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

1 1 (March 12, 2020)

handle is hein.crs/govchxq0001 and id is 1 raw text is: FF. ' ,iE ,E .$r, & t March 12, 2020 Military Health System Reform: Military Treatment Facilities The Department of Defense (DOD) administers a statutory health entitlement (under Chapter 55 of Title 10, U.S. Code) 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 (i.e., military treatment facilities (MTFs)), or through civilian health care providers participating in DOD's health care program, TRICARE. On February 19, 2020, DOD submitted a report to Congress outlining its plan to restructure selected MTFs, herein referred to as the 703 Report. DOD indicates that detailed planning and implementation will begin within 90 days of the report's submission, with restructure activities occurring over the next several years. Statute (10 U.S.C. §1073d) requires DOD to maintain MTFs for the purposes of supporting the medical readiness of the armed forces and the readiness of medical personnel. There are three distinct categories of MTFs: ambulatory care clinics, hospitals, and medical centers. In FY2020, DOD administers 721 MTFs within the United States and at overseas military installations. DOD entities that administer MTFs include the Defense Health Agency (DHA), Army Medical Command, Navy Bureau of Medicine and Surgery, and the Air Force Medical Service. By the end of FY2021, the administration and management of all MTFs are to transfer to the DHA. Congress directed numerous MHS reforms in the National Defense Authorization Act for Fiscal Year (FY) 2017 (NDAA; P.L. 114-328) and subsequent NDAAs, including: * transfer of MTF administration and management from the Service Surgeons General to the DHA Director (§702); * reorganization of DHA's internal structure (§702); * redesignation of Service Surgeons General as principal health advisors for their respective military service and as service chief medical advisors to DHA (§702); and * restructuring or realignment of MTFs to best support military medical readiness and the readiness of medical personnel (§703). The 703 Report fulfills the requirement, established in section 703(d) of the FY2017 NDAA, that the Secretary of Defense submit an implementation plan to restructure or realign the military medical treatment facilities... In addition, the FY2017 NDAA requires the Government Accountability Office to provide a review of the 703 Report to the House and Senate Committees on Armed Services no later than 60 days after the report's submission. Congressional approval of DOD's plan to restructure its MTFs is not required. After the enactment of the FY2017 NDAA, DOD established a workgroup consisting of representatives from the Office of the Assistant Secretary of Defense for Health Affairs, DHA, Joint Staff, and the military departments. The workgroup screened 343 U.S.-based MTFs to identify where a transition of capabilities might be possible. The screening applied the following criteria: 1. Readiness (is there enough clinical volume to support critical physician specialties and graduate medical education requirements?); 2. Network adequacy (can the TRICARE network absorb additional patients?); and 3. Cost-effectiveness (is it cheaper to provide care in the MTF than through the TRICARE network?). If an MTF met at least one of the criteria, DOD discontinued screening of the MTF and did not proceed with the next phase. The initial screening identified 73 MTFs for further evaluation. Four other MTFs were added at the request of the military departments. For each of the 77 MTFs subject to additional evaluation, DOD compiled a Use Case, (i.e., a compendium of health care data collected from the MTF, TRICARE contractor, military installation, and other stakeholders) for each facility. Each Use Case also included a recommendation on the MTF's future-state. The military departments reviewed and provided comments to the workgroup on the Use Cases. A senior transition leadership team, composed of senior defense officials, reviewed and validated each Use Case recommendation. The Secretary of Defense accepted the leadership team's recommendations, which include 50 MTFs identified for restructure, 21 MTFs for no change, and six MTFs deferred for further review. -,,zk DOD's o MT~s The 50 MTFs identified for restructure are to transition to one of the eight future-state categories (see Table 1). DOD's next steps include developing estimates of implementation costs and detailed implementation planning beginning no later than May 2020. Implementation plans are to include tasks that address care coordination and case management, access to care, TRICARE network adequacy, changes in MTF staffing, and a communication strategy to inform stakeholders. K~:> p\w -- , gn'a', goo mppm qq\ a , q 'S I 11LULANUALiN,

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