Military treatment facilities can do a better job of convincing military family members to use them instead of civilian providers by communicating their offerings while increasing the number of providers they have on hand for specialty care, officials said Tuesday at a hearing on Capitol Hill.
"We look at patient balance," said Air Force Col. Douglas Littlefield, who commands the 19th Medical Group at Little Rock Air Force Base in Arkansas. "Some of it is communication, talking to community partners … talking to the members that are out there and communicating the services we have and can provide that will allow them to come back in."
Over the last several years, military officials have sought to move more military family members, particularly those on Tricare Prime, away from off-base civilian providers to doctors within the Military Treatment Facility (MTF) system.
Some bases, such as Fort Campbell, Kentucky, launched publicity campaigns advertising what the MTF can offer and asking users to voluntarily move to an on-base doctor. But others, such as Marine Corps Base Camp Lejeune, came under fire last year after sending letters to Tricare Prime beneficiaries near the base informing them that they had simply been reassigned to on-base doctors.
"One of the things that we're wrestling with is: how do you incentivize the beneficiaries to come back into the MTF?" Rep. Joe Heck, a Republican from Nevada, who chairs the House Armed Services' Personnel Subcommittee, said at the hearing. "How do you address the issues of the relatively transient nature of military healthcare providers and the capability of the MTF to actually expand access to get more beneficiaries to come back in?"
Military medical facilities in the Washington, D.C., area have lowered their per-member, per-month cost over the last year by about $90 by increasing the number of specialty care providers in the MTFs, said Col. Mike Heimall, chief of staff at Walter Reed National Military Medical Center. The command recently hired 11 new physical therapists for the area, he said, and officials hope that that provider increase will bring even more users back on base.
Part of creating a system where military members want to use the MTF instead of being seen off base, said Army Col. Mike Place, who oversees Madigan Army Medical Center at Joint Base Lewis-McChord in Washington state, is creating a culture of familiarity among users and providers.
"We have to recognize that different people want different things for access," Pace said. "What's most important for us to do … is to change the culture to say we want them here and we embrace each other."
The Defense Department's ongoing attempts to move more patients from civilian care back into the military treatment facilities come as both lawmakers and the Pentagon prepare to hash out major Tricare reforms.
President Barack Obama's budget proposal, which will be released next week, is rumored to include a series of changes to consolidate the many Tricare plans into a smaller menu.
And lawmakers and Defense reform insiders, who have warned that 2016 will be the year of Tricare reforms, say they are looking at changes that will refocus the department's health care energies on "readiness" while possibly outsourcing family care to civilian providers.
"We spend a lot of time in hearings and briefings … trying to define what the role of the military health care system should be and how we structure that role to meet the requirements," Heck said in an interview with Military.com. "So we've heard from everybody that the number one purpose of the military health care system is readiness."
He added, "But how do you define readiness? How do we best ensure that the military healthcare system can meets its primary role which is to have a ready, deployable healthcare force to take care of our men and women in uniform when they deploy, and how do we best structure the healthcare benefits to keep our military member ready and provide a valued benefit to their families, to retirees and everyone to whom the healthcare benefit has been promised."