Ep 61: Why is it so hard to find a therapist who takes TRICARE with Joanne Frederick

Rachel welcomes back Joanne Frederick, founder and CEO of Government Market Strategies (GMS). Joanne first joined the show to talk about CAQH, data spraying and what provider data and credentialing mean for behavioral health practices. She founded her firm in 1992 and has helped clients win billions of dollars in government contracts across Medicare, Medicaid, TRICARE and Veterans Health programs. This time she and Rachel take up a question many practices hear often: why is it so hard to find a therapist who takes TRICARE? Joanne explains why TRICARE is separate from the VA system and who it covers. She names reimbursement and administrative burden as the two main reasons. She walks through the CHAMPUS Maximum Allowable Charge (CMAC), which is indexed to Medicare and sometimes falls below it, and how master's-level clinicians are paid at a percentage of that rate. She then shows how the Defense Health Agency awards TRICARE contracts. Bidders earn higher evaluation scores for deeper provider discounts, which gives them a clear incentive to maximize those discounts. The conversation connects those contracting decisions to access for military families and to what clinicians and practice owners can do now. Chapters 00:00 Introduction to TRICARE and Mental Health Challenges 02:24 Understanding TRICARE: Who It Serves 03:36 Challenges in Finding TRICARE Providers 06:18 Reimbursement Rates and Their Impact 11:27 The Bidding Process for TRICARE Contracts 15:12 Administrative Burdens and Access Issues 19:51 Advocating for Change in TRICARE 21:12 Strategies for Improving Access to Care Articles referenced Information on DOD's Processing of TRICARE Claims from Behavioral Health Providers — U.S. Government Accountability Office (May 2025): https://www.gao.gov/products/gao-25-1... Got to Get Fixed: Billing Delays, Coverage Issues Still Plague Tricare Patients and Providers — Stars and Stripes (May 3, 2026): https://www.stripes.com/theaters/us/2... DOD Should Improve Accuracy of Behavioral Health Provider Information in TRICARE Directories — U.S. Government Accountability Office (July 2024): https://www.gao.gov/products/gao-24-1... Connect with Joanne Frederick: https://marketstrategiesonline.com Music by Zach Harrison