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Testing value-based insurance for people in military

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tricare

The  defense bill  signed last week by President Obama includes a pilot program to test value-based insurance coverage in Tricare, the U.S. Defense Department’s health-benefits program.

A provision in the bill calls for a program to  reduce or end co-pays and other cost-sharing for some drugs and services  that are considered high quality because they offer proven results — as in evidence-based medicine. Providers considered high-value would be reimbursed at higher rates as well.

The next defense secretary must submit a report within the next six months detailing which providers, services and medications will be considered high value and identify the co-pays or  other cost-share amounts to be reduced or eliminated when Tricare patients choose high-value care.

Modern Healthcare reported: “If the pilot results in people with certain conditions, such as heart disease and diabetes, having better outcomes, reduced emergency room visits or hospitalizations, and enhanced care, it may be rolled out to the entire Tricare population, according to a press release.”

Tricare provides healthcare coverage to about 9.4 million people in the military, retirees and their families. In 2015, the Defense Department spent $48.7 billion on healthcare services through Tricare.

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