National Health Policy Forum
William Winkenwerder, Jr., M.D.
Assistant Secretary of Defense (Health Affairs)
January 28, 2004
Overview
• Military Health System
• Battlefield Medicine
• Accomplishments and Advances in Integration
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Council Structure
Joint Strategic Plan
Business Process Improvements
IM/IT Initiatives
Military Health System
• 8.9 million beneficiaries
– 4 million enrolled to the military’s health plan –
TRICARE Prime
• $27.3 billion healthcare system
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75 Military hospitals
461 Military health clinics
131,065 Personnel
TRICARE Support Contractors
Battlefield Medicine
• A continuum of healthcare for service members
wherever assigned and under all operational situations –
anyone, anywhere, anytime.
• The battlefield hasn't changed – it's still a very
dangerous place. Our response to it, however, is
significantly different.
• Medical assets are configured to support health
promotion, health hazard assessment, implementation of
countermeasures, the provision of essential care of the ill
and injured, and the rapid evacuation to definitive
medical care.
Key DoD/VA
Accomplishments
• Establishment of a Joint Council Structure
– Joint Executive Council
– Health Executive Council
– Benefits Executive Council
• Joint Strategic Plan
– Approved April 2003
– Managed Through Council Structure
• Improved Business Processes
• Supported by Electronic Exchange of Information
Joint Executive Council
• Oversee Development/Implementation of Joint
Strategic Plan
• Oversight of Health & Benefits Executive Councils
• Identify Opportunities (Policy, Operations, and Capital
Planning) to Enhance Mutually Beneficial
Coordination
Joint Executive
Council
Benefits Executive
Council
Health Executive
Council
Health Executive Council
•
Development & Implementation of VA/DoD Joint
Strategic Plan Initiatives
•
Leadership Oversight of VA/DoD Health Care
Collaboration
•
Health Care Related Policies, Procedures, and Practices
that Promote Mutually Beneficial Coordination
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Further Opportunities for the Coordination and Sharing
of Health Related Services and Resources
Benefits Executive Council
• Opportunities to Expand and Improve
Information Sharing
• Process of Records Retrieval and Identify
Procedures to Improve Benefits Claims Process
• Transition Issues from Military to Veteran
Joint Strategic Plan
• Mission - To improve the quality, efficiency, and
effectiveness of the delivery of benefits and services to
veterans, service members, military retirees and their
families through an enhanced VA and DoD partnership.
• Vision - A world-class partnership that delivers
seamless, cost-effective, quality services for
beneficiaries and value to our nation.
Joint Strategic Goals
1. Leadership Commitment and Accountability
2. High Quality Health Care
3. Seamless Coordination of Benefits
4. Integrated Information Sharing
5. Efficiency of Operations
6. Joint Contingency/Readiness Capabilities
Business Process
Improvements
• Capital Asset Planning
– Joint Capital Asset Planning and Coordination (CAPC) Steering
Committee developed
– Serves as the clearinghouse for DOD/VA collaboration activities
• Joint Contracting
– 2004 Federal Acquisition Conference on April 6-8
– Web-based medical catalog
– Joint national pharmaceutical contracts
– Shared contracting for high cost medical equipment and
maintenance services
Business Process
Improvements
• Standard Reimbursement Rate
– CHAMPUS Maximum Allowance Charge (CMAC) less
10%
– Implementation for Outpatient Services began 2003
• Joint Incentive Fund
– Each Department Contributes $15 million annually
– Implementation began October 2003
– Proposals must meet a business case analysis
– Final approval through the council
Current IM/IT Initiatives
• Federal Health Information Exchange
– Transfers electronic health information on individuals separating
– 56M messages transmitted on 1.78M unique Service members
– DoD data available to VA providers nation-wide
• Healthcare Standards -- Consolidated Health Informatics Initiative
– Improves the quality of care by ensuring federal entities use common
standards to facilitate information exchange
• Lab Data Sharing & Interoperability
– Facilitate electronic order entry and results retrieval between DoD, VA,
and commercial reference labs
– Pilot successfully tested in Hawaii
– Further implementation in selected sites in 2004
Future IM/IT Initiatives
• DoD/VA Interoperable Electronic Health Records
– A two-way exchange of health information between DoD and VA
– Interoperability between DoD’s Clinical Data Repository and VA’s
Health Data Repository in 2005
– Prototype for outpatient pharmacy data, allergy information, and
patient identification and demographics in 2004
• Credentialing
– Integrated credentialing solution for the DoD Centralized
Credentialing Quality Assurance System and the VA VetPro system
– 3 DoD/VA sites selected
Summary
Through focused collaboration, and the initiatives DoD and
the VA have undertaken together …
-- Establishing Council Structure
-- Joint Strategic Planning
-- Information Sharing
… we are realizing our shared vision in service to our
servicemembers, our veterans, and their families.