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Officials Aim to Manage TRICARE Costs, Preserve Future Benefits

Modest increases to certain aspects of military health care will help to responsibly manage costs and ensure benefits for future service members, the assistant secretary of defense for health affairs said today.

“The truth of the matter is the spiraling cost of health care requires us to adjust some fees and co-pays -- fees and co-pays that really have not been adjusted since the TRICARE program was put into place in 1994,” Dr. Jonathan Woodson said. “This allows us to responsibly manage our costs while providing access to high-quality care and ensuring the benefit is there for those that might serve in the future.”

Effective Oct. 1, military retirees enrolling in the TRICARE Prime health plan began paying slightly higher annual fees, Woodson said. “The [TRICARE Prime] fee increases for an individual has only gone up, essentially, $2.50 a month,” he explained. “And for a family, $5 a month. [The] total cost is really modest in terms of the overall cost of the entire year.”

Those enrolled before Oct. 1, however, won’t see an increase in cost until fiscal 2013, he added.

Woodson said two groups of TRICARE beneficiaries would not experience any increases: people who are medically retired and survivors of deceased active duty sponsors.

Defense Department officials recognize the potential concerns regarding fee increases during tough economic times, he said.

“We understand, particularly in the current economy and set of fiscal realities, any increase in [out-of-pocket] costs would cause some concern,” he said. “But I would remind everyone there have been no fee increases since 1994.” Woodson also noted that not all co-payments and fees have risen.

“There have been some adjustments in co-pays,” he said. “In one category, actually, the fees have gone down, so [for] those individuals who have mail-order pharmacy benefits [and] previously paid $3 for generic drugs, … that fee will go away.”

Beneficiaries will see modest increases in other co-payments for brand-name drugs, particularly at the retail level, which will go from $3 to $5, he explained. Nonformulary drugs will rise from $22 to $25 for both retail and mail-order pharmacies. For brand-name drugs, the cost will remain the same -- $9 for the mail order pharmacy.

Another potential concern Woodson addressed was staff reduction.

“It will not affect the care, and it’s important to note that while we’ve been talking about adjustments in fees and co-pays, that is really part of a real comprehensive strategy to manage our cost,” he said. “We’ve taken a look at the administrative costs of TRICARE and reduced the numbers of so-called full-time employees and contractors to reduce the cost before getting to the point of increasing the fees.

“But none of this will decrease the service or the quality of care that beneficiaries will expect and receive,” he added.

The health affairs chief also said the department has taken a very “modest posture on the current recommendation and rollout of fee increases.” Woodson said no decisions have been made on future increases, and he re-emphasized that this is the first increase since TRICARE’s inception.

“I would like everyone to understand that because of the … cost of health care, TRICARE is trying to responsibly manage its cost and ensure that this benefit is available for the future for those that who will serve,” he said. “This does require some adjustment in fees, but we’ve taken a position to really only modestly increase these fees, understanding that those men and women who have committed to service in the nation’s military should have a more generous benefit than those in the civilian sector.”

By Army Sgt. 1st Class Tyrone C. Marshall Jr.
American Forces Press Service

Special-needs Families Offer Insight on Challenges

 Military families with special needs would benefit from better consistency in services, more effective communication and improved health care education.

A group of specially selected family members offered up these suggestions for countering ongoing challenges during an exceptional family member panel held last week at the Defense Department's office of community support for military families with special needs here.

The panel was composed of 10 families with special needs -- from children with educational or physical challenges to adults with medical problems -- with representation from all services, as well as the active duty and reserve components.

The panel's aim was to help DOD officials "get a pulse" on the challenges special-needs military families face, said Rebecca Posante, deputy director of the office of community support for military families with special needs, which oversees the department's Exceptional Family Member Program.

"We want to make sure what we think are the issues are what the families think are the issues," she said, "and see if we're going in the right direction."

Panel members spotlighted three key areas of concern: consistency, communication and health care, Posante said.

Across the board, panel members raised issues about the consistency of special-needs services across the branches and between the active duty and reserve components. For example, if a Navy member goes to an Army facility, that member should expect to receive the same quality and similar types of services, Posante said. And, people should get the same support regardless of activation status or uniform, she added.

