New Regional TRICARE Contracts in 2017

by | Jul 26, 2016 | Benefits, Medical

New regional TRICARE contracts were awarded on July 21, 2016.  The East Region contract goes to Humana Government Business, Inc. of Louisville, Kentucky.  The West Region contract goes to Health Net Federal Services, LLC of Rancho Cordova, California.

Under the new regional contracts, the East Region is a merger of the North and South Regions and includes:  Alabama, Arkansas, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Indiana, Iowa (Rock Island area), Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri (St. Louis area), New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas (excluding El Paso area), Vermont, Virginia, West Virginia, and Wisconsin.

The West Region contract now includes:  Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excludes Rock Island arsenal area), Kansas, Minnesota, Missouri (except St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (southwestern corner including El Paso), Utah, Washington and Wyoming.

  • We anticipate the start of health care delivery late 2017.
  • There will be a 9-month transition period.
  • We have added improvements in the delivery, quality, and cost of your health care from previous contracts.

Most of these improvements will be behind the scenes. But, some changes you may experience include:

  • Shorter wait times for specialty care appointments
  • Improved communication between your military and civilian providers
  • Easier referral process

You Don’t Need to Do Anything Right Now

  • There is a 9-month transition period.
  • Our goal is to have a smooth transition and to keep you informed.
  • We’ll update this page regularly.
  • You can sign up now to get transition updates via email.

What’s Changing?

While the TRICARE benefit won’t change, you can expect changes in how you access care and to some processes.  Here are the two key changes in the new contract:

Improved Integration between Military Hospitals & Clinics and Civilian Care

The Military Health System (MHS) consists of military hospitals & clinics and civilian care.   There will be improved integration between these components of your health care.

How Will This Affect Me?

Change Benefit for You
Processing referrals electronically
  • Decreased wait times to get specialty care
  • Less paperwork
Sharing more data across the enterprise*

*May not apply to non-network providers.
  • Improved health care coordination
  • Improved access to care
  • More access to health records
  • Real time access to data on medical management and utilization
Increasing the use of standardized metrics and analytics
  • Fewer gaps in health care
  • Improved clinical quality
  • Compares military and civilian hospitals and clinics
  • Improved patient safety

Reduction of Three TRICARE Regions to Two

There are currently three TRICARE regions in the United States: North, South, and West.  The new regional contracts reduce the number of regions to two.  Moving to two regions standardizes how you get your benefit.

  • East Region (merges current North and South Regions)
  • West Region (same as the current West Region)

Maps of the US showing transition from North, South and West regions to East and West regions.

How Will This Affect Me?

Change Impact For You
North and South Regions merge. Your region will change to the East Region.
West Region stays the same. Your region will remain the West Region.
You may have a new regional contractor. Stay connected to learn more about your new region. >>Sign up for Email Updates
Your network providers may change. Stay connected to learn more about your new region. >>Sign up for Email Updates
Your primary care manager may change. If enrolled in TRICARE Prime, you may have a new primary care manager.
You’ll get more seamless support between regions. You’ll get more support:

  • Particularly when you move
  • Especially if you’re a family with special needs

For all the current updates regarding TRICARE, go to their website http://tricare.mil/.

Last Updated 7/21/2016