HMO will serve area military

America’s military is not immune to the soaring costs of health and medical care, and like private businesses around the nation, it is looking to managed care as an alternative to help battle medical inflation.

Coming this spring, the military version of the health maintenance organization will come to military facilities around the region, including F.E. Warren Air Force Base in Cheyenne.

It’s called TRICARE, and it’s a managed-care health and medical care program for active-duty military, eligible family members and non-Medicare retirees, their families and survivors of all uniformed services.

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The program is designed to expand access to care, assure high-quality care, control health-care costs for patients and taxpayers alike and improve medical readiness, according to TRICARE officials.

The program will be jointly managed by the military in partnership with civilian contractors, with a senior military health-care professional serving as lead agent to oversee the program in each of 12 regions around the country.

TRICARE began in March of 1995 in Washington and Oregon and now is being implemented around the country, region by region. It is scheduled to start April 1 at Warren and other facilities in the huge Region 8, which is headquartered in Colorado and extends from Idaho east to Minnesota and Missouri.

“Right now, the contractor is doing the majority of the work, building up its network and negotiating with the local hospital and local providers,” explained Capt. Lowell Glassburn, recently assigned to manage the TRICARE program at Warren.

With an April 1 projected start, establishing the provider network to augment the care provided by Air Force doctors at the base hospital is important, although Glassburn noted that Warren has always had somewhat of an HMO approach and has contracted with local civilian providers.

“There’s a lot to do in this area,” Glassburn said, noting that HMOs are not as established here as in other areas where TRICARE is up and running. “We’ve got to get the network up,” he said.

On Feb. 1, enrollment will start for military families and others eligible for the new managed-care plan.

TRICARE offers three different plans: TRICARE Standard, a basic fee-for-service option similar to the current CHAMPUS program; TRICARE Extra, a preferred provider plan that promises savings over Extra; and TRICARE Prime, a full HMO-type plan. (CHAMPUS is the Civilian Health and Medical Program of the Uniformed Services, a cost-sharing program currently in place that helps eligible military personnel pay for civilian medical care).

There are no enrollment fees for active-duty military families, but retirees will pay individual or family annual enrollment fees as high as $230 single and $460 family for the TRICARE Prime program.

The military has always prided itself on providing comprehensive medical care to its personnel and their families, but rapidly rising costs, coupled with the closure of many military bases and their hospitals, make the TRICARE managed-care alternative a better deal for military health-care providers and military patients, according to a Department of Defense briefing paper.

“Decreased access to military health-care facilities should not be blamed on TRICARE,” it says. “Massive cuts in the Services require cuts in the DoD’s medical structure. While the driving force — the end of the Cold War — is good, the resulting cuts to the Services’ medical departments require us to change the way we do business.

“The Cold War’s end is a boon to all humanity, but it has side effects — huge cuts in our forces, including medical services,” the briefing paper continues. “DoD medical leaders found a better way, one that efficiently knits military and civilian resources into a seamless system to maintain or improve quality, increase access and control costs for beneficiaries and taxpayers. TRICARE is that better way.”

At Warren, some 4,000 active-duty Air Force personnel will automatically be enrolled in TRICARE, and some 5,000 retirees in Warren’s catchment area will have the option of signing on.

“We’re working with the contractor, trying to identify the workload and the total number of eligible patients,” Glassburn said.

Warren’s catchment area has been extended beyond the normal 40-mile radius from base because of the discovery of several significant pockets of military retirees in Laramie and Northern Colorado, primarily in the Fort Collins, Greeley and Loveland areas that will be covered by Warren.

The advent of TRICARE should not have a significant impact on the base hospital at F.E. Warren or either increase or decrease medical staff there, he said.