Civilian Physician Acceptance of New Patients Under TRICARE Standard (Survey)- Phase I of III

Objective: The objective of this survey is to evaluate the Department of Defense’s TRICARE Standard health care option, in response to Section 723 of the Fiscal Year 2004 National Defense Authorization Act (NDAA). DoD, through HPA&E, is conducting a series of surveys in U.S. TRICARE market areas to determine how many civilian healthcare physicians accept TRICARE Standard beneficiaries as new patients. In FY 2005, 49 locations were surveyed (consisting of 20 state-wide market areas and 29 sub-market, Hospital Service Area (HSA) areas; 20 locations were surveyed in FY 2004. As required by Section 723, high priority was given to including locations recommended by beneficiary representatives; all recommendations were included in both years.

Results: In FY 2005, 90% of all responding physicians indicated they were aware of the TRICARE program (new question in FY 05), ranging from 99% (Watertown, NY) to 55% (Brooklyn, NY). In FY 2005 an average of 81% of physicians accepted new TRICARE Standard patients of those accepting any new patients, ranging from 96% (Peoria, IL) to 60% (Brooklyn, NY and Seattle, WA). The FY 2004 sites averaged about 82% ranging from almost 95% (Fayetteville, TN) to about 60% (Anchorage, AK). In FY 2005 90% of physicians accepting new TRICARE Standard patients accepted those patients for all claims, rather than on a claim-by-claim basis, ranging from 99% (Eau Claire, WI) to 79% (Monterey, CA). In FY 2004 89% accepted TRICARE Standard patients for all claims, ranging from almost 94% (Fredericksburg, VA) to about 71% (Anchorage, AK). In FY 2005 the 2 most frequent reasons cited for not accepting new TRICARE patients were: (1) “Dr. is not available” (e.g. too busy, not accepting new patients, limited practice) and (2) “Reimbursement”- related issues; while in FY 2004 they were: (1) “Reimbursement” issues and (2) “Only taking certain insurance”.

Status: Complete

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