Defense officials announced Thursday they’ve awarded the next round of Tricare contracts to Humana Government Business of Louisville, Kentucky, and TriWest Healthcare Alliance of Phoenix, Arizona.
The new contracts hold the promise of greater provider network flexibility, improved choices and other benefits for Tricare beneficiaries, according to defense officials.
Humana Government Business will manage the East Region, which will cover 24 states plus Washington, D.C., and TriWest Healthcare Alliance will manage the 26-state West Region. Six states that are currently in the East Region will transfer to the West Region — Arkansas, Illinois, Louisiana, Oklahoma, Texas and Wisconsin. This shift provides a more equitable balance of beneficiaries, officials said. These states include about 1.5 million beneficiaries; all told there are about 9.6 million Tricare beneficiaries, to include members of the uniformed services, their families, retirees and their families.
Humana’s contract is worth a potential $70.8 billion, while TriWest’s is worth a potential $65.1 billion. The last time the Tricare contracts were awarded, in 2016, the two regions’ potential worth was a combined $58 billion over about six years.
The contracts include a one-year base transition period beginning Feb. 1, eight one-year option periods, plus a transition out period.
The current contracts remain in place until 2024, when the new contracts take effect. The new contracts, dubbed T-5 contracts, “do not change the Tricare benefit and offer all the same Tricare options,” Defense Health Agency officials said in their announcement.
Defense leadership and the current contractors “are dedicated to managing a smooth transition to the new managed care support contractors, with minimum disruption to our beneficiaries,” said Lt. Gen. Ronald Place, director of the Defense Health Agency. There will be a 12-month transition period. The contractor for the East Region is currently Humana Military; for the West Region it’s Health Net.
Here’s what the new contracts will hold for beneficiaries, according to DoD:
♦ Greater provider network flexibility.
♦ Improved beneficiary choice.
♦ Enhanced telehealth appointments.
♦ Beneficiaries will be able to transfer specialty care referrals when they move, whether they’re moving to a new duty station with the current region or to the other region.
♦ Regions will be required to reduce their average speed to answer calls to 20 seconds; to enhance call center resolutions and callbacks; and to resolve 85% of issues on the first call.
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The new contracts require improved integration between military medical treatment facilities and the T-5 private sector care. This will help health care providers in both sectors get needed information faster to care for their patients.
Two offers were received for each contract in the competitive source selection process.
There is no need for patients to take any action now; the transition planning is scheduled for a full year. It’s always important to check the Defense Enrollment Eligibility System, DEERS, to confirm your information is current, and to help make sure you get important messages about your Tricare benefit.
Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book "A Battle Plan for Supporting Military Families." She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.
