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News | March 15, 2007

TRICARE raises Alaska reimbursement rates

By Maj. April Eckerman 3rd Medical Group

To optimize access to care for its beneficiaries in Alaska, TRICARE Management Activity has launched a three-year demonstration project.

As of Feb. 1, civilian physicians and other professional providers in Alaska will receive payment at a higher rate than the TRICARE maximum allowable charge in the lower 48.

Access to health care services in Alaska is often severely limited by the overall scarcity of providers, their reluctance to accept TRICARE payment rates, transportation issues and other factors. TRICARE is raising reimbursement rates in response to these challenges. TRICARE provider payments are generally the same as under Medicare, unless the Defense Department takes specific action to increase payment rates in response to a severe access problem in a location.

During the three-year demonstration project, Alaska doctors will receive payment at a rate approximately 1.35 times the current TRICARE allowable rate. The demonstration will test to what extent savings in travel costs, lost duty time and other factors might offset the increased costs of provider payments.

The 3rd Medical Group and the Troop Medical Clinic at Fort Richardson will continue to meet a large percentage of their enrolled beneficiaries' needs in the Anchorage area.

When necessary, beneficiaries may be referred to local civilian providers. If local civilian providers are unavailable, or unwilling to accept TRICARE, patients must be sent to Seattle or another location for treatment, which is expensive, inconvenient and involves considerable lost duty time.

This project will test how increased payment affects provider participation in TRICARE, beneficiary access to care and the cost of health care services, all of which could impact military medical readiness, morale and welfare.

For questions or comments, call the TRICARE Alaska Office at 743-1800.