🏥TRICARE Competitive Plans Demonstration
The Assistant Secretary of Defense for Health Affairs (ASD(HA)) issues this notice announcing the creation of a demonstration to offer additional opportunities for contractors of local, regional, and national plans to compete with managed care support contractors (MCSCs) under the TRICARE program and to evaluate impacts of competition in these designated markets on costs, outcomes and satisfaction. The Defense Health Agency (DHA) has awarded contracts to CareSource Military & Veterans (CSMV) in both the Atlanta, Georgia market and the Tampa, Florida market and intends to evaluate the impact of having two MCSCs (the Competitive Plans Demonstration (CPD) contractors and Humana Government Business (HGB), the current East region MCSC) providing services in these markets. Eligible beneficiaries will be provided with the opportunity to enroll in TRICARE Prime with CSMV in these markets. This demonstration will also help the DHA assess the efficacy of paying a TRICARE MCSC using a risk-adjusted, population-based capitation methodology for non-pharmacy health care and variable ongoing administrative costs and the efficacy of separately contracting for certain health care administrative tasks (e.g., eligibility, enrollment, and encounter data management functions) rather than including such requirements in the MCS contract.
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