tricare south reserve/guard advisory committee meeting april 12, 2011
TRANSCRIPT
TRICARE SOUTH RESERVE/GUARD ADVISORY
COMMITTEE MEETING
April 12, 2011
Overview
• Opening Comments
• Items From Last Meeting
•TRICARE Reserve Select and TRICARE Retired Reserve
•New TRICARE Programs
•What T-3 Contracts Mean to You
•TRO-South Support for Mobilizing/Demobilizing RC Units
•Maximizing Humana Military's Briefing Support
•TRO-South Support During Contingencies
•Feedback from the Field
•Closing Comments
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Mr. Mac Sanders Customer Service Representative TRICARE Regional Office - South
Items From Last Meeting (July 29, 2010)
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• TRICARE Eligibility and Federal Employee Health Benefits Program
• Claim Resolution Issues– Members not aware of active duty benefit
implementation
• Link TRICARE Pharmacy Home Delivery site to Air Force Reserve Web site
Items From Last Meeting (July 29, 2010)
Air Force Reserve Command (AFRC) Home Delivery (HD)
Mail Order Outreach • Partnership established between AFRC and TRO South to support
TMA’s strategic objective to encourage use of HD, when medically appropriate.
• Concept: Leverage AFRC’s Human Resource (HR) Web Portal to disseminate HD education material to AF Reservists/National Guardsmen.
• Coordination with and support gained from Chair, TMA HD Committee to provide HD educational products to AFRC.
• TMA and TRO South awaiting AFRC’s Phased plan to determine processes used to capitalize on the distribution of HD material on the HR Web Portal.
TRICARE Reserve Select and TRICARE Retired Reserve Program Overview
Ms. Sherry Steindel
RC BCAC, TRICARE Regional Office - South 6
South Region TRS Enrollment Trends: By Reserve Component
Source: DEERS Data as of March 24, 2011
Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11Army National Guard 6,517 6,734 7,124 7,443 7,797 8,040Air National Guard 2,162 2,185 2,210 2,298 2,339 2,325Army Reserve 5,122 5,314 5,322 5,350 5,433 5,489Navy Reserve 2,336 2,385 2,451 2,533 2,609 2,635Air Force Reserve 2,396 2,541 2,604 2,656 2,734 2,805Marine Reserve 725 741 772 789 804 841Coast Guard Reserve 360 403 413 429 450 451Total 19,618 20,303 20,896 21,498 22,166 22,586
http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm
South Region TRS Enrollment Trends: National Guard by State
Source: DEERS Data as of March 24, 2011
National Guard TRS Enrollment by State Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11
AL 902 930 966 1,004 1,030 1,035AR 747 742 757 800 802 799FL 916 935 937 997 1,017 1,062GA 759 834 937 1,043 1,112 1,151LA 644 657 711 756 773 799MS 740 827 925 947 998 1,017OK 715 615 621 631 638 612SC 775 806 807 830 852 855TN 880 946 1,009 1,028 1,130 1,242TX 1,601 1,627 1,664 1,705 1,784 1,823
http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm
Puerto Rico TRS Enrollment Trend: Reserve Component
Source: DEERS Data as of March 24, 2011 http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm
Army National Guard 74Air National Guard 20Army Reserve 76Navy Reserve 9Air Force Reserve 2Marine Reserve 3Coast Guard Reserve 2Total 186
Feb 11
South Region TRR Enrollment Trends: By Reserve Component
Source: DEERS Data as of March 25, 2011
Jan-11 Feb-11
Army National Guard 0 0Air National Guard 0 0Army Reserve 56 66Navy Reserve 34 38Air Force Reserve 64 72Marine Reserve 4 4Coast Guard Reserve 0 0Total 158 180
http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm
New TRICARE Programs
Mr. Bill Prevo
Network Operations, TRICARE Regional Office - South 11
TRICARE Young Adult Program (TYA)
• TRICARE Prime, Standard/Extra benefit with applicable co-payments, deductibles and cost shares for unmarried dependents
• Full premium based program available worldwide– Current premiums not yet established
• Eligible for care in military treatment facilities (MTFs) according to access priority of sponsor
• Not authorized for those eligible to enroll in employer sponsored health insurance plan
