1
Ready Medical
Ready Medical
Medically Ready
DHA Presence Across the Globe Supporting COCOMs and Services 6
55 55 H Hospital itals 36 360 0 Outpa patient tient Cl Clin inic ics
9.4M 1.5M Benefi eficia ciarie ies In Un Unif iform rm
9.4M 2.4M Benefi eficia ciarie ies Famili ilies es
9.4M 5.4M Benefi eficia ciarie ies Retir irees es/Fa Fami milie lies
Joint Concept for Health Services Chairman, Service Chief Endorsed Doctrine • “Concept encompasses the global employment of joint operational health services and the idea of interoperable Service capabilities guided by common standards and procedures …The need for integrated medical support that keeps pace…to support Globally Integrated Operations is clear.” Chairman, Joint Chiefs of Staff 11
Today’s DHA: How We Got Here DEPSECDEF DoD TaskForce DEPSECDEF DHA Planning DODD NDAA2017 “Nine on MHS Planning Memo WG Report 5136.13 Commandments” Governance Memo September2011 March2012 November2012 March2013 September 2013 Dec 2016 Recommended DHA Directed Directed planning for Provided DHA and Establishes the DHA Directed model for MHS implementationof DHA implementation Shared Services implementationof Governance DHA implementation plan Broader Responsibilities for DEPSECDEF approval 12
FY 17 National Defense Authorization Act The “Why” “The conferees believe that • the current organizational structure of the military health system • essentially three separate health systems each managed by one of the three Services – • paralyzes rapid decision-making and stifles innovation in producing a modern health care delivery system … • … that would better serve all beneficiaries.” 13
FY 17 National Defense Authorization Act The “Why” “…a single agency responsible for the administration of all MTFs would • best improve and sustain operational medical force readiness and the medical readiness of the Armed Forces , • improve beneficiaries’ access to care and the experience of care, • improve health outcomes , • and lower the total management cost of the military health system .” 14
FY 17 National Defense Authorization Act The “What” “The Director of the Defense Health Agency, beginning October 1, 2018, to take responsibility for the administration of each MTF , including all matters with respect to: 1) budget ; 2) information technology ; 3) health care administration and management ; 4) administrative policy and procedure; 5) military medical construction and 6) any other matters the Secretary determines appropriate ...[and] would require the establishment of a professional staff within the Defense Health Agency to provide policy, oversight, and direction of all matters related to the administration of MTFs .” 15
SECDEF Mattis Memo (17 Feb 2017) Department Leadership Weighs In “Rebuild” “Reform” DoD Deputy Chief Management Officer 16
SECDEF Mattis Memo (5 Oct 2017) Department Lines of Effort • Restore Military Readiness as We Build a More Lethal Force • Strengthen Alliances and Attract New Partners • Bring Business Reforms to the Department of Defense “…budget discipline and effective resource management, develop a culture of rapid and meaningful innovation, s treamline requirements and acquisition processes…” 17
Medical as Percent of DoD Budget MHS Cost Growth Has Slowed, But We Are Not Complacent 9.4% 9.3% 9.7% 9.5% 9.7% 9.7% 9.2% 9.4% 9.3% 9.5% 9.7% 9.8% $60 10.0% 9.3% 9.4% 9.1% 8.9% 8.7% 8.1% 8.1% 7.5% $45 7.5% 5.9% % of DoD $30 5.0% Topline $B $15 2.5% $- 0.0% 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 Unified Medical % of DoD Budget Topline 18 Includes Normal Cost contributions to the Medicare Eligible Retiree Health Care Fund (MERHCF)
Enterprise Support Activities (ESA) Pharmacy Programs 1 6 Facilities TRICARE Health Plan Procurement/Contracting 2 7 Health Information Technology Research, Development & Acquisition 3 8 Public Health 4 9 Budget & Resource Management Education & Training Directorate Medical Logistics 5 10 10 19
Enterprise Support Activities Beat FY15 Expectations, Beat FY16 Expectations FY14-19 Net Savings ($M) $5,000 $4,578 $4,500 $4,000 $3,370 $3,500 $3,560 $3,000 $2,262 $2,311 $2,500 $2,535 $2,000 $1,649 $1,709 $1,500 $1,000 $1,004 $242 $500 $475 $147 $- FY14 FY15 FY16 FY17 FY18 FY19 Initial Cumulative Net Savings Projection (3rd RTC) Actual (Cumulative) 20 Forecast (Cumulative) POM Booked Savings (Cumulative)
Health IT Fewer Systems, Streamlined Management Health IT (J-6) Shared Service Net Savings and Reductions ($M) $700 $600 $500 $400 Net Savings ($M) $300 $200 $100 $- FY14 FY15 FY16 FY17 FY18 FY19 $(100) Actual Savings FY14-17Q3 (Cumulative) Initial Projections FY14-19 3rd Report to Congress (Cumulative) POM Booked Savings FY15-19 (Cumulative) Forecast (Cumulative) 21
[Use slide (pics) to answer question – Why am I here?] [DoD EHR in News] $4.6B investment for DoD Talk to: Complex Acquisition, IT, and FUNCTIONAL transformation
MHS GENESIS Complex Change Effort First Major Upgrade Many Stakeholders Worldwide in > a Decade Deployment 50 System s 50+ legacy systems to 1 23
Zero Based Budget Review (ZBR) Overview • In April/May 2015 DoD leadership directed a ZBR to evaluate the existing and planned MHS IT investments in FY16, FY17, and out years of the Future Year Defense Plan. • Comprehensive examination of all IT investments used to support MHS functions, irrespective of funding source or implementation organization • Definition: Zero-based budgeting starts from a “zero base”, every function within an organization is analyzed for its needs and costs 24
MHS IT Management Reform Additional Opportunities • Further rationalization of the IT portfolio (applications) across the Services and DHA • Continued implementation of the Medical Community of Interest (MED-COI) • Continued implementation of NDAA 2017 further consolidation of MHS IT in support of managing the MTFs • Support of MHS Genesis deployment and sustainment • Cybersecurity implementation based on the DoD plan 25
Key Takeaways • Organizational Big Rocks: • TRICARE – January 1, 2018 • MHS GENESIS Deployment • NDAA Implementation • The Future Picture: • Unwavering focus on improved Readiness • Increased Quality and Safety • Greater Efficiency…without sacrificing effectiveness! 26
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