DOD announces new Tricare regional care contractors

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Department of Defense officials here have announced the selection of new Tricare managed care support contractors for the North and South Tricare regions in the United States.

The third generation contracts are worth an estimated $55.5 billion more than 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.

Tricare officials administer the health care plan for 9.4 million servicemembers, retirees and their families worldwide. Managed care support contractors provide health, medical and administrative support services to eligible beneficiaries in each of the three Tricare regions within the United States.

Aetna Government Health Plans of Hartford, Conn., is selected for the North region where Health Net Federal Services is the current contractor. UnitedHealth Military & Veterans Services of Minnetonka, Minn., is selected for the South region where Humana Military Healthcare Services is the current contractor. The Tricare West region will retain its current contractor, TriWest Healthcare Alliance Corp. 

"We expect all of our managed care support contractors to provide top quality health care and the highest possible customer satisfaction," said Ellen Embrey, the acting director of Tricare. "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."

Ms. Embrey is also performing the duties of the assistant secretary of defense for health affairs.

"Our military hospitals and clinics continue to be at the center of our health care delivery system," said Navy Rear Adm. Christine Hunter, the Tricare deputy director. "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 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 officials 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 the contract, 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 officials said. Tricare Extra is a discount given to Tricare Standard beneficiaries when they use a Tricare network provider. According to Tricare officals, both Tricare Prime and Standard are excellent options with high satisfaction rates.

"Tricare and all the managed care contractors are dedicated to making a smooth transition with minimal impact on beneficiaries," Admiral Hunter said. "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."

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