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.

Source: https://aishealth.com/health-plans/tricare-moves-toward-risk-based-contracting/