Military Families Need a Safety Net During Military Health System Reform

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(U.S. Navy/Jacob Sippel)
(U.S. Navy/Jacob Sippel)

Karen Ruedisueli is the director of government relations for health affairs for the Military Officers Association of America.

Recent short-notice Middle East deployments are stark reminders of the challenges military members and their families face.

Another less-publicized example: The aircraft carrier Abraham Lincoln’s unexpected deployment extension, together with a home port change from East Coast to West, which left many Navy families dealing with more than nine months of separation on top of a cross-country move without their service member.

Now, imagine having a sick child under these circumstances and not being able to get them appropriate medical care. That is a situation no military family should face.

Military families understand that lengthy separations, frequent relocations and threats to the service member’s safety are all part of the deal, and most face military life with strength, grace and resilience. But that doesn’t mean they should do it alone: They need support, particularly when it comes to medical care.

These families must have ready access to high-quality health care to navigate the challenges of military life successfully. That is why the Military Officers Association of America is so concerned about the unprecedented Military Health System reform currently underway.

Congressionally mandated MHS reform is touching almost every element of the system. While MOAA supports MHS reform goals -- eliminating inefficiencies; improving health care quality, access and the patient experience; and improving the readiness of uniformed medical personnel -- we are concerned the magnitude and speed of reform efforts will cause pockets of trouble across the system.

We aren’t alone in our concerns. Army Secretary Ryan McCarthy recently called for a slowdown to reform efforts.

“It's about pacing,” the secretary said during a media event. “You are bringing thousands of people and functions to one organization. Like all mergers and acquisitions, there are cultural dynamics, there are synergies you are trying to achieve and, if you do it too fast, you can make a mess."

The secretary was referring to the recent transfer of the management of Army, Navy and Air Force military treatment facilities to the Defense Health Agency -- in essence, a gigantic merger. We hope DHA Director Army Lt. Gen. Ronald Place is right that patients will “absolutely positively” see better care following the merger. But what if he’s not?

We fear DHA doesn’t have the right problem reporting and tracking systems in place to identify and resolve issues if systemwide problems -- or even if just pockets of trouble -- arise. This could leave military families struggling to obtain health care.

We believe there are some key steps DHA must take to protect military families’ access to care during MHS reform efforts. These include the following:

  • Reinstate the Tricare Select escape hatch: Tricare’s annual open enrollment policy prevents families using Tricare Prime from switching to Tricare Select to seek civilian care even if they experience problems at their MTF. Families must be allowed to switch to Select if they are dissatisfied with their MTF, particularly while MHS reform creates a system in flux and potentially rife with problems.
  • Create, and publicize, an online reporting tool for MTF access problems: Even before MHS reform began, MOAA regularly heard from families who couldn’t get appointments at their MTFs. Many are afraid to push back when they are told there are no appointments available and aren’t aware of the Patient Advocate, the primary resource to resolve MTF problems. Families need an easy-to-use online tool to report problems making medical appointments, and these problems must be addressed, tracked and reported up to DHA.
  • Provide facility-based metrics: DHA must develop meaningful access to care metrics and report them in ways that identify facilities with appointment shortages. System-level data does not allow targeted solutions for local health care problems.

Congress and DHA have undertaken a massive effort to find efficiencies, improve medical readiness and enhance the system for patients. The reforms are needed, but you can’t fix problems you don’t know about.

Any plans that don’t include common-sense ways to solicit and act on the feedback of military families, and allow them to leave their MTFs if care isn’t available, are doomed from the start.

These families have shown their willingness to make sacrifices for their service members and their nation. We can’t allow their health care to be put at risk.

-- The opinions expressed in this op-ed are those of the author and do not necessarily reflect the views of Military.com. If you would like to submit your own commentary, please send your article to opinions@military.com for consideration.

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