Military health care is seven months from rolling out "historic" reforms to improve patient access and quality of care, to streamline health operations across Army, Navy and Air Force, and to better integrate that direct care system with networks of private sector providers supporting Tricare insurance beneficiaries, said Vice Adm. Raquel Bono, director of the Defense Health Agency.
The agency is responsible for implementing the changes while following through on many previous reforms the last two defense secretaries had set in motion for modernizing the military health care system.
"This is historic because we have the opportunity here to redesign our system of health," says Bono. "At the heart of it, I believe, is a growing recognition, both in the military health system and the commercial and private healthcare system, that our patients truly need to be co-designers."
Many elements of military healthcare are flux due to three factors: a hefty package of reforms voted by Congress last December; a new generation of Tricare support contracts taking effect soon; and the introduction of the military's new electronic records and scheduling system, which began at a few medical facilities this year and will be running department-wide by 2022.
Bono sees all three as opportunities to more tightly integrate the goal of improving healthcare delivery with enhancing medical readiness, and doing so "around our patients" by incorporating their feedback in all system-wide reforms.
"They need to help us understand what the best ways are to integrate. And that's part of the historic nature that I see here," she said.
The fiscal 2017 National Defense Authorization Act directs scores of changes to Tricare benefits but also to how on-base hospitals, clinics and staffs are organized and operate so military providers care for more patients.
Last July, the Pentagon announced new Tricare support contracts so three regions are reorganized into two. Health Net Federal Services of Rancho Cordova, Calif., will replace United Healthcare in managing the West. Humana Government Business of Louisville, Ky., will consolidate northeastern and southeastern states into East Region.
One key change is to replace two legs of the current benefit - Tricare Standard, the fee-for-service insurance option, and Extra, the preferred provider option - with Tricare Select. Select will combine features of both..