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January 10, 2023 : Military family members and retirees who employ TRICARE will see modifications to their healthcare starting in 2024. The Defense Health Agency (DHA) reported its new contract for TRICARE services on December 22. The new contract for civilian health care, comprehended as T-5, will begin in 2024.
TriWest Healthcare Alliance Corporation and Humana Government Business will be the regional contractors, with Humana taking care of the TRICARE east region and TriWest supplying coverage to the TRICARE west area.
The combined $138 billion contract will deliver close to 10 million patients in the health plan. The Defense Department supersedes Health Net Federal Services in hands with TriWest Healthcare in the western TRICARE region with the new contract.
The contractors operate with DHA in providing health care and connecting the contractor’s resources and the military’s direct medical care system to deliver health, medical, and administrative support services to favor members, retirees, and eligible family members or dependents. While active duty servicemembers get direct, no-cost health care, benefits for their dependents and retirees are contracted to commercial healthcare providers. DHA said the new contracts would offer beneficiaries greater provider network flexibility, improved telehealth appointments, and more perfect referral transfers between the two regions.
Humana and Health Net succeeded the contract for services in 2016 after a process that garnered nine protests, all of which were eventually rejected. DHA expected protests owing to the large scope of the contract. The agency had proactively asked the Government Accountability Office and other investment experts to look over the process before recognition to head off protests. DHA wanted to forestall issues after a 2009 contract award for TRICARE generated objections that delayed the implementation of the agreement for close to three years.
While the contract was presented in a competitive bidding process, only two bids were presented, assuring them both a contract and no prospect of objections.
In complement to a change of provider, the T-5 contract also alters the makeup of the provinces. The new boundaries of the two areas will move Illinois, Louisiana, Arkansas, Oklahoma, Texas, and Wisconsin from the eastern to the western area. Those six states will obtain about 1.5 million beneficiaries into TriWest Healthcare’s territory.
“Pushing these six states into the west region will create a more even ratio to the TRICARE population each regional contractor manages. The movement will also streamline processes and standards for both provinces,” stated TRICARE.
