The military health system uses pilots and demonstration projects to test innovations that may become part of the TRICARE program. These can include enhancements to TRICARE coverage policy or changes to the way the TRICARE program is administered.
With the FY 2017 National Defense Authorization Act (NDAA), Congress directed significant changes to the TRICARE program. MOAA supports DoD recommendations to incorporate phased demonstration projects to test and evaluate multiple network offerings and other innovations – TRICARE changes must be tested and evaluated to ensure they maintain or improve beneficiary access to high-quality care before they are incorporated systemwide.
[RELATED: MOAA's 2021-22 TRICARE Guide]
The Defense Health Agency has several initiatives underway to evaluate potential TRICARE program changes, including:
Atlanta Kaiser Permanente Pilot: Offers metro-Atlanta area TRICARE beneficiaries eligible for TRICARE Prime and Select the option of enrolling in Kaiser Permanente as a TRICARE Prime option. This demonstration tests how well the Kaiser Permanente integrated delivery model achieves efficiencies, care effectiveness, and beneficiary satisfaction.
Buckley Prime Service Area Pilot: Aims to determine the effectiveness of a value-based payment model for providers (versus the current fee-for-service payment model) and offers dedicated, concierge-type support to network-enrolled TRICARE Prime beneficiaries in the Denver area.
TRICARE Select Navigator Pilot: Provides medically complex beneficiaries with one-on-one assistance from a nurse navigating their care to assess impact on health outcomes, overall costs, and the patient experience.
You can find more information on TRICARE pilots in this Health.mil article.
Pilots and demonstration programs also can be used to evaluate changes in TRICARE coverage policy or services offered to beneficiaries. Please watch The MOAA Newsletter and MOAA.org for upcoming articles on a TRICARE test of maternity care enhancements (expected to be rolled out Jan. 1, 2022) and a recent win in the FY 2022 NDAA for a mental health schedulers pilot.
MEDIPLUS® TRICARE Supplement
Works hand-in-hand with your Select or Prime Plan. Count on valuable protection.