May 02, 2023
The U.S. Defense Health Agency (DHA) has reaffirmed the award of the TRICARE West region managed care support contract to TriWest Health Alliance.
DHA initially awarded the contract in December 2022, but the current contractor, Health Net Federal Services (HNFS), filed a protest with the Government Accountability Office. Although the protest has been dismissed, there is the possibility of further legal action that could delay implementation. Absent any further delays, the health care delivery under the TriWest contract would begin in August 2024.
Under the new contract, TriWest will be the contractor that facilitates beneficiary health care in the civilian sector and provides administrative support services to Tricare beneficiaries throughout the 25 state western region, which includes California. (Six states will be shifting from the east region to the west region beginning in 2024 to balance to the TRICARE population each regional contractor manages.)
According to the U.S. Defense Health Agency (DHA), built into the new contract is an ongoing commitment to improving access to and quality of health care services. The regional contractors will do this in a variety of ways, including:
- Supporting innovation and health care industry best practices
- Creating efficient ways to reduce health care costs
- Providing a foundation for future health care demonstrations and pilots
- Improving how military hospitals and clinics and civilian care can work together to enhance patients’ health care experience
The California Medical Association will be closely monitoring the transition, and will provide more information as it becomes available. Physicians can also sign up for email alerts from TRICARE to receive information about the upcoming changes.