• Phased implementation – TRICARE Standard/Extra retroactive to 1 Jan 2011 beginning 1 May 2011
– TRICARE Prime enrollment October 2011
• Enrollment Projections for South Region– 77,861 eligible, 7,565 initial enrolled increasing to 21,615 by 2015
– Approximately 1,300 enrolled in CHCBP will convert to TYA if eligible
Enrollment Portabilityfor ADSMs and ADFMs
• “Movement Made Easy for Active Duty Family Members”– Designed to simplify and expedite PCM changes for PCS moves– Includes overseas transfers
• Allows verbal notification to losing MCSC of upcoming transfer without visiting MTF/TSC
• Losing MCSC emails transfer info to gaining MCSC daily
• Retains current PCM enroute– Referral/Auth for non-urgent care still required
• Gaining MCSC contacts family within 5 days of date of relocation to obtain additional information to complete PCM change to new region
• PCM change form required if signed ATC waiver is required
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New TRICARE Contract and
What It Means to You
(Update on T-3)
Ms. Martha Lupo
Chief Operating Officer, TRICARE Regional Office - South14
T-3 Managed Care Support Contracts
• New Managed Care Support Contractors Selected
– Current Awardees: HealthNet, Humana, TriWest (red = under protest)
– North Region started health care delivery
under T3 on 1 April 11
– South Region target start date is 1 April 12
– West Region will start after the South
– Minimum 10-month transition period
– Current contractors continue care in interim
• No significant change in covered services in T3
• T3 improves focus on preventive health, case management, quality outcomes, coordination of care, and consistent communication
Enhanced RC Outreach
Mr. Mac Sanders Customer Service Representative, TRICARE Regional Office - South
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Strategy
Coordinate with all pertinent parties to:
• Ensure accurate TRICARE benefit information provided to Reserve Component (RC) members and their families
– During early eligibility period and deployment– During demobilization and transitional
assistance management program (TAMP).
Enhanced Outreach Objectives
• Ensure RC beneficiaries have up-to-date TRICARE information– Humana Military provides TRICARE briefings during all Yellow
Ribbon events Emphasize access to care for member and family
• Utilizing personnel listing with address provided by the unit– Provide mapping of where the member/family reside– Provide physician (network/non-network) in all zip codes where
families reside Meet with unit personnel to discuss findings
• Maintain constant contact with unit commander, rear detachment leadership, or TRICARE liaison as appropriate
• Ensure TRICARE issues are addressed as they occur.
Current Outreach
• Quarterly RC telephone conferences– All health benefits advisor RC personnel invited– Subject matter experts speaking on relevant issues– Share success stories
• TRICARE BCAC & Communications Partnership meetings
• Post Card Mail-outs• TRICARE email blasts• Direct2U• TRO-South RC Web site
http://www.tricare.mil/trosouth/Reserve-Guard_Education.cfm
TRICARE Support to the
53rd Infantry Brigade Combat Team
Mr. Ray Sanchez Chief Program Operations Division , TRICARE Regional Office - South
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Demobilization Preparation
•On 9 Nov 10, a Working Group met with reps from:-TRO-South -Humana Military Healthcare Services-Value Options-Florida State Surgeon’s Office-53rd IBCT (National Guard, Florida)-Winn Army Community Hospital
•Goal to develop a plan for an effective medical referral process for redeploying Soldiers and to sign up the maximum number of Soldiers for TAMP Prime.
Process Changes
•Same day processing for all referrals to receive care at home.
- Behavioral Health: Soldiers departed Fort Stewart with date, time and name of BH provider they would see at home (Value Options).
- Other Medical: Soldiers departed Fort Stewart with authorizations in hand (name and contact information for specific provider).
