Overview of The Military Health System, TRICARE, and Navy Medicine

1. Overview ofThe Military Health System, TRICARE, and Navy Medicine CAPT James Chun, MC, USN LCDR Eric A. Polonsky, MSC, USN LT D. Todd Uhlman, NC, USN November 4, 2011

2. MHS Mission In Peace & War Deploy to Support the Combatant Commanders Patient Care, Sustain Skills and Training Promote & Protect Health of the Force and to Deploy Medical Force Deploy A Healthy Force Deploy A Healthy Force Manage Beneficiary Care Manage Beneficiary Care Manage Beneficiary Care

3. How Do We Support Changein the Right Direction? Balanced Approach to Quadruple Aim • Readiness • Pre- and post-deployment • Family health • Behavioral health • Professional competency/currency • Population Health • Healthy service members, families, and retirees • Quality health care outcomes • A Positive Patient Experience • Patient and family centered care, Access, Satisfaction • Cost • Responsibly managed • Focused on value

4. What Is TRICARE? TRICARE is… … the health care program for active duty service members, National Guard and Reserve members, retirees, family members, survivors, and certain former spouses worldwide. … a network of military and civilian health care professionals working together to foster, protect, sustain, and restore health for those entrusted to their care.

5. TRICARE - Who We Are • 9.6 million beneficiaries • 3.7 million TRICARE Prime enrollees Direct care system • 1.6 million TRICARE Prime enrollees Contractor networks • Remainder • • TRICARE Standard/Extra • • TRICARE for Life • • TRICARE Reserve Select • Military Treatment Facilities (MTFs) • 59 Hospitals & Medical Centers • 364 Health Clinics • Over 380,000 network providers • Over 60,000 retail pharmacies

6. TRICARE Prime Options Benefit Information TRICARE Prime is a managed care option, meaning most of your care will be provided by a primary care manager dedicated to your care.* * ADSMs must enroll in a TRICARE Prime option, other than USFHP.

7. Other TRICARE Programs Benefit Information Other TRICARE programs work more like fee-for-service plans, allowing you to see any TRICARE-authorized provider for care. * In most cases, TRICARE is the last payer after other health insurance (OHI), including Medicare.

8. Benefit Information TRICARE Pharmacy Program Prescription drug coverage is the same regardless of your beneficiary category or which health plan option you are using. There are four ways to have your prescriptions filled: • At any military treatment facility pharmacy • Through TRICARE Pharmacy Home Delivery • At any TRICARE retail network pharmacy • At a non-network pharmacy (highest cost) TRICARE has partnered with Express Scripts, Inc. to provide home delivery and retail network pharmacy services. For more information, visit Express Scripts, Inc. at www.express-scripts.com/TRICARE or call 1-877-363-1303.

9. Other Benefit Information Dental Program Options • Active Duty Dental Program (ADDP) • Available to ADSMs • Care through military dentist referrals and remote access • For more information, visit www.addp-ucci.com • TRICARE Dental Program (TDP) • Available to eligible ADFMs and National Guard and Reserve members and their families • For more information or to enroll online, visit www.TRICAREdentalprogram.com • TRICARE Retiree Dental Program (TRDP) • Available to retired service members and their families, retired National Guard and Reserve members, survivors, and others • For more information or to enroll online, visit www.trdp.org

10. A Week in the Life of TRICARE 2.5 million prescriptions 923,000 direct care 1.39 million retail pharmacies 202,000 home delivery 179,300 behavioral health outpatient services 46,100 direct care 133,200 purchased care 21,800 inpatient admissions 5,000 direct care 16,800 purchased care 1.6 million outpatient visits 737,000 direct care 876,400 purchased care 2,300 births 1,000 direct care 1,300 purchased care 3.5 million claims processed 12.6 million electronic health record messages Behavioral HealthOutpatient VisitsPer Year

11. Who We Are – Education and Training • Uniformed Services University of the Health Sciences – Doctoral, Masters, Graduate Medical Education – residencies, fellowships, nursing, out service training, etc. • Technical Training/METC(2010) – medics, corpsmen, technicians (lab, X-ray, pharmacy, pulmonary, preventive medicine, veterinary, physical therapy, orthopedic, surgical, etc.) • Defense Medical Readiness Training Institute - joint medical readiness

12. Who We Are – Research • Uniformed Services University of the Health Sciences • 36 Medical Research Laboratories • 18 Clinical Investigation Programs (Army, 8; USAF, 6; Navy, 3; USUHS, 1) • Over $2B in research funding is devoted to DoD biomedical research

13. The Core Mission: Readiness • Observed vs. Predicted Survival Rate • Battle Wounds in Operation Enduring/Iraqi Freedom • THEATER CARE • Next-generation, quick clotting hemostatic bandages • En-route care during air transportation from theater (ICU on a plane) • Negative Pressure Wound Therapy in Combat-Related Injuries to promote wound healing • 31 clinical practice guidelines as a result of Joint Theater Trauma System (JTTS) • MEDICAL EVACUATION • Total Global Patient movements1 137,100 • Total Evacuated2 73,290 (13,478)3 • Return to CONUS as quickly as 72 hours • PREVENTIVE AND PRIMARY CARE MEDICINE • Disease Non-Battle Injury per Week • Operation Joint Guardian (Kosovo) – 8.1% • Desert Shield/Storm – 6.5% • OIF – 4% • Global Patient Movements1 Since 9/11/01 • (000s) 13

14. TRICARE Network US Overseas Hospitals Hospitals & Research Labs Hospital Ships & Smart Power Expeditionary Medical Facilities Casualty Receiving & Treatment Ships & Medical Battalions Operational Fleet & Fleet Marine Forces Navy Medicine Warrior & Family Centered Care. . . .Anytime, Anywhere Benefit Mission Readiness Mission

15. Who are we? Navy Medicine

16. Maritime Strategy:A Cooperative Strategy for 21st Century Seapower – Core Capabilities • Forward Presence • Deterrence • Sea Control • Power Projection • Maritime Security • Humanitarian Assistance and Disaster Response (Smart Power)

17. Mission: Expeditionary Care Provide direct medical support around the world from the deckplatesto the battlefield

18. Mission: Humanitarian Assistance/ Disaster Response For the first time ever, HA/DR is now a core capability of the Navy Navy Medicine is often the face of our national humanitarian assistance/ disaster response efforts around the world

19. Mission: Garrison Health Care Navy Medicine supporting medical readiness, providing health care to the warfighter and their families

20. Questions