Military’s Plan to Cut 18,000 Medical Billets Is on Hold During Pandemic

Madigan personnel participate in a surgical exercise held on Joint Base Lewis-McChord.
Madigan Army Medical Center personnel team up to with Soldiers of 758th Forward Support Team during a weeklong surgical exercise May 18, 2017, on Joint Base Lewis-McChord, Washington (U.S. Army/Sgt. Youtoy Martin)

Fighting the novel coronavirus pandemic has put on hold a controversial plan to cut medical billets in the Military Health System and transfer retirees to outside providers, according to the Defense Health Agency.

"We are shifting our focus to support the nation ... and devoting all available resources to combat COVID-19," DHA officials said in a March 31 statement to "We are assessing all available medical facilities, services and personnel that can be used to provide assistance to our nation's health care providers."

The plan approved by Congress for the DHA to take over management of the service branches' Military Treatment Facilities was meant to be "conditions based" to put more focus on treating the active-duty force, officials said.

The changes, when they come, "are being made in a deliberate, phased fashion, in some cases over a period of up to five years, ensuring every one of our beneficiaries continues to have uninterrupted access to outstanding health care," according to the statement.

Related: DHA Director: Freedom to Switch Health Plans Makes it Harder to Plan for the Future

However, "the location of that care may change in the future" for retirees, it added.

DHA officials did not dispute that the plan, if fully implemented, could result in cutting as many as 18,000 medical billets, but said, "The medical billet reductions are being undertaken by the services, not by the Defense Health Agency."

In addition, the changes would not impact all retirees and result in a rush to outside providers, officials said.

"In fact, 98% of our beneficiaries will see no change in where they receive their care," DHA officials said. "The changes affecting the remaining 2% will be carefully phased in during a three-to-five year period, and patients will receive a warm hand-off from MTF providers to [Tricare] network providers."

In response to the DHA's statements, the Military Officers Association of America said the conditions-based policy for implementation of the plan is reassuring, but "MOAA believes simply pausing the current MHS reform strategy is not enough."

"The COVID-19 pandemic will yield many lessons learned for the whole of government and national medical systems [DoD, Department of Veterans Affairs, Medicare and networks] and, potentially, a new vision for DoD's role in any future nationwide medical emergency," Karen Ruedisueli, director of health affairs at MOAA, said in a statement.

"When this crisis has passed, we can't just move ahead with reform designed around pre-COVID evaluations of the MHS and medical readiness requirements," she added. "The current situation demands all plans to reduce medical provider billets and military hospital and clinic capacity be reconsidered once a full evaluation of the COVID-19 national response has been conducted."

In a Feb. 19 report to Congress, the DHA said that, of 50 facilities ultimately designated for restructuring under the plan, 37 outpatient clinics currently open to all beneficiaries will eventually see primarily only active-duty personnel.

"Active-duty family members, retirees and their families who currently receive care at those facilities will transition over time to Tricare's civilian provider network," it said.

The DHA's plan for a major overhaul of the MHS has raised concerns in Congress and within the DoD itself.

In a December memo to DoD Deputy Secretary David Norquist, Army Secretary Ryan McCarthy questioned the "lack of performance and planning with respect to the transition" by the DHA.

In a Jan. 15 Defense Writers Group breakfast with reporters, McCarthy cautioned that in moving "too fast, you can make a mess" in implementation of the plan.

Editor's Note: The DHA statements above were provided by Kevin J. Dwyer, the chief of media relations at DHA, who died last week of an as-yet undetermined cause. Dwyer served in the Marine Corps and was a dedicated professional whose assistance on complex health care issues was valued by reporters. joins in mourning his passing.

-- Richard Sisk can be reached at

Read more: Military Services Wanted Major Health Care Personnel Cuts, New DHA Director Says

Story Continues