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GAO Report Mandates DHA To Implement Required Elements of the Current TRICARE Contract

February 18, 2020 | Uncategorized

Currently, the Military Health System (MHS) is operating in the TRICARE 2017 (T-2017) contract. Recently, a report was released from the Government Accountability Office (GAO). This release indicates that DHA has only partially implemented six of the 13 elements required by the National Defense Authorization Act of 2017 (NDAA 2017) for T-2017. A full copy of this report can be found here.

Partially Implemented Elements

As a result, the GAO found six partially implemented elements which are as follows:

  • Provider Networks
  • Medical Management
  • Telehealth
  • Value-Based Methodologies
  • Prevention and Wellness Incentives
  • Beneficiary Involvement.

Elements Not Yet Implemented

However, the GAO found seven elements that have not yet been implemented. They are as follows:

  • Financial Incentives
  • Referrals
  • Medical and Lifestyle Incentives
  • Rural, Remote, and Isolated Areas:
    • Unique Characteristics
    • Network Challenges
    • Beneficiaries’ Access, Quality of Care, Outcomes, and Experience

In light of the report, we believe organizations that can help DHA address these elements could have opportunities to support the current TRICARE program as well as the next generation of TRICARE (T5).

Parties interested in T5 contract opportunities represent a diverse range of different segments of the health industry. Depending on the opportunity, the best role for a hospital, health system, or another type of provider may be as a subcontractor to a Managed Care Organization (MCO). In other situations, it may be better positioned to contract directly with DHA or one of the branches of the service.

Please contact us for more information on how your organization can actively pursue these opportunities.

 


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quoteMark

MYTH: Government agencies always award contracts based on price alone. Lowest price always wins.

FACT: While some contracts are awarded to the lowest bidder, government agencies also make awards based on the best value which includes trade-offs between the ability to perform the work, quality, past performance, and price.

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