Leading the Way Upstream:

The Military Health System for 2012 and Beyond

June 21, 2011

RADM C.S. Hunter, MC, USNDeputy Director

TRICARE Management Activity

• Program enrollment– 5.4 million TRICARE Prime

– 3.7 million in direct care system– 1.7 million in contractor networks

– 2.1 million TRICARE Standard/Extra – Others use TRICARE Reserve Select,

TRICARE For Life

• USPHS beneficiaries - 30,476

• Beneficiaries by category– Active duty: 1.7 million– Active duty family: 2.4 million– Retirees: 1 million – Retiree family: 1.8 million– Medicare-eligible: 2.1 million

TRICARE Beneficiaries:Who We Serve

Over 9.6 Million Beneficiaries

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A Week in the Life of TRICARE

• 2.7 million prescriptions* (7,392 PHS)– 924,000 direct care– 1.44 million retail pharmacies– 228,000 home delivery

• 231,000 behavioral health outpatient services– 52,000 direct care– 179,000 purchased care

• 23,300 inpatient admissions– 5,100 direct care– 18,200 purchased care

• 1.8 million outpatient visits (5,364 PHS)– 810,000 direct care – 1.0 million purchased care

• 2,400 births– 1,000 direct care– 1,400 purchased care

• 3.5 million claims processed

• 12.6 million electronic health record messages

Behavioral HealthOutpatient Visits

Active Duty Family

Active Duty

* Pharmacy from 6 mo. Period: 10/01/10 – 3/31/11; All others FY10

Military Health System Quadruple Aim

Aligning Behind a Well-Articulated Goal

• Readiness– Pre- and Post-deployment– Family Health – Behavioral Health – Professional Competency/Currency

• Population Health– Healthy service members, families, and retirees– Quality health care outcomes

• A Positive Patient Experience– Patient and Family centered Care, Access, Satisfaction

• Cost– Responsibly Managed– Focused on value

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Fulfillment of the Quadruple AimAcross the Military Health System

• The Quadruple Aim has been successful because it:

– Focuses our efforts, yet is broad enough to be inclusive

– Is relevant to both military and national health care landscapes

– Can be applied across multiple domains

• Force health protection and prevention

• Direct care at military treatment facilities (MTFs)

• Purchased care through civilian partners

• Electronic health information systems

• Education, training and workforce development

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How PHS Officers Contribute PHS Officers Fill Key TMA Leadership Positions

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RADM Thomas McGinnisChief, Pharmaceutical Operations Directorate

CAPT Cheryl BordenExecutive Officer

•Provide continuity

•Provide deep subject matter expertise

•Close gaps in care left by deployed DoD providers

CAPT Robert DeMartino Director of Behavioral

Medicine

Providing Critical PsychologicalHealth and TBI Expertise

• USPHS mental health professionals serve at 46 MTFs

• DoD-USPHS Memorandum of Agreement (MoA) signed June 4, 2008

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DisciplinesSocial Workers 62

Psychologists 40

Nurses 26

Psychiatrists 8

Physician Assistants 7

Physical Therapists 4

Occupational Therapists 3

Nurse practitioners 2

Speech pathologists 2

Clinical pharmacologist 1

Co-liaison officer 1

Neurologist 1

TOTAL 157

Where is DoD Headed?

• Prevention

• Resiliency

• Diet

• Fitness

• Child-rearing

• Meaningful work

Focusing on Upstream Determinants of Health

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Where is DoD Headed?

• Patient-centered medical home

• Self management support

• Health literacy

• Health information access

Empowering Patients

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How is DoD Addressing Costs?

• Focusing on prevention

• Reducing ER use

• Encouraging economical pharmaceutical outlets

• Reducing hospital readmissions throughPartnership for Patients

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How Can Leaders Prepare for the Future?

• Diversify your reading

• Be open to opportunities

• Seek out mentors and mentor others

• Learn to communicate well

• Nurture your humanity

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We Are All Part of the Solution

12Thank You For Your Service