As the Military Health System and Army Medicine continues to transform and modernize healthcare delivery to increase Soldier medical readiness, Ireland Army Health Clinic is preparing for its part of this change.

According to Col. Kevin Bass, IRAHC and Fort Knox MEDDAC commander, IRAHC's primary mission is to support active duty Soldier medical readiness, but the clinic must also ensure access to quality and timely healthcare services for the remaining beneficiary population.

"While Army Medicine continues to implement new initiatives to increase medical readiness, IRAHC-- like all military treatment facilities-- is experiencing increased demands to improve efficiency, access to care, and patient experience," Bass said.

"To decrease appointment wait times for active duty Soldiers and ensure a better patient experience for everyone, we're transitioning some retired beneficiaries and their family members to the local managed care (Tricare) network," he said. "While these beneficiaries will receive their care from a network provider, they will continue to have access to pharmacy, laboratory and other specialty services at IRAHC. Leveraging our local network allows us to manage our beneficiary population at the MTF while still providing our retiree population with access to quality care."

The beneficiaries effected by the transition fall into one of four categories: 1) They are enrolled in the Tricare Plus Program, 2) enrolled in the Tricare for Life Program, 3) have been granted a driving waiver to travel more than 30 minutes from their home to be seen at the clinic, or 4) have not been seen as a patient at IRAHC in more than one year.

To help with the change from the military facility to the network, Bass and his IRAHC team have created a process to immediately address requests for assistance and to answer any questions.

That gateway to ready-assistance is called the Beneficiary Transition Cell and according to Tina Birch, the chief of the Managed Care Division, the BTC will act as a bridge between IRAHC and network primary care providers to facilitate a smooth transfer of care.

"The BTC will help meet patients' needs with items like scheduling a transition appointment with a patient's current primary care manager to ensure medications, lab-work, and referrals are up to date," she explained. "Other things they can do to assist include coordinating the initial network PCM appointment, providing benefit information to include Tricare options, cost and claim information and assisting patients in obtaining their medical records."

Additionally, any retiree who served in active military service and was separated under any condition other than dishonorable, may qualify for VA healthcare benefits. The BTC staff can assist retirees apply for an eligibility determination. If the VA determines a veteran is eligible for benefits and enrollment is an option, BTC staff can help provide resources to complete the process.

Birch said one of the reasons she feels the cell is an important component of the beneficiary transition is that many beneficiaries are unfamiliar with the use of network providers and the changes associated with the process.

"Establishing a healthcare support cell with personnel who are available to assist and provide resources will improve outcomes and lessen the anxiety related to the change," she noted. "And it offers beneficiaries several options to obtain assistance which include calling with questions, stopping by to see a counselor, or scheduling an appointment for care coordination."

Birch added that the cell is made up of multidisciplinary healthcare personnel who are trained in administrative skills, health benefits education, and Arbinger fundamentals and tools.

The BTC opened April 23 and Birch said in the first three days the team fielded more than 125 phone calls and worked with more than 30 walk-ins during the same timeframe.

"Our staff is spending as much time with each patient as the patient needs--sometimes more than a couple of hours--to make sure the patient is comfortable with the next step," she said.
"Our goal is 100 percent accountability, making contact with all of our effected beneficiaries to offer services."

SIDEBAR/INFOBOX:
The Beneficiary Transition Cell is located in the old Acute Care Clinic/ER area at IRAHC, on the lower level. You can walk-in or call staff directly at 502-624-0278. It's open from 8 a.m. to noon, and 1-3:30 p.m., Monday through Friday.

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