TRICARE, the military healthcare system, went through some major changes at the end of 2017. These included consolidating coverage regions, expanding the enrollment to additional personnel, and adjusting the fees for those who opt into plans that allow a patient to choose their doctor from among a network of approved providers.
These changes were met with skepticism from military personnel, families, and veterans using a variety of TRICARE plans offered. Military medical commands worked hard to unroll the new changes and explain them to patients.
The most significant change that immediately impacted coverage was the change in regions and contracted providers. Military treatment facilities remained unchanged but civilian providers, including specialized care providers, had to opt into the new networks—Humana Military and Health Net Federal Services. Other important changes included copays and cost structure, which led to higher costs in many cases.
After over a half a year, how is the new plan working? Unfortunately, not well—yet.
The Military Officers’ Association of America, MOAA, recently conducted a survey to determine how the recent changes to the TRICARE system are being received by beneficiaries. The more than 8,500 survey participants shared “increasing dissatisfaction across all categories, including provider choice, access to providers, and especially among medication costs.”
This was compared to a similar survey conducted in December 2017, before the changes were made. According to an article published by Military Times, around 4,000 people participated in the 2017 survey. The number of respondents more than doubled, an indication that patients are taking a more active role in providing feedback about the TRICARE system.
What is Working?
MOAA identified some key takeaways from the survey. Some were positive and showed patient satisfaction with the plan.
80 percent of TRICARE for Life beneficiaries were “either very satisfied or mostly satisfied.” TRICARE for Life provides supplementary coverage for those eligible for Medicare Part A and B.
According to Military Times, around 50 percent of those taking the survey participated in TRICARE for Life.
Survey: Troops, families are increasingly dissatisfied with Tricare https://t.co/GY6IAXtfVI pic.twitter.com/RUAECRaE8r
— Military Times (@MilitaryTimes) August 3, 2018
What Needs Improvement?
Those under the TRICARE Select plan had the most concerns with their healthcare.
TRICARE Select operates as a referred provider organization-type model. Only 50 percent of those opting into this model were “very or mostly satisfied,” with 28 percent of respondents saying they were very to mostly dissatisfied. Under the new TRICARE procedures, patients are only able to change plans at certain times, such as the birth of a family member or a relocation.
Rising costs under the new plans were also cited as a major point of dissatisfaction. Medication costs were identified as a big concern. Those responding as “very satisfied” with costs of medication fell 33 percent compared to responses in December 2017.
Over 50 percent of those who took the survey responded that they were “somewhat to very concerned about being able to afford their medications.” MOAA called those responses a “dramatic shift from previous responses when beneficiaries were largely unconcerned about affording their prescriptions.”
Scheduling appointments based on cost is also an area for concern. 85 percent of respondents said they had never “canceled or postponed medical appointments in the past year out of cost concerns,” compared to 94 percent in the previous survey.
One respondent said that weekly copays for speech therapy services for her four-year-old increased from $36 to $90. It caused the family to limit the services based on the higher costs. “It is hard to provide adequate care for my son who has special needs that should be met,” the survey respondent said.
The Future of Military Healthcare
With the regions consolidating and restructuring, many providers are no longer participating in the TRICARE network. This has led to delays in appointments and dissatisfaction among patients. The dissatisfaction with choice of providers was highest among those under the age of 65.
Mark your calendars now! https://t.co/Q298dle1fC pic.twitter.com/TwIIGeCD0Q
— MOAA (@MilitaryOfficer) August 12, 2018
“It is becoming increasingly clear, most beneficiaries’ view their TRICARE benefit as one for which they are paying more and receiving less,” said MOAA in a summary of the survey. “Whether it is for narrower provider networks, higher costs for medications, and much greater copayments for medical appointments—beneficiaries are experiencing an erosion to their earned health care benefit.”
MOAA plans to continue to monitor and share how policy changes impact military and veteran healthcare. “We will fight any new disproportionate cost shares,” said the article.
The Military Officers’ Association of America is a non-profit association of military officers. The organization advocates for military personnel and families, provides networking benefits to members, and funds scholarships and philanthropic efforts through the MOAA Foundation.
