Changes to TRICARE managed care support contracts, coverage regions

TRICARE providers should be aware that the U.S. Department of Defense (DOD) has re-upped two managed care support contracts, but dropped a third, resulting in a regional reshuffling of coverage areas.

These new contracts-awarded to Humana Government Business, Inc., and Health Net Federal Services, managed by Centene Corp.-are expected to take effect April 2017, and will establish two TRICARE coverage regions in the United States, instead of the current three. UnitedHealthcare was not awarded a contract.

The East Region, now managed by Humana, provides care for the nearly 6 million TRICARE beneficiaries across a new, 32-state coverage area that absorbs most of the beneficiaries previously served by UnitedHealthcare.

The West Region, now managed by Centene, provides care for about 3.4 million beneficiaries across a new, 21-state coverage area. However, both companies provide coverage in Iowa, Missouri and Texas.

These new contracts do not change the TRICARE benefit and offer all the same options, the DOD notes. The move is geared to help improve patient care coordination and access to care as the Military Health System seeks to standardize care between civilian and military facilities.

AOA recommends that members who serve TRICARE patients watch for more information from these companies about the transition.

Click here to read the full DOD announcement-released July 21, 2016-on the next generation of TRICARE managed care support contracts.