WASHINGTON — Tricare contractors say finding doctors who accept military patients in rural areas is becoming a major headache, a problem exacerbated by the number of guardsmen and reservists returning from overseas.

Scott Celley, a vice president for TriWest Healthcare Alliance, said part of the problem is that in states such as Oregon and Iowa, which have few military facilities, many doctors have never had military patients or dealt with the Tricare system before.

And as reserve and National Guard units have taken a more active role in operations in Iraq and Afghanistan than in past wars, those troops are returning to small towns and rural counties not prepared to help veterans. All Guardsmen and reservists who have served on active duty are eligible for coverage through Tricare Reserve Select.

“They’re not just coming back around military bases,” he said. “They’re all over the state.”

Defense officials have noted that the Idaho National Guard troops currently serving in Iraq, who number about 2,000, represent residents of 42 of the state’s 44 counties.

TriWest is contracted by the Defense Department to administer the military health-care system, Tricare, in 21 Western states. Celley said his company has stepped up efforts to identify doctors in rural regions and convince them to accept Tricare payments.

TriWest has signed up about 95,000 providers, but most are in California. In states such as Minnesota and Utah, the company averages one doctor every 50 square miles.

“If there are providers out there, we’re doing everything we can to get them into the system,” he said.

The company has seen some successes: In Idaho, the number of doctors who accept Tricare jumped from 400 to 1,600 in the past year. Celley said state officials in Washington and Oregon are spearheading similar efforts to sign up more doctors.

But at a special Congressional hearing in Idaho on Monday, state and Defense Department officials acknowledged that many Western states have a problem with physician accessibility generally.

TriWest CEO David McIntyre testified that, especially in areas outside a 40-mile radius of military treatment facilities, finding specialists and even general practitioners who can provide the services needed by Tricare families is difficult.

“Those gaps are happening across the West in varying degrees,” Celley said. “We’ve been meeting with congressional representatives to see what can be done about that.”

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