Results from Military Health System Review Forthcoming

Published: August 20, 2014

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At the end of May, Defense Secretary Hagel ordered a review of the Defense Department’s Military Health System, targeting access to care and identifying areas for improvement. The assessment is expected to be completed by the end of August 2014.

Last year, a report from the Government Accountability Office (GAO) on Defense Health Care Reform noted that the cost of DOD’s Military Health System (MHS) has increased to almost $50 billion over the last decade, and that cost is expected to double by 2030. As the GAO report explained, “health care consumes an increasingly large portion of the defense budget, DOD leadership has acknowledged the need to reduce duplication and overhead, operate its health system as efficiently as possible, and realize savings in the MHS through the adoption of common clinical and business processes.”

Secretary Hagel ordered the assessment of MHS in the wake of issues around access to care at Veterans Affairs hospitals. The 90 day review of the Military Health System is being led by Deputy Secretary of Defense Bob Work, with support from the Acting Undersecretary of Defense for Personnel and Readiness Jessica L. Wright and the Assistant Secretary of Defense for Health Affairs Jonathan Woodson, and the direct participation of the secretaries of the Departments and the Service chiefs.

According to a statement from DOD, the “review will focus on the following core areas: access to health care, safety of care, and quality of care.” The MHS assessment will aim to address eight objectives:

1. Assess prior recommendations and findings from relevant internal and external reports, including the last ten years of Government Accountability Office (GAO) and DoD Inspector General (IG) reports. The assessment will include what problems were identified, what actions were taken to remedy the problems, and whether the remedy has been sustained.

2. Review all relevant Office of Secretary of Defense (OSD), Service and TRICARE policy standards and assess the degree to which the policies have been implemented.

3. Evaluate data to assess compliance with existing policy or national standards. Determine how the MHS can consistently exceed these standards. Determine if any variance from the standards is due to data inaccuracy or inconsistency.

4. Review education and training documentation of health care professionals and staff regarding the execution of policies and assess knowledge of existing standards.

5. Compare MHS performance to at least three civilian health systems, where standards are relevant and comparable.

6. Assess the experiences and perceptions of MHS patients’ regarding access, quality and safety standards.

7. Determine the effectiveness of governance in policy and system performance.

8. Identify current resources for access, safety and quality efforts to the extent possible.

A final report to Defense Secretary Hagel is due by August 29, 2014. This report will include recommendations for specific improvements paying particular attention to meeting nationally defined standards or DOD policy-directed standards. Planned improvements resulting from the review are likely to receive priority funding as the program progresses.