Tricare Facing New Troubles

[island doc]

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Did you all see the cover article on this week's edition of American Medical News ? The title: "Doctor Payment Cut Could Limit Access for Military Families". (www.amednews.com)

According to the article, Tricare suffers from red tape, low payments and baffling rules. If Medicare cuts proceed next year many physicians are expected to start dropping Tricare patients. According to an AMA Survey, 43% said they would limit or stop accepting new Tricare patients in 2007 when the program's reimbursement is scheduled to drop 5%. Tricare is in a race to the bottom of the reimbursement scale. Tricare not only pays poorly, it also follows the old gatekeeper model, requiring authorizations for specialists. "It is just odious".

So, not only is the direct care system flawed in so many ways, but now the civilian component of the military healthcare delivery system is on the brink of collapse.

 

[Pemberley]

According to the article, Tricare suffers from red tape, low payments and baffling rules. If Medicare cuts proceed next year many physicians are expected to start dropping Tricare patients. According to an AMA Survey, 43% said they would limit or stop accepting new Tricare patients in 2007 when the program's reimbursement is scheduled to drop 5%. Tricare is in a race to the bottom of the reimbursement scale. Tricare not only pays poorly, it also follows the old gatekeeper model, requiring authorizations for specialists. "It is just odious".

Some people think that a federal bureaucracy should established to handle ALL americans' medical needs. 😱 Those people should be made to deal with Tricare for a few years... they'd change their minds.

Can anybody explain to me (single when in the military, just showed up to the clinic when I needed treatment and got treated!) what Tricare does for us in theory? What is it supposed to bring to the fight, besides more layers of bureaucrats?

I've been wondering this for a while now, and you folks seem like people to ask 🙂 .

-Pemberley

 

[USAFdoc]

Some people think that a federal bureaucracy should established to handle ALL americans' medical needs. 😱 Those people should be made to deal with Tricare for a few years... they'd change their minds.

Can anybody explain to me (single when in the military, just showed up to the clinic when I needed treatment and got treated!) what Tricare does for us in theory? What is it supposed to bring to the fight, besides more layers of bureaucrats?

I've been wondering this for a while now, and you folks seem like people to ask 🙂 .

-Pemberley

Tricare serves the same purpose that any of the insurance providers do such as Blue Care Network, HealthPlus, Blue Cross/Shield, Aetna etc...only they do this for the military.

My opinion is that they do provide a service, only that it is NOT probably cost effective. They act as a gate keeper in some respects, denying coverage for certain imaging studies they deem un-needed. In my years in the USAF, however, I never had a request denied, EVER, SO in that regard, they functioned only as unneeded extra time and frustration for me to take care of patients.
They are also the worst in terms of the efficiency of their system. If I wanted to order a screening colonoscopy on a 55 yo male, first I needed to enter the complete referral myself in the computer including certain patient demographics (a 22 step process). This took about 2 minutes. That info went to another part of the base which then faxed the request to TEXAS (no matter where in the USA your base was). Texas then mailed a form to the patient and it was up to the patient to arrange the appt. If the request was denied, they faxed a denial to the base and hopefully it made it to the physician that ordered the test. You can imagine that all this "red tape" caused alot of frustration for docs and patients and many times ended in the test not being done at all.

And finally, I would add that there are way too amny "middle men" in todays healthcare system. And all these people are paid well (Wallgreens, CVS, TRICARE reps, pharmaceutical reps CEOs, etc); I would love to see a simpler sytem involving only the local pharmacist, the doc (and his/her staff) and the patient.

 

[militarymd]

Tricare is supposed to give our military healthcare recipients access to healthcare, but IT DOESN'T.


It is another lie perpetrated on poor unsuspecting military members!!!

It reimburses at the same rate as Medicare/MediAid.....That's right...It reimburses at a rate similar to people WHO ARE ON WELFARE.

Many physicians won't accept it because it costs them money to take care of Tricare patients...the most deserving patients in the world.

After paying for overhead, many times you wind up losing money to take care of Tricare patients.

What a joke...just like the rest of military medicine.

 

[orbitsurgMD]

Tricare is supposed to give our military healthcare recipients access to healthcare, but IT DOESN'T.


It is another lie perpetrated on poor unsuspecting military members!!!

It reimburses at the same rate as Medicare/MediAid.....That's right...It reimburses at a rate similar to people WHO ARE ON WELFARE.

Many physicians won't accept it because it costs them money to take care of Tricare patients...the most deserving patients in the world.

After paying for overhead, many times you wind up losing money to take care of Tricare patients.

What a joke...just like the rest of military medicine.

I agree. Tricare, with the way it is run and with its bottom-of-the-barrel payment schedules is a cruel deception. The decent thing would be to provide military retirees commercial medical insurance of at least the same quality as that which federal civil service employees are offered. Anything less is a miserable form of cheating people who have earned and deserve better.

Given the way active-duty healthcare goes in so many places, the lousy leadership and willful neglect of quality, it is expecting too much for the change needed to come from the senior medical leadership and the line authority with which they correspond. Really, it is a disgrace.

 

[alpha62]

I had about 6 years to go, just to make a reserve pension that would have been held out to age 60 anyway.

I threw in the towel when I considered Tricare wasn't worth eating this BS for another 6 years, probably getting pulled back into AD during the grey zone anyway.

MTF care , please. I see how those people really find out what "space avalible" means.