“Medically Ready Force…Ready Medical Force” The Defense Health Agency in 2015 ERIC F. THAXTON Acting Director of Procurement Defense Health Agency March 2015 “Medically Ready Force…Ready Medical Force”

“Medically Ready Force…Ready Medical Force” Agenda MHS Governance Reform The Defense Health Agency Topics of Interest! Current / Pending requirements “Medically Ready Force…Ready Medical Force”

“Medically Ready Force…Ready Medical Force” Medical as Percent of DoD Budget Continued cost increases within MHS are unsustainable over time Includes Normal Cost contributions to the Medicare Eligible Retiree Health Care Fund (MERHCF) “Medically Ready Force…Ready Medical Force”

“Medically Ready Force…Ready Medical Force” Governance Reform: Influencing the Big Rocks Management Activities represent a small part of DoD’s health care costs Opportunities exist for a properly organized management HQ to effect change with shared services *Source: FY 2012 President's Budget position for DHP O&M “Medically Ready Force…Ready Medical Force” 3

“Medically Ready Force…Ready Medical Force” Our Leadership Team Lt Gen Douglas Robb Director CMDCM Terry Prince Senior Enlisted Advisor Mr. Allen Middleton Deputy Director MG Richard Thomas Director Healthcare Operations RADM Bruce Doll Director Research & Development Mr. David Bowen Director Health IT Brig Gen Robert Miller Director Education & Training RADM Raquel Bono Director NCR Medical Mr. Joseph Marshall Director Business Support “Medically Ready Force…Ready Medical Force”

“Medically Ready Force…Ready Medical Force” DHA Vision and Mission Vision A joint, integrated, premier system of health, supporting those who serve in the defense of our country. Key Mission Aspects A Combat Support Agency supporting the military services Supports the delivery of integrated, affordable, and high quality health services to beneficiaries of the Military Health System (MHS) Executes responsibility for shared services, functions, and activities of the MHS Serves as the program manager for the TRICARE Health Plan, medical resources, and as the market manager for the National Capital Region (NCR) enhanced Multi-Service Market Manages the execution of policy as issued by the Assistant Secretary of Defense for Health Affairs Exercises authority, direction and control over the inpatient facilities and the subordinate clinics assigned to the DHA in the NCR Directorate. “Medically Ready Force…Ready Medical Force”

Military Health System Secretary of Defense CJCS Sec Army Sec Navy Sec Air Force USD(P&R), Vice Chiefs MHSER USD(P&R) ASD(HA) SGs, JSS SMMAC ASD(HA) CSA CNO CMC CSAF MDAG, DASDs, JSS PAC Policy & Oversight Execution USUHS Defense Health Agency Army SG Navy SG Air Force SG PDASD, Deputy SGs, JSS, DD, DHA Combat Support Agency Responsibilities MDAG Army MEDCOM Navy BUMED Air Force MAJCOMs NCR Directorate MTFs MTFs MTFs MPOG MOG MBOG Lt Gen Robb: (Discuss your vision of the DHA and its interaction with the rest of the MHS) DHA and Services working together to better integrate how we deliver care. DHA will add value to the services Personnel Operations Budget Army Operational Units Navy Operational Units Marine Operational Units Air Force Operational Units MTFs MHS Governance Defense Health Agency Service Medical Organization

Defense Health Agency Secretary of Defense USD(P&R) ASD(HA) CJCS Policy Development & Oversight Policy Execution Combat Support Agency Responsibilities Defense Health Agency Director Deputy Director Sr. Enlisted Advisor Defense Health Agency Director Deputy Director Sr. Enlisted Advisor DHA OGC IPO PEO DHMS EHR Functional Champion Chief of Staff Special Staff HA / DHA Liaison Component Acquisition Executive Communications Innovation Admin & Mgt EEOO Manpower Comptroller Strategic Mgt Def Health Board DoD/ VA PCO Procurement Prog Integration Analytics Small Business Healthcare Operations Directorate (CMO) Research Development & Acquisition Directorate Health IT Directorate (CIO) Education & Training Directorate Business Support Directorate NCR Medical Directorate TRICARE Health Plan Advanced Development Innovation and Advanced Technology Dev (CTO) METC HQ Facility Planning Walter Reed National Military Med Center Pharmacy Science & Technology Portfolio Mgmt and Customer Relations DMRTI Medical Logistics Ft. Belvoir Community Hospital Clinical Support Clinical Infrastructure Program Infrastructure & Operations JMESI Budget & Resource Management Joint Pathology Center Public Health Veterans Affairs R&D Liaison Solution Delivery Academic Review & Oversight Program Integrity Readiness Information Delivery Prof Development , Sustainment, & Prog Mgmt Warrior Care Program Cyber Security Defense Health Service System (DHSS) Defense Health Clinical Systems (DHCS)

