The Department of Defense is tasked with getting the right people, both medical staff and patients, to the right military hospital or clinic at the right time.
On December 6, 2023, the Deputy Secretary of Defense signed a memo directing the stabilization of the military's medical system. This memo adds the ability for MHS to re-attract patients and beneficiaries, improve access to care at military hospitals and clinics, and increase opportunities for medical units to maintain military clinical readiness. is requesting.
It is clear that MHS needs to be stabilized. Combined with health economic instability over the past three years, health workforce restructuring has created challenges to beneficiary care and impacted the ability to efficiently generate and maintain a responsive medical force.
“The impact of COVID-19 has placed capacity constraints on all health care systems in the United States and other countries,” said David, Deputy Assistant Secretary of Defense for Health Preparedness Policy and Oversight and Health Care Policy and Oversight.・Dr. J. Smith said. A special committee tasked with carrying out the memo's directives. “Health-seeking behaviors have changed, and so have the demands on warfighters and readiness…health systems around the world have been unable to keep up.”
In line with the recently released MHS Strategy for Fiscal Years 2024-2029, this memo primarily aims to help MHS provide high-response forces and a responsive medical force while providing quality care to beneficiaries. It mentions the need to continue to do so. As stated in the memo, to do this effectively requires “a stable and predictable workforce that is sufficiently staffed, trained, and regularly available to provide health care to beneficiaries.” It takes strength.”
“A big part of this memo was to provide stability. Increase stability for our staff and allow our staff to provide additional stability to our patients,” Smith said. “This will improve access to care and increase clinical capacity.”
MHS issues have rarely come to the forefront like this. Recognizing the lasting effects of the COVID-19 pandemic and reorganization, the Under Secretary of Defense for Personnel and Readiness has begun relying heavily on the Military Health System Executive Review Board to oversee and implement major improvement projects. Additionally, the Board began referring issues to the highest military and civilian leadership of the Department of Defense through the Deputy Secretary's Workforce Council.
“The board will be chaired by the Under Secretary of Defense for Personnel and Readiness, and will include official representatives from all major components of the U.S. Department of Defense: Army, Navy, Air Force, Joint Staff, Marine Corps,” Smith said. . “This is very important to our senior leadership because we are actively discussing and updating this initiative on the Deputy Staff Council, the most senior governance forum within the department for human resources issues. .”
“This is something that our nation's highest leadership has devoted a great deal of time to because we know that health care is critical in wartime,” Smith said. In connection with this, he added: This is critical to the health of the patient and the health of the family. ”
Under this reorganization, all military clinics and hospitals for the U.S. Army, U.S. Navy, and U.S. Air Force were reorganized into the Defense Health Agency. While doing so could leverage economies of scale and standardize care for combatants and beneficiaries in the long run, the changes were enormous. Smith said the organization is being characterized as the largest reorganization and transformation in the Department of Defense since the creation of the U.S. Air Force in 1947. Especially in an organization as large and diverse as MHS, large-scale transitions often take time to stabilize and realize improvements.
Future steps to stabilize MHS
The department will prioritize military and civilian staffing and unified personnel management in military hospitals and clinics, and will incorporate the memo's guidance into planning and planning activities. The focus is on increasing the number of medical personnel providing care in military hospitals and clinics to optimize capacity for serving beneficiaries and mission requirements. ” [Secretary’s] “The goal of taking care of our people is to invest in our workforce,” Smith said, saying exactly what the deputy secretary's memo does in the short and long term.
First and foremost, by June 30, 2024, the Under Secretary of Defense for Personnel and Readiness will complete a comprehensive review of all medical personnel and staffing. This review will inform how best to increase our capacity to improve access to care for military members, their families, and all MHS beneficiaries, while maintaining and improving our readiness.
The memo also directs the department to reconsider its policies regarding the deployment of military medical personnel to hospitals and clinics. In the short term, limited redeployment of medical personnel will occur to increase capacity at several key locations “to stabilize medical delivery and reduce risks to operational forces and missions.” , which is expected to begin no later than July 1, 2024.
“Start PCSing [permanent change of station] We have a lot of medical professionals participating,” Smith said. “From there, we will gradually work to assign these providers to military hospitals and clinics.” By assigning military medical units primarily to military hospitals and clinics, patient forecasting is possible. Possibilities and continuity will increase, improving daily medical capabilities.
“The other big change will be civilian staffing,” Smith said. “We will introduce authorities that will enable us to better recruit and retain civilian employees. This will include facilitating the payment of commensurate pay to civilian employees. will appear. [Department of Veterans Affairs] and the private sector. ”
As Mr. Smith said, one of the important and important initiatives is the implementation of the authorities under Chapter 74 of the Act. title 38 To improve the pay of private health workers. The department recognizes the need to become a more competitive employer and pay private health care workers salaries comparable to those of the Department of Veterans Affairs and the Department of Health and Human Services.
Increase staff to win back beneficiaries
The Department of Defense wants to bring beneficiaries back to military hospitals and clinics whenever possible. With fewer military and civilian personnel available to provide care at the province's hospitals and clinics, many people rely on the private sector for medical care. The Department also recognizes that healthcare worker burnout is a serious challenge in the United States. Recruiting and deploying more healthcare workers in military hospitals and clinics will reduce burnout, improve the work environment, and enhance the patient care experience.
“If we had more people in military hospitals and clinics, people wouldn't be so exhausted. We also know that burnout is correlated with experience in providing care to beneficiaries. '' said Smith. “That way we can attract beneficiaries back to MHS.”
The memorandum directs “on average at least 7 percent of the care available from the private sector to be returned to the MTF,” based on an economic model that optimizes the future state of the MHS with a focus on combatants and military families. ing. Recovering her 7% of patients from the private health system is an ambitious but realistic goal, given that it will take time to close the health worker staffing gap. Return visits to military hospitals and clinics should be easy for patients and out-of-pocket costs should be limited.
“We want to bring beneficiaries back to MHS … and we want to make MHS a place where they truly want to be cared for,” Smith added. “We will first rebuild that capacity to gain trust from our beneficiaries.”
The department does not plan to require patients to change their health plans or doctors. The goal is to make MHS more accessible so that receiving treatment at a military hospital or clinic is the easiest and simplest option.
“We remain focused on preparedness and medical care for all beneficiaries,” Dr. Lester Martinez Lopez, assistant secretary of defense for health, said in the strategic plan. “The two are inseparable. Having our people taking care of our people increases the readiness of our entire force. It will lead to a stronger MHS that can meet the challenges we inevitably face. I look forward to this initiative.'' His message to MHS is: We know we have a serious problem and we have a plan to resolve the situation. We appreciate your support as we make the necessary changes. ”
After all, MHS exists to support the military and the nation. Doing so is a supreme mission, and the Deputy Secretary's memorandum will stabilize the entire MHS and enable it to provide better access to care for the Department of Defense's 9.6 million beneficiaries in the United States and around the world. .
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