DECEMBER 23, 2022 – The Defense Health Agency (DHA) today announced the Department of Defense (DoD) awarded the next generation of TRICARE Managed Care Support Contracts. The new T-5 contracts will go into effect in 2024. The T-5 MCS Contract maintains the requirement for two TRICARE regions in the United States – East and West. However, six states currently managed in the East Region will transfer to the West Region, provide a more equitable balance of the beneficiary population. States transferring to the TRICARE West Region are: Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin with approximately 1.5 million beneficiaries.
The $70.9 billion East Region T-5 MCS Contract was awarded to Humana Government Business of Louisville, KY and in the West Region the $65.1 billion T-5 MCS Contract was awarded to TriWest Healthcare Alliance of Phoenix, AZ. These contracts will replace the current set of T-2017 managed care contracts under which health care is provided to eligible members of the uniformed services, their families, retirees and their families beginning in 2024. Until then the T-2017 contracts remain in place.
“I am pleased that our new T-5 TRICARE contracts will continue to focus on enhancing the experience of care and great health care outcomes for our service members, retirees and their families,” said Lt Gen Ronald Place, Director, Defense Health Agency.
The new contracts will continue to provide for the delivery of health care, customer service, claims processing and other administrative services to the estimated 9.6 million TRICARE beneficiaries. The new contracts do not change the TRICARE benefit and offer all the same TRICARE options.
“TRICARE is moving into a new era, making use of the lessons learned in the first three contract phases,” said Place. “Defense Department leadership and the incumbent managed care support contractors are dedicated to managing a smooth transition to the new managed care support contractors, with minimum disruption to our beneficiaries.”
The new contracts include a requirement to improve integration between military medical treatment facilities and the T-5 private sector care. One such improvement will increase interoperability with MHS GENESIS through Health Information Exchanges to deliver info faster to providers in both sectors.
Beneficiary experience is a major feature of these new contracts. Beneficiaries will be able to transfer specialty care referrals when they move, whether their orders take them to a new duty station within their current region or to the other region. Customer service will also improve. We will require our regions to reduce their average speed to answer calls to 20 seconds, matching health care industry standards; enhance call center resolutions and call backs; and first-call resolution requirements to align with industry standard for 85% of initial calls.
“We listened to our beneficiaries about what impacts their experience of care and address many of those concerns in T-5,” said Place.
After the 12 month transition-in period from the current contracts to the new ones, military hospitals and clinics will have real-time access to medical management data. This increased ability to share data will improve both patient care coordination and access to care. And through improved visibility of data, the Military Health System will be able to standardize care between civilian and military facilities, which promises both better care and greater patient safety.
TRICARE beneficiaries do not need to take any actions at this time. The DHA will launch an extensive and comprehensive communications campaign with TRICARE beneficiaries keeping them informed of coming changes during the year-long transition. Those interested in the progress should bookmark the web page www.tricare.mil/changes and sign up for regular bulletins through our e-alert system, at http://www.tricare.mil/About/Newsroom.
For additional information, please visit https://newsroom.tricare.mil/Articles/Article/3254092/changes-to-tricare-expected-in-2024
For the contract announcement, please visit www.defense.gov/News/Contracts/Contract/Article/3254039/
The Defense Health Agency (DHA) provides health services to approximately 9.6 million beneficiaries, including uniformed service members, military retirees, and their families. The DHA operates one of the nation’s largest health plans, the TRICARE Health Plan, and manages a global network of more than 700 military hospitals, clinics and dental facilities.
Defense Health Agency https://health.mil/About-MHS/OASDHA/Defense-Health-Agency