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Careful, deliberate changes ahead for select MTFs

The Department of Defense today 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. Of the 343 facilities in the United States initially screened for this report, 77 were selected for additional assessment, with 21 identified for no changes. (DoD file photo) The Department of Defense today 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. Of the 343 facilities in the United States initially screened for this report, 77 were selected for additional assessment, with 21 identified for no changes. (DoD file photo)

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The Department of Defense’s top health official shared plans today to restructure 50 military hospitals and clinics, emphasizing changes will prioritize the warfighter and enhance force readiness.

“The bottom line is we are committed to refocusing our hospitals and clinics on readiness, in addition to providing access to health care for our beneficiaries. I am confident the Military Health System can accomplish both of those goals,” said Tom McCaffery, DoD’s assistant secretary of defense for health affairs, who reiterated changes would be implemented over time, in some cases several years.

"We will help guide beneficiaries (moving into private care) through every step of the enrollment process when the time for actions arrives," he said.

McCaffery, Dr. Dave Smith, acting principal deputy assistant secretary of defense for health affairs, and Lt. Gen. Ron Place, director of the Defense Health Agency, discussed the plans outlined in the report during briefings with Military and Veteran Service Organizations and members of the media to announce the restructuring plans. Read the entire transcript.

While some facilities may expand, others will reduce capabilities, with 37 slated to move to active duty care only. This means active-duty family members, retirees and families who currently receive care at identified facilities will transition into the TRICARE health plan’s civilian provider network. 

McCaffery confirmed active duty and their family members will not be responsible for copays in downsizing locations. An exception is when filling a prescription at a retail pharmacy.

“We will implement changes in a deliberate fashion, at a pace local health care markets can handle,” McCaffery said.

Changing some facilities to active duty-only clinics is the most significant change, McCaffery said, adding that it collectively applies to roughly 200,000 beneficiaries enrolled at those MTFs.

“We are taking a careful, deliberate approach as we assess the market capacity of each location to accept new patients,” McCaffery said. “If we determine market capacity in a particular location is more constrained than we estimated, we will reassess our plans and adjust as necessary.”

Immediate next steps involve collaboration among DHA staff, MTF leadership, installation leadership, and TRICARE network partners to continue tailoring MTF-specific transition plans while maintaining uninterrupted access to health care for all patients.

The report “makes very clear that we recognize this is a MTF-by-MTF, market-by-market implementation,” McCaffery said. “We readily recognize that some of these changes may take two, three, four years to implement because it's going to be contingent upon that local health care market to be able to take on those additional patients.”

McCaffery acknowledged retirees and their families who transition to TRICARE Select will be responsible for co-pays.  Currently, a primary care visit costs $30, and specialty care from in-network TRICARE providers is $45 per visit.

TRICARE is the health care program for the U.S. armed services. The two most popular plans available to most eligible beneficiaries under 65, TRICARE Prime and TRICARE Select, include more than 6.7 million enrolled patients.

Earlier today DoD sent a report to Congress titled, “Restructuring and Realignment of Military Medical Treatment Facilities.” The report outlines changes to the scope of operations at 50 hospitals and clinics. Section 703(d) of the National Defense Authorization Act of 2017 required DoD to analyze its footprint of hospitals and clinics and submit an implementation plan to Congressional defense committees.

Track updates on MHS transformation and reform at Health.mil/MHSTransformation. Follow #MHSTransformation and #MHSRestructuring on social media channels. For more information about TRICARE, go to TRICARE.mil.

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Continuing Implementation of the Reform of the Military Health System

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This memorandum directs the continued implementation of the Military Health System (MHS) organizational reform required by 10 U.S.C. § 1073c, and sections 71 land 712 of the John S. McCain National Defense Authorization Act (NDAA) for Fiscal Year (FY) 2019. The DoD policy for this reform is guided by the goals of improved readiness, better health, better care, and lower cost. The Department will advance these objectives through specific organizational reforms directed by Congress and the continued direction of the Secretary of Defense·anct the National Defense Strategy.

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