US DoD to Restructure 50 Hospitals to Improve Readiness

The U.S. Department of Defense (DoD) 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.

Image credit: Military Health System

Military readiness includes making sure MTFs are operated toensure service members are medically ready to train and deploy," said TomMcCaffery, assistant secretary of defense for health affairs. "It alsomeans MTFs are effectively utilized as platforms that enable our militarymedical personnel to acquire and maintain the clinical skills and experiencethat prepares them for deployment in support of combat operations around theworld.”

The restructuring effort focused on strengthening on theprime responsibility of military medical facilities for training medicalpersonnel and “for keeping combat forces healthy and ready to deploy accordingto readiness and mission requirements – all while ensuring the MHS provides ourbeneficiaries with access to quality health care,” McCaffery added.

These plans were described and explained in a report sent toCongress, titled "Restructuring and Realignment of Military MedicalTreatment Facilities."  This reportwas required by law under Section 703(d) of the National Defense AuthorizationAct of 2017, which directed the DoD to analyze its hospital and clinicfootprint and submit a plan to Congressional defense committees.

Of the 343 facilities in the United States initiallyscreened for this report, 77 were selected for additional assessment, with 21identified for no changes.

Of the 50 facilities ultimately designated forrestructuring, 37 outpatient clinics now open to all beneficiaries willeventually see primarily only active-duty personnel. Active-duty familymembers, retirees and their families who currently receive care at thosefacilities will transition over time to TRICARE's civilian provider network. Thereport states that seven of these clinics may continue to enroll active dutyfamily members on a space-available basis.

In addition, many active duty-only clinics will continue toprovide occupational health services to installation civilian employees relatedto their employment.

The report acknowledges that transitioning patients fromMTFs to the TRICARE network will take time – in some cases several years – andif local TRICARE networks cannot provide access to quality care, DoD willrevise implementation plans.

During his keynote address at the December 2019 annualmeeting of the Society of Federal Health Professionals, known as AMSUS,McCaffery offered a broad overview of intentions for changing the scope ofoperations at certain MTFs in what is known within the MHS as the Direct CareSystem. Direct care refers to military hospitals and clinics, also known as“military treatment facilities” and “MTFs.”

"In optimizing the operation of the Direct Care systemto most effectively support the MHS readiness mission, we need to identifythose areas where we could expand capacity at MTFs that offer potential forsustaining the skills and knowledge of our medical force," McCaffery saidduring his AMSUS speech. "But we also must examine those areas wherefacilities do not offer now, and likely will not be able to offer in the future-- a platform for maximizing capabilities to support medical readiness. Inthose situations, we need to be open to right-sizing MTF services andcapabilities so as to ensure that we are using finite resources mostefficiently... while not compromising our ability to meet mission."

The final report delivered to Congress contains a summary ofall the changes, a description of how each change was made, and supportingdata.