About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

1 1 (July 26, 2019)

handle is hein.crs/govbaon0001 and id is 1 raw text is: ~ Inf1r. in the leiltvedbt, sn 11 July 26, 2019 Military Health System Reform The Department of Defense (DOD) administers a statutory health entitlement (under Chapter 55 of Title 10) through the Military Health System (MHS). The MHS offers health care benefits and services to approximately 9.6 million beneficiaries composed of servicemembers, military retirees, and family members. Health care services are available through DOD-operated hospitals and clinics- known as military treatmentfacilities (MTFs)-or through civilian health care providers participating in TRICARE. Currently, various DOD entities administer the MTFs and the TRICARE program. Those entities include the Defense Health Agency (DHA) and the military services' medical departments (i.e., Army Medical Command, Navy Bureau of Medicine and Surgery, and Air Force Medical Service). In 2016, the conference report accompanying the National Defense Authorization Act for Fiscal Year 2017 (H.Rept. 114-840) noted that the current organizational structure of the military health system-essentially three separate health systems each managed by three Services-paralyzes rapid decision-making and stifles innovation in producing a modern health care delivery system that would better serve all beneficiaries. Subsequently, numerous reforms were directed in law. An overview of the contributing factors, reform mandate, and DOD's implementation efforts are discussed below. Contributing Factors to MHS Reform Over the past three decades, various committees, commissions, and federal government entities have issued reports highlighting a need to re-evaluate, or restructure, the MHS, such as: * Final Report of the Military Compensation and Retirement Modernization Commission (2015); * MHS Modernization Study (2013); * DOD Task Force on MHS Governance (2011); * Task Force on the Future of Military Health Care (2007); * Medical Readiness Review of the Quadrennial Defense Review (2006); * Comprehensive Study of the Military Medical Care System (1993); and * various assessments by the Government Accountability Office (GAO). Many of the reports have noted that MHS reform may bring opportunities to enhance medical readiness of the armed forces, improve health care quality and access, increase patient satisfaction, reduce administrative burden on beneficiaries, and lower overall costs. Congress Mandates MHS Reform MHS reform was directed in the National Defense Authorization Act for Fiscal Year 2017 (NDAA; P.L. 114- 328) and codified in 10 U.S.C. §§1073c-1073d. This reform includes: * a transfer of MTF administration and management from the Service Surgeons General to the Director of the DHA (§702); * reorganization of DHA's internal structure (§702); * redesignation of the Service Surgeons General as principal advisors for their respective military service and as service chief medical advisors to the DHA (§702); and * restructure or realignment of MTFs to best support military medical readiness and the readiness of medical personnel (§703). Congress originally directed that MHS reform be completed by October 1, 2018. However, the FY2018 NDAA (P.L. 115-91) and FY2019 NDAA (P.L. 115-232) provided additional clarifications on the transfer of MTFs, the roles and responsibilities of the DHA and the Service Surgeons General, and an extension on implementing reform efforts to September 30, 2021. The reforms do not impact any TRICARE health plan options or its cost-sharing features. Implementing MHS Reform DOD submitted its implementation plan to Congress in June 2018, describing a streamlined organizational model that standardizes the delivery of care across the MHS with less overhead, more timely policy-making, and a transparent process for oversight and measurement of performance. DOD later revised its plan to reflect certain accelerated tasks and milestones, such as the transfer of MTFs to the DHA. Changes are to occur through 2021. MHS Governance and Financial Management Reform Since DHA and the service medical departments report to separate senior defense officials, decisions on MHS policy, programs, processes, and resources are vetted in a variety of working groups, boards, and councils. DOD describes the current MHS governance as a sclerotic decision-making process that often serves as a barrier to timely improvements. The revised governance process delineates who makes certain decisions. The Assistant Secretary of Defense for Health Affairs is to have primary authority and oversight of the MHS. DHA is to make all decisions relating to health care delivery in MTFs. Meanwhile, each respective service medical department is to make decisions relating to operational readiness matters. https://crsreports.congress.go

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Short-term subscription options include 24 hours, 48 hours, or 1 week to HeinOnline.

Purchase Access

Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most