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TRICARE Health Program, New Regional Contracts to Administer the TRICARE Benefit
With two of TRICARE’s regions set to merge, the TRICARE Regional Office (TRO) North and TRO South became TRO East on July 1, 2016. TRO West is continuing as before covering the western United States. The move was made in advance of the pending award of the TRICARE-2017 (T-2017).
“We wanted to make our operations more efficient,” said Ken Canestrini, chief operating officer for TRO East. “The bottom line is that beneficiaries won’t see any difference in delivered care.”
Current TRO North staff in Falls Church, Virginia, and TRO South staff in San Antonio, are functioning under the new TRO East business model. Some staff rebalancing occurred to eliminate redundancies, but each office will continue to provide management and support services in their respective geographic areas covering 33 states.
Canestrini said having two major regional offices hits the right balance of combining operations for efficiencies while making sure not all of the eggs are in one basket.
“With just one contractor for all stateside areas, if you had any issues with a contractor or service, it would likely affect all our beneficiaries,” said Canestrini. “This way you’ll continue to have two major sectors of terrain, while still capitalizing on best practices from the different regions.”
TRO East will handle the lion’s share of those enrolled in TRICARE, with about six million beneficiaries – about two-thirds of all TRICARE beneficiaries.
Under the future T-2017 Managed Care Support Contracts, one government business partner will manage the network of civilian medical providers for the entire East Region where previously, two business partners split that responsibility in eastern geographic regions designated as North and South.
The TRICARE Regional Offices provide essential government oversight and coordination for those civilian contractors.
Canestrini said this move is one of many initiatives in the Defense Health Agency to improve the Military Health System and ensure active-duty, retirees and family members receive the highest-quality health care services for years to come.
“This will help us better oversee the contractors providing the care,” he said. “In addition, this increases TRO East’s focus on supporting military hospital and clinic commanders in managing their market and facilitating a more integrated system, while helping our beneficiaries.”