1. Your Military Health System
VADM (Dr) Rocky Bono
Director, Defense Health Agency
October 15, 2018

2. Secretary Mattis’ Priorities
Restore Readiness and Lethality
Strengthen Alliances
Bring Business Reforms to DoD 2

3. Patient Outcomes & Experience of Care
Enterprise Approach
Patient Outcomes & Experience of Care
Safety & Quality
Improve
Focused
Improvement in critical patient safety measures
avg. length of time between a referral order a specialist appointment
Increase
Unintended Retained Foreign Objects, Wrong Site Surgery, Hospital Infections
patients satisfied with getting care when they need it ( 1 in 6 not satisfied) 4
New MHS measures focused on better health for 2019
Transparency of performance at MHS and MTF levels
Readiness
Efficiencies
6.3%
Active Duty, Guard & Reserve Non Deployable
~1,900
MIL/CIV FTE HQ reductions
$870M
75%
Non-deployable conditions related to medical
FY18 Savings Reprogrammed
$648M Night vision goggles
$210M DoD-wide Working
Capital Fund
> 80%
CENTCOM MEDEVACs for Disease & Non-Battle Injuries
Cybersecurity 7 87
Separate medical networks with different Cyber standards
IT systems identified for decommissioning

4. Military Health System Consolidation
1 OCT 2018
1 OCT 2019
1 OCT 2020
1 OCT 2021
Previously transferred
Transferring within phase
7% Facilities
13% MIL/CIV FTEs
12% Enrollees
17% Dispositions
52% Facilities
54% MIL/CIV FTEs
57% Enrollees
55% Dispositions
81% Facilities
93% MIL/CIV FTEs
89% Enrollees
88% Dispositions
100% MHS Enterprise
Full Authority to Standardize Policies for all MTFs
Health Plan, Pharmacy & Quadruple Aim Performance Plan (QPP) Functional Capabilities
Facilities, MEDLOG & Acquisition Functional Capabilities
Click 1 – Dates
Click 2 – Phase 1
Click 3 – Phase 2
Click 4 – Phase 3
Click 5 – Phase 4, then first bar re. policies
Click 6 – Health Plan, Rx and QPP FC
Click 7 – Facilities, MedLog and Acq FC
Click 8 – All other FCs
All other Functional Capabilities

5. Military Health System Reforms Our Goals
What Stays the Same
Support to the Mission
Patient-Centered Care
What’s Changing
Standardized Appointing & Referrals across System
“Market” Orientation
Reporting Relationships

6. Standardized Appointing & Referrals
 MHS TARGET = 1 DAY
Measure Description: The purpose of this measure is to monitor how well the MHS is able to book the patient’s initial specialty care referral appointment before leaving the MTF per the Defense Health Agency Interim Procedural Memorandum (DHA-IPM) on specialty care referrals and appointing business rules. The measure displays the average number of days from when the referring provider submits the referral in CHCS/AHLTA to when the initial specialty care appointment was booked in CHCS.

7. Market Orientation Resources closest to health care delivery
Local medical leaders with real authority
to effectively move money and people to responsibly coordinate patient-centered care
Data-driven

8. NCR Medical Directorate
Reporting Relationships – Old
Army
Operational
Units
Navy
MEDCOM
Marine
Air Force
MAJCOMs
CNO
CMC
BUMED
CJCS
Secretary of Defense
Sec Army
Sec Navy
Sec
CSAF
CSA
USD(P&R)
ASD(HA)
Defense Health Agency
USUHS
Combat Support Agency
Responsibilities
Policy & Oversight
Army SG
Navy SG
Air Force SG
NCR Medical Directorate
MTFs

9. Military Health System – Before FY 2019 Reporting Relationships – New
Secretary of Defense
CJCS
Sec Army
Sec Navy
Sec
Air Force
USD(P&R)
ASD(HA)
CSA
CNO
CMC
CSAF
USUHS
Defense Health Agency
Policy & Oversight
Army SG
Navy SG
Air Force SG
Combat Support Agency
Responsibilities
Air Force
MAJCOMs
Markets
MTFs
Army
Operational
Units
Navy
Operational
Units
Marine
Operational
Units
Air Force
Operational
Units

10. TRICARE Changes in 2019: Introducing TRICARE Open Season
2nd week of NOV to 2nd week in DEC (12 NOV to 10 DEC in 2018)
If you like your plan, you don’t need to do anything
Starting in 2019 you’ll need to use open season to change plans (Prime and Select)
For more information, go to TRICARE.mil/openseason
Open season is an annual period when you can enroll in or change your health care coverage for the next year

11. TRICARE Changes in 2019: Introducing FEDVIP Open Season
Federal Employee Dental and Vision Insurance Program (FEDVIP) Open Season – For RETIREES
2nd week of NOV to 2nd week in DEC (12 NOV to 10 DEC in 2018): Aligns with TRICARE open season
New access to FEDVIP dental and vision plans!
Must take action during 2018 open season to get coverage in 2019
To check eligibility and explore/compare plans go to TRICARE.Benefeds.com

12. TRICARE Changes in 2019: Representative FEDVIP Premiums
2018 TRICARE Retiree Dental Program Premiums
METLIFE
FEP
GEHA
Delta PPO
AETNA PPO
UCCI PPO
2019 FEDVIP Premiums for 6 Representative Plans
METLIFE
FEP
GEHA
Delta PPO
AETNA PPO
UCCI PPO
Sources:

13. Humana Government Business Health Net Federal Services
Managed Care Support Contractor (MCSC)
Monthly Status: Oct 2018 (Aug data)
Humana Government Business
East Region
Health Net Federal Services
West Region
Claims/TED: the #1 issue in the East. Numerous issues from beneficiaries & providers. CAP submitted 15 June, get-well date ~Dec 2018.
Correspondence: addition of secure s pushed metrics into the RED. Claims are also a large factor. Estimated Sep 2018 compliance.
Provider Directory: HGB increased from 50% in Jul to 62% in Aug. Marked improvement due to LexisNexis. 1
Provider Directory Accuracy: #1 issue: 35.5% per interim audit results on 21 Sep 2018.
Referral Management: Meeting timeliness standard. Accuracy issues continue.
Call Centers: Metrics improved, but not completely stabilized. 1 2 2 3 3 2

14. Both contractors have Corrective Action Plans (CAPs)
Key Performance Indicators (Aug 2018) 1
81%
81% 2
Both contractors have Corrective Action Plans (CAPs)
HGB (East) - Claims Processing, Correspondence, Provider Directory Accuracy, Autism Care / ABA Therapy
HNFS (West) - Provider Directory Accuracy, Customer Call Centers 3 3 1 2 3
GREEN - MEETS/EXCEEDS REQUIREMENTS / RED - DOESN’T MEET REQUIREMENTS
ARROW: CHANGE IN COLOR FROM PREVIOUS MONTH

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