TRICARE families report worse access to care than commercially insured, uninsured: study

veteran health care
A new study examines TRICARE members' access to care. (Rawf8/Getty Images)

Families who are covered through TRICARE report worse access to healthcare than people with private plans—and even the uninsured, according to a new study. 

Researchers led by a team at the Children’s Hospital of Philadelphia (CHOP) analyzed a sample of nearly 85,000 children to see how different coverage groups rated their access to care and the quality of the care they received, according to a study published in the latest issue of Health Affairs. 

Those with TRICARE reported similar access and outcomes compared with those who are covered by other public plans, according to the study. For example, about 34% of those enrolled in TRICARE described care as “accessible,” compared to about 51% of those with private coverage and close to 37% of those who were uninsured.  

Whitepaper

Elevate Health Plan Member Engagement Through Call Center Transformation

Learn how health plans can rapidly transform their call center operations and provide high-touch, concierge service to health plan members.

“Overall, families covered by TRICARE face greater challenges in access to the care they received compared to non-military persons,” Roopa Seshadri, M.D., a research scientist at CHOP’s PolicyLab and the study’s lead author, told FierceHealthcare. 

RELATED: Most of the DOD’s telehealth services are concentrated at 7 facilities, GAO says 

In addition, about 47% of those on TRICARE described their care as responsive, compared to about 52% of the commercially insured and about 51% of the uninsured. 

The results were starker among families with a child that has special healthcare needs, which were common in the TRICARE population, Seshadri said. These families may struggle to access needed specialty or behavioral healthcare services to meet those needs. 

Several factors are at play that can contribute to challenges faced by military families, according to the study. For one, these families move frequently, which can disrupt care and require regular switching between providers. 

Military bases are also often located in remote areas that may make it harder for these families to reach the care they need—especially in the case of specialty care, according to the study. 

RELATED: VA to spend $4.9B maintaining EHR over the next decade as it rolls out Cerner replacement 

The researchers hope that the findings lead to additional consideration about how the military could most effectively ensure families that need it have access to pediatric care and other specialty services, Seshadri said. 

Solutions that could be considered, according to the study, include reducing the administrative steps needed to allow families to seek care off-base, more effectively monitoring how resources within military medical facilities are deployed and identifying where there are the most notable geographic access gaps. 

“The purpose of this paper is really to highlight where there is a need and hope that those who are in a position to act upon and make the changes dive more into this area,” Seshadri said. 

Suggested Articles

Nearly 10,000 patients involved in research studies were impacted by a third-party privacy breach that may have exposed their medical diagnoses, test results…

Employers looking to continue investing in their wellness programs are eyeing services targeting mental health and women’s health, a new survey shows.

Payers have made strides digitizing and automating many core processes, yet prior authorization remains a largely manual, cumbersome process.