“Medically Ready Force…Ready Medical Force” Defense Health Agency: Global Support DHA - Aurora TRICARE Europe: TRICARE Pacific TRO North Defense Health Agency TRO West TRO South METC Health IT “Medically Ready Force…Ready Medical Force”

“Medically Ready Force…Ready Medical Force” DHA Shared Services 1 Facilities FOC 3 March 15 6 Budget & Resource Management IOC 1 FEB 14 2 Medical Logistics FOC 3 March 15 7 Procurement/Contracting IOC 1 MAR 14 3 Pharmacy Programs FOC 3 March 15 8 Research, Development & Acq IOC 1 JUN 14 4 Health Information Technology 9 Medical Education & Training IOC 10 AUG 14 Updated slide? Public Health IOC 30 SEP 14 10 5 TRICARE Health Plan IOC 1 OCT 13 “Medically Ready Force…Ready Medical Force”

Shared Services Savings Five Year Defense Plan (2015-2019) IOC FY14 Net Savings FY15-19 Savings Facilities 1 Oct 13 $537 M Medical Logistics $189 M Health IT $265 M Health Plan $456 M Pharmacy $1,224 M Contracting 1 Mar 14 $136 M Budget & Resource Mgmt 1 Feb 14 $279 M Medical Research & Dev 1 Jun 14 $98 M Medical Education & Tng 10 Aug 14 $ 5 M Public Health 1 Oct 14 $293 M Total $3.482 Billion “Medically Ready Force…Ready Medical Force”

Shared Services Savings Five Year Defense Plan (2015-2019) IOC FY14 Net Savings FY15-19 Savings Facilities 1 Oct 13 $18.4 M $537 M Medical Logistics $13.5 M $189 M Health IT $33.1 M $265 M Health Plan $25.5 M $456 M Pharmacy $160.5 M $1,224 M Contracting 1 Mar 14 ($2.9 M) $136 M Budget & Resource Mgmt 1 Feb 14 $0 M $279 M Medical Research & Dev 1 Jun 14 $98 M Medical Education & Tng 10 Aug 14 $ 5 M Public Health 1 Oct 14 $293 M Total $248.1M $3.482 Billion “Medically Ready Force…Ready Medical Force”

The Eight Largest Markets (and Service/Department Leads) Multi-Service Markets: 2 or more Services, large beneficiary population, 45% direct care dollars, large GME & readiness platforms = eMSM = Single Service National Capital Region (DHA) Tidewater (Navy) Ft. Bragg (Army) San Antonio, Texas (rotate Air Force/Army) Oahu, Hawaii (Army) San Diego (Navy) Puget Sound, Washington (Army) Colorado Springs, Colorado (rotate Air Force/Army) The Eight Largest Markets (and Service/Department Leads)

“Medically Ready Force…Ready Medical Force” Final Thoughts This is a once-in-a-generation opportunity to shape the future of military medicine Local health delivery and Multi-Service Markets are central to our strategy and a core element of our reform efforts There are millions depending on us to get this right “Medically Ready Force…Ready Medical Force”

DoP Proposed Future State = Existing = Realigned = New Legend Procurement Division Policy, Compliance & Quality Branch Business Operations Branch Contracting Operations Branch - San Antonio Contracting Operations Branch - Aurora Contracting Operations Branch - NCR Contracting Operations Branch - Falls Church Quality Management Section Knowledge Management Section Health IT - Army Section CO-AA - Managed Care Contract Support Section Bethesda Group 1 - NCR SAP Section Professional Services Section Health IT - DHA Section Bethesda Group 2 - NCR Complex Svcs. Section Specialized Requirements Section Government Purchase Card Section Enterprise Performance Management Section Medical Services Section CO-AB - TRICARE Support Section Skyline-Ft Belvoir Svcs. Section Pricing Support Section Systems Support Section Pricing Support Section CO-AP - Pricing and Program Support Section Pricing Support Section

DHA Current Acquisitions

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