Results
• 457 ADSM = 770 Referrals (80 BH) – 764 subsequent referrals
• Appointments made for all Behavioral Health referrals
• 550 TAMP enrollment forms completed
• 457 tracked by Warrior Navigation Assistance Program (WNAP) (30, 60 and 90 day intervals)
Future Behavioral Health Support
Deployment or Redeployments
• TRICARE Behavioral Health Care Provider Locator and Appointment Assistance Line was discontinued on 31 March 2011.– Behavioral Health referrals to be accomplished like
physical medicine referrals, authorization and provider information given
– No appointments made
Maximizing Humana Military’s Briefing Support
Mr. Wendell Cheek, Director Guard and Reserve Programs, Humana Military Healthcare Services
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Maximizing Humana Military’s Briefing Support
BRIEFING TIME VS. BOOTH ONLY
– BENEFITS OF A 30 MINUTE BRIEFING
– ALLOWS CREDIBILITY WITH AUDIENCE– UPDATED INFORMATION
– EVERYONE HEARS THE BRIEFING– STIMULATES DISCUSSION
– ALLOWS FOR QUESTION AND ANSWER– MORE FOCUSED ON THE TARGET AUDIENCE
– BENEFICIARY BECOMES MORE KNOWLEDGEABLE– LEADS TO ONE-ON-ONE DISCUSSIONS
– OPPORTUNITY TO PLUG TRS– SLIDES HELP SM AND FAMILIES TO RETAIN
INF0RMATION
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Maximizing Humana Military’s Briefing Support
BENEFITS OF BOOTH ONLY
– ALLOWS FOR ONE-0N-ONE PERSONAL DISCUSSION
– INDIVIDUAL SM OR FAMILY MEMBER GAINS KNOWLEDGE
BEST OPTION IS BRIEFING AND BOOTH/INFORMATION TABLE
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TRO-South Support During Contingencies
LT William Chew
Coast Guard Liaison Officer, TRICARE Regional Office - South29
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2011 Hurricane Season
Source: http://[email protected]
Hurricane Season begins 1 June through 30 November, peak season exists from
mid-August to late October
TRO-S Contingency Support Activities
• Generate TMA Primary Care waivers for referrals– Eliminates point of service fees– MTF/TRO initiate in collaboration with MCSC– Pharmacy and Dental waivers– End Automatic Disenrollment of Beneficiaries due to non-payment
• Communication: provide updated information and outreach to beneficiaries, (webpage and printed informational materials, mail postcards, visit evacuation shelters, and toll-free numbers)
– Resource Sharing Opportunities– Increase awareness of Stakeholder Participation ( Contingency Exercises)– Increase awareness of MTF, Humana Military, and TROS
• Value: rapid response to contingency events– Established communication with waiver granting authorizes – Collaboration and team work– Lessons learned locally transferred throughout the region
• Recent Events: 116 contingency exercises completed last year with the MCSC and 45 MTFs– Monitored 4 hurricanes and 6 Tropical Storms– Tracked and supported Haitian earthquake patient evacuees– Supported Deepwater Horizon Gulf oil spill disaster– Assisted with relocation and waiver approval from TN floods affecting Millington, Nashville and
Knoxville– Monitored OK wildfires affecting statewide Emergency Prescription Refill authorizations– Engaged with ongoing support of Japan and Bahrain evacuation relief efforts
Contingency Support for National Guard and Reservists
• Activated Service members under Federal orders for contingency– Various search and rescue, command and control and
evacuation missions following hurricanes and other disasters
• Activated Service members displaced from duties at contingency site
• TRS enrollees• Deep Water Horizon Gulf Oil Spill
• Targeted TRICARE Briefings and Prime Enrollment support
Open Discussion
Feedback From the Field
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Questions ?
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Mr. William Thresher,Director, TRICARE Regional Office - South
Mr. Larry Burchfield, Senior Executive, Humana Military Healthcare Services
Closing Comments
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