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

1. “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”

2. “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”

3. “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

4. “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”

5. “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”

6. 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

7. 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)

8. “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”

9. “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”

10. 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”

11. 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”

12. 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)

13. “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”

14. 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

15. DHA Current Acquisitions

16. “Medically Ready Force…Ready Medical Force”
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“Medically Ready Force…Ready Medical Force”