49th Dental Flight Surgeon (right) and 49th Dental Flight Dental Assistant Tammy Mendez (left) pose for a photo on June 26, 2018. (U.S. Air Force photo illustration by Airman Kindra Stewart)
More than 155,000 military family members and retirees will be transferred from military hospitals systems to civilian health care providers starting later this year, according to a new Department of Defense report. This process is expected to last until mid-2026.
However, under the revised plan, at least 29 facilities that were scheduled to serve only active-duty patients may still see some active-duty family members to maintain the clinical skills of their staff.
In a July 1 report to Congress, Gil Cisneros, undersecretary of defense for personnel and readiness, said the number of facilities scheduled to downsize has changed and active-duty family members may Will remain in the military system, depending on location and training needs.
The program gives 29 clinics the option to retain some active family members "to maintain provider skills."
According to the report, these facilities "generally transition non-active duty military primary care to the purchased care portion of the TRICARE program," including those in the provider network and Tricare for Life, the comprehensive defense health program that serves as Medicare. Report to the Congressional Defense Committees.
But unlike the initial recommendation, all 29ers will be recruited "with active duty family members as appropriate."
The changes are part of an effort that began in 2017 to reform the military health system to slow rising health care costs by sending more patients to the private sector, paid for by Tricare, and focusing military providers primarily on active duty personnel and training. The Defense Department process calls for downsizing or closing dozens of hospitals and clinics.
In the revised plan, developed after studying the impact of the COVID-19 pandemic on the health system and the availability of care in communities near military bases, three clinics will be exempted from downsizing or becoming military-only installations: Fort Meade, Maryland, and Joel and Robinson Clinic, Fort Bragg, North Carolina.
Kimbrough plans to transition to an outpatient-only clinic serving all beneficiaries, while the Joel and Robinson clinics will transition to active-duty-only facilities.
But the review determined that Kimbrough is an important part of the National Capital Region's military health system in Washington, D.C., and that changes the Army made to Fort Bragg improved the clinic's efficiency and service to military families, resulting in the preservation of both facilities.
Community Medical Center in Columbus, Georgia, and Air Force Sabal Park Clinic in Brandon, Florida, will remain closed.
At Columbus, patients can choose to join Martin Army Community Hospital or use Tricare as space becomes available.
In Brandon, all patients will transition to Tricare.
A clinic at the Naval Submarine Base in New London, Connecticut, will continue to serve active-duty troops and active-duty family members, but will not serve retirees.
Since this work began, 12 facilities have converted to active clinics or closed.
The military health system has been undergoing reform since 2013, when The Pentagon established the Defense Health Agency to assume responsibilities such as medical management, information technology, logistics and training under the Army, Navy and Air Force Medical Commands Exist in triplicate.
In 2017, Congress authorized DHA to reevaluate the scope of its facilities and how the Department of Defense serves Tricare beneficiaries who are not in the military, such as family members and retirees.
These services are primarily responsible for military operations medicine and maintaining combat readiness of medical forces. "The purpose of this program is to increase the readiness of military medical personnel to focus on medical platforms that have the high volume and complex medical cases necessary to maintain their medical skills," the
report states. Congress has The Department of Defense will have 180 days to review the proposal, which will begin in fiscal year 2023, which begins in October.
MPs have expressed concern about the lack of capacity in some areas to accept new patients into the community. Recently, Rep. Greg Murphy, R-N.C., wrote to Defense Surgeon General Director Lt. Gen. Ronald Place asking him to ensure service members and families have timely access to appointments and care, including obstetric care.
Military doctors and spouses report missing appointments and waiting weeks for pregnancy care because of provider shortages.
Murphy wrote on April 6: "This problem may not just be one my district is experiencing, but may be a systemic problem for all military hospitals as the DHA is leading to cost-cutting reforms."
DOD Officials said in a report to Congress that network assessments have determined there are enough network primary care managers to absorb at least 120% of patients expected to transition.
According to the report, Army treatment facilities will continue to care for patients until they have a primary care manager. Those enrolled in the case management program will be reviewed to determine whether to remain in the program and continue in the program or transition to private care.
Those transitioning with complex medical needs will receive "warm assistance from new key managers"
"MHS's commitment to beneficiary health care has not changed. While the location of care may change, access to quality health care will be provided opportunities," the report states.
As a result of the post-pandemic review, the following changes have been made, including clinics that will be closed to retirees and their family members but retain the option to treat active-duty family members:
