Since the full rollout of Tricare's Nurse Advice Line last August, more than 366,000 calls have poured in at an average rate of about 1,700 a day, mainly from Tricare Prime beneficiaries seeking medical care and advice for minor illnesses, Defense Department data show.
Of greatest significance to the Pentagon, which is trying to rein in the cost of providing health care to nearly 9.5 million beneficiaries, is the impact the call center is having on emergency room visits — a nearly 66 percent decline in trips among those who called the line.
Defense Health Agency officials said that while 36 percent of callers initially intended to go to an ER for their illness, just 12 percent went within 24 hours of calling.
More than 22 percent said they were thinking about going to an urgent care facility at the start of a call but just 12 percent went within 24 hours.
And the number of callers who decided to seek care at a military treatment facility rose, by nearly 17 percent, according to DoD data.
The cost of a military or network ER visit for a routine illness is roughly $400 while the cost of a medical appointment in the military system is less than $77 — which is why DoD has for years has tried to chip away at the nearly 177,000 emergency room visits made by beneficiaries each week.
In its fiscal 2016 budget request released Feb. 2, DoD proposed new fees designed to reduce overuse of hospital emergency rooms.
The plan would introduce new fees for retirees to use military and civilian emergency rooms and active-duty families also would pay a penalty for going to an emergency room for nonemergency care, from $30 to $70 depending on the sponsor's rank.
When military families can't get an appointment with their primary care physician for urgent care — either because appointments are full or they need care outside office hours — they often turn to military or civilian emergency rooms for primary care visits.
The Nurse Advice Line was established, in part, to ward off unneeded trips.
"You go to an emergency room at any one of our MTFs any night and you'll see the overutilization of health care — you see a room absolutely filled with people who tried to get an appointment and couldn't, so they are camped out," retired Army Gen. Peter Chiarelli said in a recent congressional hearing.
The most common calls to the Nurse Advice Line are for colds, flu, abdominal pain, fever, rashes and neonatal concerns, officials said.
Tricare reintroduced the service after a 10-year hiatus largely to provide information on self-care for acute illnesses and improve use of military treatment facilities.
Answering nurses can make recommendations about whether beneficiaries should seek care; help find the closest medical facility; and will check on a caller by phone a few hours later if requested.
Advice line representatives also can make appointments for Tricare Prime beneficiaries at most military hospitals or clinics.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
