Military Health Care News

Military Health Care News

On Oct. 1, 2008, TRICARE Management Activity awarded contracts to the six designated providers of the Uniformed Services Family Health Plan (USFHP).
The USFHP is a Department of Defense (DoD)-sponsored health plan, made available by nonprofit healthcare providers in six service areas across the country. Over the years, DoD has partnered with these former U.S. Public Health Service facilities to provide care for military beneficiaries. Initially, they were given a statutory deemed status as military healthcare facilities. In 1997, Congress mandated that they become a permanent part of the Military Health System, to administer a program that became known as the US Family Health Plan.

USFHP offers the TRICARE Prime benefit to over 100,000 military beneficiaries, including active-duty family members, activated Guard and Reserve family members, and retirees and their family members. More than 40 percent of the USFHP participants are 65 and older.

The six not-for-profit healthcare organizations awarded these five-year contracts are:

Saint Vincent Catholic Medical Centers, New York, N.Y.;
Brighton Marine Health Center, Boston, Mass.;
CHRISTUS Health Systems, Houston, Texas;
Johns Hopkins Medical Services Corporation, Baltimore, Md.;
Martin’s Point Health Care, Portland, Maine; and
Pacific Medical Centers, Seattle, Wash.
One of the hallmarks of the USFHP is its ability to maintain a consistently high level of patient satisfaction. In 2008, overall satisfaction with the health plan was 87.9 percent, as compared to 61.9 percent for traditional HMOs. Contributing to this high level of satisfaction is a wide array of disease and care management programs, designed to keep members healthy and provide individualized care. Members are provided a comprehensive range of benefits, from preventative and wellness programs to intensive case management for members with chronic or multiple health conditions.

The 1997 National Defense Authorization Act directed DoD to include designated providers (DPs) in the health care delivery system of the uniformed services using sole source contracts. On Oct. 2, 2009, TRICARE Management Activity announced that TRICARE now provides primary caregivers of active duty service members (ADSMs) a respite benefit due to section 1633 of the 2008 National Defense Authorization Act (NDAA).
This respite benefit gives caregivers who help homebound ADSMs needing frequent help a break from their responsibilities.

It is important to know that “homebound” members are service members whose conditions or injuries make them unable to leave home without taxing effort. “Frequent” means that service members need more than two interventions during the eight-hour period per day that the primary caregiver normally would be sleeping.

To provide the best possible help and respite for caregivers, this benefit will provide a maximum of eight hours of respite per day, five days per week.

ADSMs, or their legal representatives, can submit receipts for reimbursement of respite care services that were provided after Jan. 1, 2008, by a TRICARE-authorized Home Health Agency.

For more information about this benefit visit the TRICARE Web site at http://www.tricare.mil

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