AIS Health: TRICARE Moves Toward Risk-Based Contracting

“The Dept. of Defense (DoD) is taking the first steps toward bringing value-based contracting to the TRICARE program — the government’s health insurance program for members of the armed forces, military retirees and their dependents.”

“Currently, Centene Corp. subsidiary Health Net Federal Services LLC holds a contract to cover the West TRICARE region, while Humana Military Healthcare Services Inc. controls the East region.”

“In a request for information (RFI) issued in late September, the DoD’s Defense Health Agency (DHA) says it’s ‘planning the future generation of managed care contracts,’ which will be called T-5.”

“In that RFI, the DHA ask stakeholders what TRICARE should consider when developing incentives for T-5 contract holders to increase access to and utilization of high-value care, and how it can design contracts that encourage contractors to create alternative payment methodologies for their in-network providers.”

“Dan Mendelson, founder of the consulting firm Avalere Health, says the moves TRICARE is considering would be a major departure from the current version of the program, which involves administrative services only contracts with insurers…” Read the full article here.

Source: TRICARE Moves Toward Risk-Based Contracting – By Leslie Small, October 15, 2019. AIS Health.

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