TRICARE Tests Competition to Shake Up Military Health Plans
Published Date: 4/28/2025
Notice
Summary
TRICARE is shaking things up by letting new health plan companies compete with current ones in Atlanta and Tampa. If you live there and use TRICARE, you’ll get more choices for your health care starting soon. This test will help see if competition saves money and makes care better for military families.
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
New TRICARE Choice in Two Markets
If you are a TRICARE beneficiary in the Atlanta, Georgia market or the Tampa, Florida market, you will be given the opportunity to enroll in TRICARE Prime with CareSource Military & Veterans (CSMV). The Defense Health Agency has awarded contracts to CSMV to compete with the current East region managed care support contractor, Humana Government Business, in those markets.
Competition Demonstration to Measure Effects
The Department of Defense will run a Competitive Plans Demonstration in the designated Atlanta, Georgia and Tampa, Florida markets to evaluate how having two managed care support contractors affects costs, health outcomes, and beneficiary satisfaction. The demonstration will also evaluate use of a risk-adjusted, population-based capitation payment method for non-pharmacy care and the effects of separately contracting certain administrative functions (like eligibility, enrollment, and encounter data management).
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