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DoD to restructure 50 hospitals, clinics to improve readiness

Defense Health Agency Director Lt. Gen. Ronald Place speaks to Evans Army Community Hospital leaders at BK George Hall about the Military Health System transformation. Place visited military medical teams at Peterson Air Force Base, the U.S. Air Force Academy and Buckley Air Force Base, which also encompass the Colorado Springs Military Health System. (Photo by Jeanine Mezei)
The Department of Defense announced plans to restructure 50 military hospitals and clinics to better support wartime readiness of military personnel and to improve clinical training for medical forces who deploy in support of combat operations around the world.

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MHS Transformation

The Defense Department is transforming the Military Health System to improve the readiness of our forces and the health care we provide to our warfighters, retirees and their families.  Reform efforts focus on organizational, infrastructure and manpower changes.  As changes are implemented, MHS priorities are to:

  • Support the operational readiness of our Joint Force by ensuring they are medically ready to deploy
  • Increase opportunities for medical professionals to improve their readiness skills
  • Provide beneficiaries with access to high quality care

Military Treatment Facility Transition

Organizational Changes

The Defense Health Agency is assuming administration and management responsibilities from the Army, Navy and Air Force for all military hospitals and clinics on Oct. 1, 2019. Congress initiated this change in administration and management because they saw a need for a more flexible, adaptable, effective and integrated system to manage our facilities.  

DHA will initially oversee these facilities through a direct support relationship with the Military Medical Department intermediate management organizations. The DHA will relieve the Military Departments of this support during a transition period in which responsibility for specific health care and administrative functions are fully transferred from the Military Departments to the DHA. 

DHA is establishing a market-based structure to manage the hospitals and clinics. These market organizations will provide shared administrative services to the hospitals and clinics in their region. They will be responsible for generating medical readiness of active duty members and families in their regions, as well as ensuring the readiness of their medical personnel. They will do that by flexing resources throughout their market regions to ensure we meet patient demand and the readiness needs of the medical troops, setting goals and monitoring progress through Quadruple Aim Performance Plans.

In 21 large markets where we have large concentrations of facilities and patients - markets will be centered on large medical centers, establishing centers of excellence for specialty care that meet the needs of beneficiaries across their market regions. Nearly two-thirds of our current patient encounters happen in these 21 regions. Another 16 Small Markets, such as Central Oklahoma and the Great Lakes, will be centered on inpatient community hospitals, focused on providing ambulatory and some specialty and inpatient care across their regions. These small markets, as well as many stand-alone hospitals and clinics located outside a market region, will report to a “Small-Market and Stand-Alone Organization” (SSO) that will provide administrative support. When DHA assumes responsibility for overseas hospitals and clinics, two regional offices will provide similar support, one for Europe and one for the Pacific.

More detail on the Market Model is provided in the resources below:

Market Construct

Alignment of Hospitals and Clinics by Market Type

The Military Departments are restructuring their Medical Departments to enhance readiness capabilities to better support the warfighter and optimize their ability to meet the operational requirements of line commanders. The Military Departments continue to maintain command and control of all uniformed medical personnel, and responsibility for manning, training and equipping these personnel, setting medical readiness standards, and delivering certain installation-specific clinical functions outside the hospital and operational clinical services under the operational control of combatant commanders.

Another organizational reform effort is the development of the new electronic health record, MHS GENESIS, which provides enhanced, secure technology to manage your health information. MHS GENESIS integrates inpatient and outpatient solutions that will connect medical and dental information across the continuum of care, from point of injury to the military treatment facility. This includes garrison, operational, and en route care, increasing efficiencies for beneficiaries and healthcare professionals.

When fully deployed, MHS GENESIS will provide a single health record for service members, veterans, and their families.

Infrastructure changes

Congress directed the Defense Department to assess existing hospital and clinic infrastructure and determine whether some facilities should be realigned or restructured.  The Office of the Assistant Secretary of Defense for Health Affairs is now conducting the required analysis in conjunction with the Military Departments, DHA and the Joint Staff.  It’s expected that some facilities may be re-scoped, some may have capabilities reduced, while others may expand. DHA will be responsible for implementing the final determinations made by the Department and is working with the Military Departments to ensure that all beneficiaries continue to enjoy access to high-quality care.

Manpower changes

The Department’s FY20 budget proposal recommended the realignment of about 17,000 uniformed billets from the MHS into operational forces. The Military Departments made recommendations to support the intent of the Department after rigorous analysis of their operational responsibilities and requirements. This proposed reduction meets the Department’s intent of increasing the combat capability of our forces. With this direction, DHA is formulating plans to ensure that beneficiaries continue to have uninterrupted access to high-quality care through a combination of new civilian and contract personnel, outside partnerships, and the TRICARE network.

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