Family members wanted to know, "Why do we get this when we're here, but not in another place?" Posante said.

Panel member Debora Childs, wife of Navy Chief Petty Officer Louis Childs, said she was pleased this issue was brought to the table. The couple has five children, three of whom are enrolled in the Exceptional Family Member Program. Their 11-year-old daughter, Desiree, was diagnosed with sickle cell anemia at birth and has asthma, and their two adopted sons, 14-year-old Jordan and 10-year-old Scottie, have issues ranging from learning disabilities to autism.

The 17-year Navy spouse said she hopes the department can find a way to make the program universal across the branches to "make sure the language is the same, the application process is the same and the services are the same" for all. That way, she said, if she's living near an Air Force base, she can be assured the experts there will know what types of services she's supposed to receive regardless of her service affiliation.

These consistency issues, Childs noted, can be compounded when moving. Parents want to ensure important services aren't interrupted during transition, she said.

Fellow panel member Army Maj. Charlotte Emery, mother of twin boys and a military lawyer at Fort Belvoir, Va., said she'd like to see better consistency regarding respite care for children. Her 2-year-old sons both are enrolled in the Exceptional Family Member Program. One was diagnosed with autism at 18 months and his brother with developmental delays for speech, language and socio-emotional behavior.

Emery said she relies on respite child care for a break from her full-time job and parenting of the twins and her older daughter. Just a few hours for a run or a nap can carry her through the tough days when the boys are running around nonstop, she said. However, the ease of getting a few hours of child care varies from service to service.

"It's disconcerting, when you see such a difference between service branches, especially when we're in such a joint environment," she said.

Military families with special-needs families all start the same process with the same form, she said, and "everything that flows from that form should mirror."

Communication is another point of concern, Posante noted. It's an ongoing challenge to ensure the right information is getting to the right people in a timely manner. Her office, she pointed out, already is working this issue. They just launched a mobile website, she explained, that can be accessed via smartphone with the simple swipe of a barcode.

The site offers a program overview, links to service program sites and features an Exceptional Family Member Program contact locator. "We're hoping this will open up the program to a lot of younger people," she said.

Posante said military families who aren't near an installation, including those of the National Guard and reserves, can call a Military OneSource consultant for support and to discuss special-needs concerns. Families can receive 12 free consultations per year by calling 1-800-342-9647 or by visiting the Military OneSource website.

On the topic of health care, families discussed the need for better education regarding benefits, Posante said. Panel members suggested TRICARE develop an online health care course that describes benefits for special-needs families clearly and in detail. An online course, she noted, is "very doable."

Other health care issues, Posante explained, center on Extended Care Health Option, or ECHO, a supplemental program to the TRICARE basic program that offers financial assistance for a certain set of services and supplies for eligible active duty family members.

The panel also discussed fiscal constraints and how the current austere budget environment would affect the program, Emery noted.

"Much of the time, we were talking more policy -- how to do more with less," she said. "What should we do to optimize successes for everyone? What can we do that wouldn't be cost-added, but effective?"

Emery said the family members tried to give personal examples, but veered away from keeping the topics too personal, trying to make sure they addressed the big-picture issues that affected the most people possible.

It was encouraging to note that "much of what we discussed, they are already working on or had conceived of," Emery said of Posante's office. "We were validating where they're already headed. That's the telling point. We weren't that far apart."

Officials will use the panel's feedback and suggestions in an after-action report, which will help them devise an approach to tackling these issues, Posante said. Some of the suggestions, such as TRICARE online training, can be implemented quickly, while other ideas will call for a longer haul, she added.

Either way, the plan is to bring the same family members back in six months to evaluate progress and offer suggestions for the future, she said.

"I walked away feeling like we had a real partnership with the families," Posante said, noting her gratitude for the families' participation. "A lot of what we're doing, we're right on track, but a few things we might need to put a new focus on."

Childs said she was grateful for the experience.

"I feel extremely hopeful," she said. "The people who put this together really valued and sought our opinion. They encouraged us to be frank, and reassured us that they will take the suggestions and will apply them to the program appropriately, accordingly, and the program will be better than it is today."

By Elaine Sanchez
American Forces Press Service