Defense Health Care: Lessons Learned from TRICARE Contracts and Implications for the Future

This testimony discusses lessons learned from the Department of Defense's (DOD) TRICARE contracts and their implications for the future. TRICARE's successes and maturity reflect the ability of the DOD and its contractors to work within the current contract structure. However, it has not been easy, and there are important lessons from current contract shortcomings that need to be addressed in designing future TRICARE contracts. Most, including DOD, believe that the current contracts are too large, complex, and prescriptive in nature, limiting innovation and competition. Also, numerous adjustments to these contracts have created an unstable program, and program costs have been difficult to predict, contributing to annual funding shortfalls. Additionally, financial incentives, accountability, and data quality need to be strengthened to achieve greater efficiencies. To address these weaknesses, DOD redesigned its solicitation for the next round of TRICARE contracts; however, the initial issuance was withdrawn because of internal concerns and reservations about its costs and specifications. DOD is now reassessing how to structure the TRICARE contracts and is considering the views and recommendations of the Defense Medical Oversight Committee, a group formed to oversee TRICARE.