Sunday, February 8, 1998

Improvements reported in military health care program

By Charles Stenholm

A little over a year ago, I brought together representatives of the Department of Defense, the Air Force, Foundation Health Federal Services, Dyess Air Force Base and the Abilene community to resolve concerns about the implementations of TRICARE, the military managed health care program, in Abilene. I was proud to show outsiders the high level of support for Dyess in the Abilene community as well as our ability to seriously tackle the challenges of dealing with the TRICARE program in our region.

I am happy to report great strides have been made in all areas that were identified. The group tackled all the issues with enthusiasm and determination, with each member focused on the end result -- creating long-term solutions, rebuilding trust in the community and improving the TRICARE program nationwide.

The efforts put forth by the local community contributed immeasurably to successful resolution of many of the issues. We owe a debt of thanks to Abilene Regional Medical Center and Hendrick Health System; Russ Brown and Burt Means, representing beneficiaries; and Pat Evans and Dr. David Bailey, representing the medical community. Also, the Dyess military leadership, Foundation Health Federal Services and the TRICARE Southwest Lead Agent deserve a round of applause for their continued support during this process.

The many accomplishments include:

n Claims processing -- The most pressing problem was the correct and timely payment of claims. Foundation Health, the TRICARE administrator in Region Six, working with Abilene physicians, resolved all previously identified outstanding claims.

To facilitate improved claims processing, Foundation Health is providing education for providers on electronic filing of claims that will allow for quicker payment of claims and has made electronic billing capability available for provider offices. Also, Foundation Health initiated a provider "call-back" program to provide personalized services for providers experiencing claims problems.

n Availability of and access to care -- Since the town hall meetings, there have been multiple efforts to increase the availability of and access to care at Dyess AFB and in the community. The working group's success has resulted in establishment of Resource Sharing Agreements that will provide expanded services at Dyess Hospital. Additionally, the hospital established an Extended Care Clinic, which has increased appointment availability and is open after hours, weekends and holidays.

The recent return of deployed military providers from Saudi Arabia will further increase Dyess Hospital's healthcare capacity.

To improve healthcare delivery capability, Foundation Health Federal Service is recruiting physicians to increase the provider network. This remains an ongoing process, and I will be closely monitoring Foundation Health's progress in providing the services needed for the Dyess community.

n Customer service enhancements -- I am pleased to confirm that the Air Force plans to provide approximately $9 million to upgrade Dyess Hospital. This funding will improve outpatient functions, including pharmacy, radiology and laboratory services.

To improve customer services, Foundation Health has increased the size of the hospital's TRICARE Service Center and upgraded its telephone systems. Also, three new Foundation Health staff members were added to enhance the overall relationship of the military-provider community and provide an avenue for timely resolution should problems arise.

Increased education efforts are ongoing in an effort to help assist TRICARE beneficiaries and providers in navigating the TRICARE system more effectively.

I am pleased with the continued improvements in all areas. Once again, I commend the TRICARE working group for their efforts. The communication and trust among all partners were vital to success.

Health care in general, and military health care in particular, is an important issue that has a profound effect on a large number of people. It is an issue in which I will continue to take the lead to ensure patients receive the best care, that health care providers are appropriately paid for that care and that we achieve this while living within budgetary constraints.