More Civilian Providers Accepting TRICARE Standard

  • Published
  • By TRICARE
  • Public Affairs
FALLS CHURCH, Va. --  There's good news for TRICARE Standard beneficiaries--more civilian providers are accepting new patients, according to a recently released survey. Yet, TRICARE officials acknowledge that increasing the number of providers and types of providers across the Nation remains a high priority, especially in remote areas.

The findings, part of the Department of Defense Survey of Civilian Physician Acceptance of TRICARE Standard, show that in Fiscal Year (FY) 2007, almost 93 percent of responding physicians in 53 hospital service areas (HSAs) were aware of the TRICARE program, with 84 percent of physicians in those 53 HSAs accepting new TRICARE Standard patients.

"The survey results are very encouraging," said Army Major General Elder Granger, Deputy Director, TRICARE Management Activity (TMA). "It shows that more doctors are working with us to ensure that our Reserve Component warriors, retirees, and their families have access to quality care."

The 2007 survey was the final installment of a three-year national effort to measure awareness of TRICARE and to determine the number of physicians that accept new TRICARE Standard patients. The Department randomly surveyed physicians in 20 states in both FYs 2005 and 2006. The 10 remaining states and Washington, DC, were surveyed in FY 2007. Physicians in local HSAs were also surveyed each year. Approximately 40,000 physicians from a variety of medical specialties were randomly picked.

The aggregate results show that civilian provider awareness and acceptance is generally high, but may vary depending on location. In addition, the survey revealed a need for increasing both TRICARE awareness and acceptance among psychiatrists--a specialty critical in meeting the behavioral health needs of veterans of the Global War on Terror.

Specifically, the three-year findings across all states and HSAs show:

Approximately 87 percent of all physicians surveyed are aware of the TRICARE program.
About 81 percent of physicians that accept new patients also accept new TRICARE Standard patients.
Of those accepting new TRICARE Standard patients, almost 91 percent do so for all patients, rather than on a case-by-case basis.
Reimbursement rates were among the most commonly cited reasons for not accepting TRICARE Standard.

"The survey exceeded our expectations," said Rich Bannick, Ph.D., Director, Performance Evaluations, TMA. "In the three surveys completed since 2005, more than 50 percent of the physicians we surveyed responded. That's a very respectable survey response rate in the health care industry. The survey results provide us a reliable measurement as to our effectiveness in expanding access to TRICARE providers and the challenges of getting more doctors on board. Congress has given additional guidance to continue the survey process through 2011," he said.

While Active Duty Service Members receive the bulk of their medical care at one of the more than 500 military treatment facilities, family members, National Guard and Reserve members, and retirees often rely on civilian physicians for their health care needs.

"In some locations, access to TRICARE Standard providers remains a major concern for family members and retirees," Granger said. "Some doctors limit the number of TRICARE patients they see or refuse to see them altogether. This leads to fewer choices for beneficiaries."

States showing a need to increase acceptance and awareness of TRICARE include Alaska, Maryland, Colorado, Hawaii, Oklahoma, New York, New Jersey, and Texas. Hospital service areas with lower than average TRICARE acceptance include Washington, DC; Raleigh, North Carolina; Seattle and Olympia, Washington; Lihue/Kealakekua/Wailuku, Hawaii; Dallas, Texas; and Falls Church, Virginia.

TRICARE leaders, with support from their managed care support contractors, are working to overcome these challenges. "We are reaching out to state officials, medical associations, and individual physicians to educate them and appeal to their sense of patriotism in accepting TRICARE," said Granger.

The outreach is showing promising results. For example, the Oregon legislature approved incentives including a one-time tax credit for new providers in the TRICARE network, plus an additional annual credit for treating patients enrolled in TRICARE. Since 2004, Oregon's TRICARE provider network has increased by 35 percent.

In addition, the governors of 20 Western States have supported TRICARE's efforts to encourage more health care providers to accept new TRICARE patients. Their combined efforts led to an overall increase in western region TRICARE network doctors from approximately 80,000 in 2004 to more than 125,000 today.

"Expanding our network of TRICARE providers is critical to our ability to care for our beneficiaries," said Granger. "Today, more than 220,000 men and women are TRICARE providers. We are grateful to them for seeing the value in supporting those who serve our Nation, and we are actively seeking other physicians who want to become part of our TRICARE provider team."

About TRICARE Management Activity and the Military Health System
TRICARE Management Activity, the Defense Department activity that administers the health care plan for the Uniformed Services, retirees and their families, serves more than 9.2 million eligible beneficiaries worldwide in the Military Health System (MHS). The mission of the MHS is to enhance the Department of Defense and national security by providing health support for the full range of military operations. The MHS provides quality medical care through a network of providers, military treatment facilities, medical clinics, and dental clinics worldwide. For more about the MHS go to www.health.mil.