TRICARE enrollees face obstacles finding mental health providers

Participants in the Defense Department's TRICARE health insurance program might have trouble finding providers, especially for mental health treatment, according to a new report from the Government Accountability Office.

"Concerns about the ability of TRICARE beneficiaries to access health care and mental health care from civilian providers continue," the report (GAO-10-402) stated. "In the wake of current military operations in Afghanistan and Iraq, [the Defense Department] and others have reported that service members and their families are at risk for mental health problems, given the stress of deployment and exposure to combat."

The report, based on a 2008 survey of doctors conducted by TRICARE Management Activity, a Defense oversight office, found mental health providers lacked knowledge of the program and were more reluctant than physicians to accept TRICARE patients. Ninety-five percent of physicians said they had heard of TRICARE. By comparison, 75 percent of mental health providers surveyed said they were familiar with the program, which covers 9.6 million people.

Eighty-one percent of physicians who were taking new patients said they would accept TRICARE participants, but only half of mental health providers in the same position said they would do so.

"The reason most often cited by [mental health providers and physicians] … for not accepting [participants in TRICARE's Standard, Extra and Reserve Select programs] as new patients, if they were accepting any new patients at all, was that they were not aware of the TRICARE program," GAO wrote. "Other reasons included concerns about low reimbursement rates and that the provider did not participate in TRICARE's provider network."

Providers' reluctance or inability to accept TRICARE patients hurts beneficiaries' ability to find care, the survey found. Thirty-three percent of system beneficiaries who use TRICARE Standard, Extra, or Reserve Select reported having trouble accessing a civilian mental health provider. Twenty-seven percent had difficulty finding a medical specialist to treat them, and 29 percent reported difficulty in finding a primary care doctor or nurse.

"The problem most commonly reported by [participants in those TRICARE programs], regardless of the type of provider, was that their provider was not accepting TRICARE payments," GAO said.

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