TriWest Healthcare Alliance Corp Revenue and Competitors

TriWest is the only alliance of locally-based corporations and health care systems to be operating one of these contracts. The strength of this concept is that it permits the organization to draw on the existing local-market presence of these organizations as networks are built and managed, particularly in very difficult markets where government reimbursement rates are not seen as adequate. TriWest is owned by 11 Blue Cross and Blue Shield plans and two University Hospital systems, all of which are based within the geographic area that comprises the Central Region. Most of these health care entities have been serving the health care needs of the communities in which they are located for more than 50 years. Today, in addition to the more than 1.1 million TRICARE-eligible beneficiaries in the Central Region, these prominent local health care entities service the health care needs of over 10 million individuals located within the Region through other health plans and programs. As some of you may know, TriWest came to exist as a result of a group of health care businesses wanting to create a strong and viable business to serve this very unique and deserving population. Though the program is sometimes wrought with overwhelming complexities and seemingly endless crises, we did not during creation, nor do we now, lose sight of the fact that what we all do has deep purpose and meaning and carries with it an awesome responsibility…a responsibility to the men and women who serve in defense of our freedom and to their readiness for duty. TriWest is headquartered in Phoenix, Arizona, and has remote office locations within or in close proximity to each military treatment facility (MTF) in the TRICARE Central Region. The map below reflects TRICARE Service Center (TSC) and TRICARE Customer Assistance Center (TCAC) office locations as of November 2001. Areas not included in the TRICARE Central Region: Yuma, Ariz., contained in Region 10; six northern counties in Idaho contained in Region 11; certain ZIP codes in the St. Louis, Mo. area, and the Rock Island Arsenal area in Iowa, contained in Region 5. The Central Region comprises nearly half of the geographic land mass of the continental United States in a 16-state area that stretches from Arizona, Nevada, and Idaho in the West to Minnesota, Iowa, and Missouri in the East, making it the largest TRICARE Region in the United States. The region is home to 17 Air Force bases, nine Army posts and one Naval air station, along with two Base Realignment and Closure (BRAC) sites in Arizona (Williams Air Force Base) and Colorado (Fitzsimons Army Medical Center). While some of these facilities are located in or near large metropolitan areas, such as Phoenix, Denver, Omaha, El Paso, and Las Vegas, there are a number of remote and more rural areas, such as Great Falls, Montana; Rapid City, South Dakota; Minot, North Dakota; and Alamogordo, New Mexico. The TRICARE Central Region has 28 prime areas within its 16 states and encompasses 1,382,577 square miles. In addition, there are 89 congressional offices, six Air Force MAJCOMs, three Army RMCs, and nine DVA VISNs in the region. TriWest has contracted with 19,000 network providers and 334 institutional providers, of which 26 are DVA facilities, to provide care to the region's beneficiaries. Enrollment in the TRICARE Prime option in the Central Region has remained at the target level of approximately 350,000 enrollees for the third year in a row. Prime enrollment in the Central Region eclipsed the government's five-year Prime enrollment projection almost immediately, and has remained at this level since that time, with no major spikes or dips in enrollment. TriWest sees this data as a sign that the Prime option is accepted by the TRICARE-eligible population and recognized as a good value for the beneficiary, while also being cost-effective for the government. The history of collaboration and partnering in the Central Region is strong. From the work done to consolidate two regions into a single region and create a stand-alone TRICARE Regional Office (a move which saved the government money and streamlined operations, and is a model which the DoD wants replicated throughout the system), to a no-cost contract modification to reengineer an antiquated approach to utilization management, to the only integrated public-private sector regional Internet site in the entire program. TriWest has successfully partnered with the TRICARE Regional Office on many joint ventures, which we believe has proved to be beneficial to the beneficiaries of the Central Region as well as to the government and the taxpayer. As TriWest continues to deliver services to eligible TRICARE beneficiaries in the Central Region for the fifth year, I would be remiss if I did not acknowledge the tremendous strides that the entire Central Region partnership (the TRICARE Regional Office - Central Region, the Office of the Assistant Secretary of Defense for Health Affairs (HA), the TRICARE Management Activity (TMA), the Region's 26 military treatment facilities (MTFs), and TriWest) has made in taking the TRICARE program from its infancy just four years ago to what is now a maturing and successful multi-faceted program. In addition, we recognize that service members and their families would not be accessing the robust program they have today were it not for the support and commitment of many entities, including Congress. As with anything, however, there is room for improvement. One of the areas where there is room for improvement is the way in which we collaborate with the Department of Veterans Affairs facilities. That is why I am so excited about the work of this Task Force and am pleased to be before you this afternoon. While the missions of these two important federal systems may differ slightly, and the populations may have slightly different needs in some cases, I believe that the President was right when he said that the potential gain that can be garnered from greater collaboration is significant. It is important to acknowledge from the outset, however, that some work has already been done in this area.