A Vision for the Future of the MHS. VADM (Dr) Rocky Bono Director, Defense Health Agency November 28, 2018

Transcription

1 A Vision for the Future of the MHS VADM (Dr) Rocky Bono Director, Defense Health Agency November 28, 2018

2 Session Objectives At the conclusion of this activity, the participant will be able to: 1. Describe the MHS s desired end-state following the NDAA 2017 Section 702 MTF transition and how it will lead to improved readiness, health, and care and lower cost. 2. Discuss how the MHS is prioritizing value in all of its initiatives to ensure that every dollar is spent effectively to deliver better health and better care. 3. Explain how MHS s goal of becoming a High Reliability Organization (HRO) aligns to the Quadruple Aim of Better Health, Better Care, Lower Cost, and Improved Readiness. 1

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

4 An Approach Aligned with Strategy The Department s management structure and processes are not written in stone, they are a means to an end.department leaders will adapt their organizational structures to best support the Joint Force. We will reduce or eliminate duplicative organizations and systems for managing human resources, finance, health services, travel, and supplies. 3

5 DHA Strategy Map 4

6 Business Case for an Enterprise Approach Outcomes & Experience of Care Improve processing time between appointment referrals and appointment scheduling Increase patients satisfied with getting care when they need it Safety & Quality Improve critical patient safety measures Unintended Retained Foreign Objects, Wrong Site Surgery, Hospital Infections Transparency of performance at MHS and MTF levels Readiness Active Duty,Guard & Reserve Non Deployable 6.3% ~1,900 Efficiencies MIL/CIV FTE reductions from HQ Consolidation >80% Non-deployable conditions related to 75% medical CENTCOM MEDEVACs for Disease & Non-Battle Injuries $870M FY18 Defense Health Program Savings Reprogrammed to Line Standardize medical networks and Cyber standards Cybersecurity Eliminate duplicative IT Systems 5

7 Future of the MHS 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

8 Facilities MIL/CIV FTES Enrollees Dispositions Facilities MIL/CIV FTES Enrollees Dispositions Facilities MIL/CIV FTES Enrollees Dispositions Facilities MIL/CIV FTES Enrollees Dispositions Military Health System Consolidation Previously transferred Transferring within phase 1 OCT OCT OCT OCT % 80% 60% 40% 20% 0% 7% Facilities 100% 80% 13% MIL/CIV FTEs60% 12% Enrollees 40% 20% 17% Dispositions 0% 100% 52% Facilities 80% 54% MIL/CIV FTEs 60% 40% 57% Enrollees 20% 55% Dispositions 0% 100% 81% Facilities 80% 93% MIL/CIV FTEs 60% 40% 89% Enrollees 20% 88% Dispositions 0% 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 All other Functional Capabilities 7

9 Increasing Value as a Combat Support Agency Combatant Commander Feedback / Actions Lethality How can the DHA: Enhance Theater Patient Movement Support Synchronize bio-surveillance activities Better coordinate Medical Research and Development efforts Integration - DHA establishing liaisons in each COCOM CSART Findings and Recommendations Significant opportunity for DHA as a Medical Logistics coordinator Significant opportunity for DHA to enhance Theater Patient Movement Support DoD Bio-surveillance activities lack synchronization DoD Medical Research & Development efforts are redundant and uncoordinated Holistic approach needed for Health Services education and training 8

10 Increasing Value in Readiness CENTCOM Air Transports 100% Battle Injury 80% Non-Battle Injury 60% 40% Disease 20% 0%

11 Enterprise Activities (EAs) Supporting Readiness Pharmacy Programs TRICARE Health Plan Health Information Technology Budget & Resource Management Medical Logistics Facilities Procurement /Contracting Research, Development & Acquisition Public Health Education and Training Force Provider: All in regardless of Service; responsive to COCOM needs Training Platform: Medical Education and Training Center (METC) ensure we train to the same standard; advance external certification (EMT, PT, etc.) Medical Logistics: Standardized, interoperable surgical equipment sets for war and peacetime Health Information Technology: Common infrastructure, common systems, common cybersecurity Family Readiness: Ensuring a comprehensive integrated TRICARE benefit back home 10

12 Increasing Value in Healthcare Delivery Value Based Design Standardizing MTF and Purchased Care Policies and Coverage Increasing Agility / Streamlining TRICARE Policy 11

13 MHS Metrics for the Way Forward 12

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17 Solutions: Greater External Transparency (Volumes) And includes performance over time 16

18 Solutions: Greater External Transparency (Volumes) 17

19 Solutions: Greater External Transparency (Volumes) This hospital performed 1 esophageal resection compared to Leapfrog s standard of 20 procedures annually 18

20 Solutions: Greater External Transparency (Volumes) This hospital performed 1 esophageal resection compared to Leapfrog s standard of 20 procedures annually But plans to implement process in 12 months...of at least 7 procedures (for individual surgeon volume) 19