3) of TRICARE managed care support contracts. They are worth an estimated $55.5 billion over the base and five options periods. Transition from the current contracts is scheduled to begin immediately, with the start of health care delivery under the new contracts anticipated 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.

States included in each region and other contract information can be found at a special Web page at http://www.tricare.mil/T3contracts.

TRICARE Management Activity (TMA) is the Defense Department activity that administers the health care plan for 9.4 million members of the uniformed services, 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 T-3 contracts 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 (BRAC) sites. Under T-3, some prime service areas may be discontinued, and as a result some beneficiaries will no longer be offered Prime. These beneficiaries still retain TRICARE coverage under the Standard or Extra plan. 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 that 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 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.”

About TRICARE Management Activity and the Military Health System
TRICARE Management Activity, the Defense Department activity that administers the health care plan for the uniformed services, retirees and their families, serves more than 9.4 million eligible beneficiaries worldwide in the Military Health System (MHS). The mission of the MHS is to enhance Department of Defense and national security by providing health support for the full range of military operations. The MHS provides quality medical care through a network of providers, military treatment facilities, medical clinics and dental clinics worldwide. For more about the MHS go to www.health.mil.

source: Tricare  Press Release

Related Posts

Comments are closed.