Because access to health care continues to be a top complaint across the force, MOAA will once again feature this issue as part of our annual Advocacy in Action event April 15, where nearly 200 members and MOAA staff will visit hundreds of Capitol Hill offices.

Participants will be asking their elected officials to support the Military CARE Act (H.R. 6796), a bipartisan bill that would require the Pentagon to establish a digital system that:

• Allows TRICARE beneficiaries to report and track military treatment facility (MTF) access-to-care issues.
• Sends access complaints to the proper patient advocate.
• Aggregates those data points for use by the Defense Health Agency (DHA) to help officials identify and address barriers to access.

[TAKE ACTION: Ask Your Lawmakers to Address MTF Access Problems]

MOAA’s issue paper provides background information on the issue, including why such a system is so important now and the benefits it would bring to both patients and the MHS. Here are some more answers to frequently asked questions regarding the legislation.

Q. How is this different from the patient satisfaction surveys (e.g., the Joint Outpatient Experience Survey, or JOES) the Defense Health Agency (DHA) already fields?

A. Patient satisfaction surveys and other reports are retrospective and typically include data at an aggregate level that does not illuminate the types of barriers patients face at the MTF or clinic level. The Military CARE Act would require a digital system that forwards reports of access problems to MTF patient advocates in real time so families with fixable issues can receive help navigating the MHS. Data from such a system would be at the patient level, providing MTF leadership and DHA with actionable insights.

[RELATED: MOAA’s 2026 Advocacy Playbook]

Q. Isn’t something like this already available through the Interactive Customer Evaluation (ICE) system?

A. Yes, sort of, but ICE comments are handled inconsistently from one installation to the next and it is unclear whether ICE reports are escalated to MTF or DHA leaders. It is possible ICE could serve as a suitable platform to fulfill Military CARE Act requirements.

Q. Doesn’t the newly launched Patient Advocate Assistance Reporting Tool (PAART) address this issue?
 

A. DHA recently introduced the Patient Advocate Assistance Reporting Tool (PAART), a standardized system to manage feedback reported to patient advocates. It replaces inconsistent legacy methods and gives patient advocates a new platform to collect, track, and resolve patient concerns. MOAA appreciates that PAART will improve consistency in data collection from patient advocates, but it is only a partial solution. We continue to urge Congress to expand digital problem reporting down to the patient level to ensure unfiltered patient feedback on access-to-care challenges.

[LEARN MORE: New Patient Advocate Tool Will Improve MHS Experience ... But It Isn’t a Full Fix]
 

Q. How will patients be prevented from making complaints that aren’t legitimate? For instance, what if a patient is offered three appointment times within access standards but declined them due to scheduling conflicts? The MTF has met the access standard, so that’s not a legitimate access complaint.

A. Someone, likely the patient advocate, will have to be designated to assess, prioritize, and determine how to respond to reports of access problems. Those responses will sometimes explain and direct the patient to policy – in this case, access to care standards – to help provide context to the patient’s experience. If the patient included details – for example, they were seeking a later afternoon or evening appointment to avoid missed school for the child and missed work for the parent (commonly available in civilian pediatric practices) – that would be a valuable insight for MHS leaders when considering pediatric clinic operating hours.
 

Q. Will complaints submitted to a digital access assistance system be tracked in the patient’s electronic health record (EHR)?

A. The legislation outlines broad requirements for the digital system and does not address electronic health records. If access complaints submitted to the digital system were tracked in the patient’s EHR, they would be subject to all health record privacy laws and policies.
 

[RELATED: MOAA’s TRICARE Guide]

Q. Do civilian health systems offer something similar?
 
A. Not typically. While MOAA often looks to civilian health care for benchmarks, most civilian health plans allow patients to seek care across a variety of providers. If a civilian encounters problems scheduling appointments or otherwise securing access to care, they can seek care elsewhere. The unique nature of the military’s direct care system requires TRICARE Prime beneficiaries to enroll at the MTF and get all their care at nearby MTFs unless they lack the capability or capacity to treat the patient. For military patients enrolled at MTFs, moving their care to civilian providers without a referral incurs substantial costs that do not apply to the catastrophic cap. And, they can only change TRICARE plans at the annual open season or with a qualifying life event. Patients who cannot readily leave the MTF must have a standardized, digital system to report access-to-care challenges.
 

Q. Doesn’t referral-free urgent care address most MTF access problems?

A. Prior to 2016, TRICARE Prime patients needed a referral before seeking urgent care from a civilian provider. MOAA and other associations successfully fought to eliminate this requirement – now, TRICARE Prime beneficiaries can get urgent care from any TRICARE network urgent care center without a referral. Streamlined access to urgent care has provided an effective relief valve for military hospitals and clinics that lack same-day appointments for acute issues. However, patients still face other access challenges such as difficulty scheduling primary care manager (PCM) appointments to get referrals to specialty care, long waits for specialty appointments, and referral processing hiccups and delays.

[RELATED: Can You and Your Family Access the Health Care You’ve Earned? This Bill Could Help]

Q. Why doesn’t MOAA pursue something more prescriptive that actually fixes the problem?

A. With a mission to represent beneficiaries, and limited visibility on root causes of MTF access problems, MOAA advocates for resources that help beneficiaries navigate the MHS; options for self-directed care outside the MTF; transparency on access to care problems; and congressional oversight with the goal of improvements through accountability.

Q. Is there a Congressional Budget Office score or cost estimate?

A. No. Because the legislation gives the Pentagon latitude in how to provide a digital access assistance system, it would be difficult to score the bill.