On January 1, Tricare – Essential health care services at the service of the millions of soldiers, retirees and their families – entered a new cycle of contracts to manage the military health care system. This transition, intended to improve efficiency and service, has rather exposed Tricare to a systemic failure, mismanagement and what seems to be more and more serious negligence.
Since the launch, families across the country have experienced a Catastrophic disruption of care. Registration errors have left uninsured beneficiaries. The surgical procedures were canceled when hospitals were unable to check the prior authorization. Patients with chronic patients had trouble finding providers to maintain survival treatment. For many disabled children, years of harshly disputed progress may be erased because the therapy meetings have been suddenly arrested.
The source of these failures does not only reside with regional entrepreneurs – Humana Military (East) and Triwest Healthcare Alliance (West) – but with the Defense Health Agency (DHA), who assumes full responsibility for monitoring contracts and system responsibility.
It is clear that the DHA ignored the lessons of the past or has failed to learn. In 2019, the Office of government responsibility (GAO) warned that the previous Tricare transition in 2017 was spoiled by weaknesses in transition and surveillance advice. Gao’s recommendations have been poorly implemented or ignored – and now the families of the military pay the price.
Despite years to prepare for the 2025 transition, similar traps have emerged – only this time, the consequences seem to be wider and deeper.
Many suppliers across the country have unpaid past for monthsDespite the submission of complaints through systems which should have been validated before the start of the provision of health care. Complaints are refused or delayed with little or no explanations. Providers – including many military spouses or veterans – were forced dive into personal savings or completely close operations. Some have left the Tricare network for good, citing the lack of reliability and the financial damage caused by this transition.
In a recent survey led by the Alpha Plaidoyer mission, Family report Spend hours pending with Tricare entrepreneurs – to be disconnected or say to “recall later”. In one case, a retiree reported that their surgical intervention had been postponed because Tricare wrongly affirmed that they had another health insurance. Another family shared their child’s applied behavior analysis services has stopped due to the lack of payment of service providers since January 1, leaving this parent to be concerned about loss of progress. In addition, a beneficiary could not plan to monitor surgery because the reference was not processed and the supplier refused to accept the DHA reference referral because of the unpaid allegations.
The ineffectures have now aggravated in what can be described as a drain on federal and beneficiaries. Each unpaid complaint, each poorly directed call and each lost supplier is equivalent to a waste of dollars of taxpayers. Family report Pay more than expected for services that should be covered and are concerned about their financial stability if they are not reimbursed.
And what has been lost in chaos is confidence. Confidence between families and their health care system. Confidence between providers and military medical infrastructure that they have been supported for a long time. And perhaps the most critical, the confidence between strength and the leaders responsible for ensuring military preparation.
Preparation does not only concern planes and ammunition. It is a question of bringing the troops back to combat after having undergone an injury – but that cannot occur without access to health care. These are also families who can work at home so that the service member can focus on the mission. When a child loses critical therapy, when a spouse cannot obtain prenatal care or when a service member cannot ask for a timely care to deploy it – that The preparation is compromised.
Resilience – the capacity of the military’s families to resist relocations, deployments and constant separation – is based on predictable support systems. When families move to a new service station and discover that their Tricare services are inaccessible, resilience becomes even more difficult.
What about retention? It evaporates when the families of the military feel neglected. No incentive salary or patriotic call can convince a family to stay if the health care system that serves them is broken.
It is not only a failed transition. This is a breach of duty by people responsible for managing one of the most critical advantages of military life. The military health care system has always been a promise – a commitment to take care of those who serve and their loved ones. This promise was broken and people’s lives was negatively impacted.
Unless there is an account in the way the Ministry of Defense and the DHA manage and supervise Tricare, this crisis will continue to disentangle our health care services. And with it, the confidence of the very people who ensure our nation safe.
Dr. Kristi Cabiao is the CEO and president of Mission Alpha Advocacy, an organization that collaborates with legislators, military leaders and other organizations to create legislation to improve the quality of life of families in the exceptional family members’ program. She is a retirement spouse of the Air Force, mother of an autistic child and defender of disability.