The push to save Tricare Prime where bases are closing

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Subject: The push to save Prime where bases are closing

 
http://tricare.osd.mil/eenews/downloads/072605primes.doc

The push to save Prime where bases are closing
Civilian networks might replace military clinics

By Deborah Funk
ArmyTimes staff writer
August 1, 2005 Issue


While the Pentagon has proposed closing relatively few military bases with health care services, advocacy groups want to ensure that defense officials continue to operate the low-cost managed care option Tricare Prime for people living near clinics that may shut down.

“What we would hope they would say is, ‘Yes, we’re going to keep Prime service areas where we’re closing bases,’” said Joyce Raezer, government relations director for the National Military Family Association.

So far, the Defense Department has not committed one way or the other. But the companies that manage Tricare and are responsible for building the system’s provider networks are looking ahead at possible needs and making plans to continue offering Prime.

Air Force Surgeon General Lt. Gen. (Dr.) George Peach Taylor Jr. chaired the joint service committee that recommended how to realign medical services.

Speaking only for the Air Force, Taylor said commanders at Ellsworth Air Force Base, S.D., and Cannon Air Force Base, N.M. — both recommended to shut down under the base realignment and closure process — have been working with Tricare managers in their areas and believe that primary care will be continued through the civilian network in South Dakota and New Mexico.

David McIntyre Jr., president and chief executive officer of TriWest Healthcare Alliance, which manages Tricare near Cannon and Ellsworth and elsewhere in the Tricare West region, agreed.

Some 1,935 retirees and their family members are enrolled in primary care at Cannon; at Ellsworth, the figure is 3,341.

“We’ll probably have to add some providers ... we don’t have a problem with that,” McIntyre said. “We believe that we have a responsibility to continue Prime in areas where BRAC occurs,” if Prime already is available there.

Gauging the demand

TriWest is collaborating with the military, and is using a sophisticated modeling tool the company developed several years ago to determine demand.

Similarly, Humana Military Healthcare Services is assessing how BRAC could affect its Tricare South region and plans to continue offering Prime.

“We certainly assume that’s part of our commitment,” said Richard Mancini, Humana’s director of network management.

The greatest impact in the South region would be on retirees enrolled at Fort McPherson, Ga., and Naval Air Station Atlanta. But there is ample capacity in the area’s civilian network to absorb the primary care business now provided at the military clinics, Mancini said.

As of July 11, some 3,978 retirees were enrolled in Prime at the McPherson clinic and assigned to a military health care provider.

“BRAC, as it relates to Fort McPherson, is merely a phenomenon of finding a new primary care manager,” Mancini said.

There are 838 civilian primary care managers in the Tricare network within a 20-mile radius.

No retirees are assigned to military providers at NAS Atlanta, which is actually in suburban Marietta, Ga., he said.

Tricare North region

Officials of Health Net Federal Services, manager of the Tricare North region, are meeting with individual military hospital and clinic commanders to determine supply and demand, and to plan for any changes that might be needed in the civilian network if particular bases close.

Submarine Base New London, Conn., and Fort Monmouth, N.J., are among the installations recommended for closure in the North region.

Some 2,624 retirees and their dependents receive primary care at the military clinic in New London. At Fort Monmouth, 1,484 retirees and family members rely on the military clinic for primary care.

And 612 retirees and their family members get primary care at Fort Monroe, Va., also in the North region, said Scott Kelly, Health Net’s program manager.
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Contributed,
YNCS Don Harribine, USN(ret)