NCPA April 5, 2013

An estimated 620,000 Pentagon health care recipients -- a group that includes military retirees, National Guard members and reservists and the children of some active-duty troops -- struggle to find private doctors who will accept them as patients, according to a new study from the U.S. Government Accountability Office.

• Many doctors reported that they turn away these patients because they are unfamiliar with the Pentagon health care program known as TRICARE.
• Others say they did not like how little they are compensated or how long it takes TRICARE to reimburse them.

The end result "is a potential problem with (beneficiaries) getting access to care, and that's particularly mental health care," says Debra Draper, director of the study.

The number of private doctors accepting new TRICARE patients is trending downward, the study says, and is worse in certain categories.

• Only about 40 percent of civilian mental health providers take these patients compared with 67 percent of primary doctors and 77 percent of specialty physicians.
• Civilian doctors in California and Texas were the most likely to turn away TRICARE patients.
• While nearly all doctors in those states were accepting new patients, more than half rejected TRICARE beneficiaries.

The Pentagon provides health care for 9.7 million active-duty troops, military retirees, some National Guard members and reservists, and military children. The majority receive care mostly from military doctors. But about 2 million choose a form of TRICARE, allowing greater flexibility in picking doctors, in many cases because they do not live near military bases. About 70 percent of this group are military retirees and their dependents. The rest are children of active-duty troops or National Guard and reservists and their dependents.

Sources:

Gregg Zoroya, "Civilian Doctors Wary of Accepting Military's TRICARE," USA Today, April 3, 2013.

"Defense Health Care: TRICARE Multiyear Surveys Indicate Problems with Access to Care for Nonenrolled Beneficiaries," U.S. Government Accountability Office, April 2013.