A recent Government Accountability Office (GAO) report, Eating Disorders in the Military, raises concerns about access to care for eating disorders within the TRICARE network. It also reveals accuracy problems with the TRICARE provider directory that could have implications for forecasting civilian care availability as DoD considers cuts to military medicine that would send military beneficiaries into the TRICARE network for care.  

MOAA will leverage the GAO report’s findings as part of efforts to improve access to mental health care, including treatment for eating disorders, and as we continue to demand rigorous analysis and mitigation planning related to proposed military medical downsizing.  

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A 2018 bipartisan letter from Rep. Seth Moulton (D-Mass.) and the late Rep. Walter Jones (R-N.C.), along with 30 bipartisan signatories, prompted a GAO performance audit on access to treatment for eating disorders within the military health system. GAO conducted its analysis from June 2019 to August 2020.  

The GAO notes DoD typically does not have the specialized facilities or staffing necessary to provide treatment for eating disorders in military hospitals or clinics, and therefore relies on purchased care from TRICARE providers.  

Data from TRICARE managed care support contractors show that, as of Spring 2020, there were 166 eating disorder treatment facilities (103 network and 63 non-network) covered under TRICARE. These facilities are in only 32 states, according to the GAO. 

However, a press release from the Eating Disorders Coalition (EDC) expresses concerns about the accuracy of this data as well as military beneficiary access to eating disorder care compared with nationwide availability.  

EDC found that of the 166 TRICARE facilities listed in the report as providing care for eating disorders, 40 of them (24%) were not actually available: 

• 32 of the facilities do not provide treatment for eating disorders. 
• Five of the centers listed do not exist. 
• Three of the centers were listed twice.  

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According to the EDC, military beneficiaries are only covered for a fraction of the providers available to care for those with eating disorders. Only 35% of the nation’s 365 eating disorder treatment facilities are authorized by TRICARE, and only 21% are in-network. 

The report highlights challenges that have made it difficult for TRICARE to enter into contracts with eating disorder treatment facilities, including the lack of facilities in rural locations, facilities that aren’t willing to accept the level of TRICARE reimbursement, and a shortage of facilities offering inpatient treatment for adults. 

The GAO also notes that according to Defense Health Agency (DHA) data for 2018-19, no access to care complaints related to eating disorder treatment were reported by TRICARE beneficiaries.  

MOAA is concerned that servicemembers and their families may have fewer options to access eating disorder treatment than their counterparts in the civilian population. Inaccurate provider directories may also deter servicemembers and their families from seeking treatment. 

[RELATED: MOAA's TRICARE Guide]

MOAA is following up with DHA to seek context for the GAO report and EDC press release findings. This will help reconcile information and determine next steps toward a solution.  

Has your family encountered barriers to seeking care for a family member with an eating disorder? Please let us know at legis@moaa.org.