New Regional Contracts in 2017
The new regional contracts were awarded on July 21, 2016. The East RegionUnder 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. contract goes to Humana Government Business, Inc. of Louisville, Kentucky, and the West RegionAlaska, 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. contract goes to Health Net Federal Services, LLC of Rancho Cordova, California.
- 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)
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
|
Contract Protest Filed
The Government Accountability Office (GAO) notified the Defense Health Agency (DHA) that multiple vendors have filed formal protests against the TRICARE 2017 East Region Contract and TRICARE 2017 West Region Contract award announcements made July 22, 2016.
- The protests don't impact the delivery of health care for any TRICARE beneficiary.
- The current TRICARE contracts will remain in place until the protests are resolved.
- The DHA's top priority during this protest period is to maintain quality and continuity of care for its TRICARE beneficiaries in all regions.
As required by law, once notified by GAO that a formal protest had been filed:
- DHA's contracting office will issue a Stop Work Order on the new contract.
- The Stop Work Order will remain in place until a GAO decision on the protests are made.
- GAO protests are normally adjudicated within 100 days.
The DHA followed the source selection and contract award processes described in the Federal Acquisition Regulation for competitive acquisitions. Bid protests are not unusual in this competitive environment.