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S&W to accept Tricare

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Posted: Saturday, April 22, 2006 12:00 pm | Updated: 3:16 pm, Wed Aug 15, 2012.

By Don Bolding

Killeen Daily Herald

Scott & White Memorial Hospital officials announced Friday that they would begin accepting Tricare at all facilities after negotiations with Humana Military Healthcare Services.

Humana administers Tricare, the Defense Department health care program for members of the military and their families and military retirees. Local active-duty military personnel are supposed to go first to Fort Hood's Darnall Army Community Hospital, but family members and retirees have a choice with Tricare insurance, and soldiers may use it when they need medical care and are far from military facilities.

At times, also, military patients might be referred elsewhere when Darnall and its doctors are operating at capacity.

Tricare offers two levels of coverage: prime, which Scott & White officials said corresponds to a health maintenance organization level, and standard, which corresponds to a preferred-provider organization.

Officials of King's Daughters Clinic in Temple announced Thursday that they would continue accepting Tricare after saying earlier that they would discontinue it because Humana could not negotiate an acceptance contract because of limits the federal government imposes on Tricare's reimbursement amounts.

Those limits had been a factor in Scott & White's reluctance to carry the insurance, too, but Brent Blumenthal, executive director of the health group's regional clinics, said Friday, "We felt we should do more to aid our people in the service, and we were able to produce a new business model that will allow us to accommodate what Tricare can pay."

King's Daughters Clinic Chief Executive Kristi Glover said Thursday that Humana had asked the clinic to reconsider discontinuing Tricare because of the lack of medical facilities in the area that accept it, the Temple Daily Telegram reported Friday. She did not return telephone calls about the development Scott & White announced Friday.

Scott & White officials announced April 10 that they plan a new clinic that can accommodate five primary-care physicians at 1002 Wales Drive in western Killeen. Plans call for it to begin operation about the first of August with one doctor and a physician's assistant and to build up to meet demand.

Blumenthal said Friday that the physician staff at the existing Killeen clinic will be increased from 20 to 22. Scott & White's Killeen facilities currently include capacities for obstetrics and treatment for cancer and kidney disease. The clinic currently logs about 90,000 patient visits annually.

Blumenthal said that as far as he knew, the Humana-Tricare plans had not been decided when the plans for the western Killeen clinic were announced and that the insurance development would not accelerate its growth unless experience makes it necessary.

"We planned the western clinic because of the growth of population in the county, and everything now depends on what proves to be needed," he said.

Scott & White officials are not expecting a flood of new patients because people are not apt to change primary-care physicians suddenly. They expect more growth in referrals to specialists.

Scott & White clinics in Killeen, Florence, Gatesville, Temple, Belton and Georgetown will accept an established, limited number of Tricare patients.

Enrollment for Tricare primary care services with Scott & White begins May 1, with a June 1 effective date.

Contact Don Bolding at dbolding@kdhnews.com

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