Leading the Way Upstream: The Military Health System for 2012 and Beyond June 21, 2011

1. Leading the Way Upstream:The Military Health System for 2012 and BeyondJune 21, 2011 RADM C.S. Hunter, MC, USN Deputy Director TRICARE Management Activity

2. TRICARE Beneficiaries:Who We Serve Over 9.6 Million Beneficiaries • Program enrollment • 5.4 million TRICARE Prime • 3.7 million in direct care system • 1.7 million in contractor networks • 2.1 million TRICARE Standard/Extra • Others use TRICARE Reserve Select, TRICARE For Life • USPHS beneficiaries - 30,476 • Beneficiaries by category • Active duty: 1.7 million • Active duty family: 2.4 million • Retirees: 1 million • Retiree family: 1.8 million • Medicare-eligible: 2.1 million

3. A Week in the Life of TRICARE 2.7 million prescriptions* (7,392 PHS) 924,000 direct care 1.44 million retail pharmacies 228,000 home delivery 231,000 behavioral health outpatient services 52,000 direct care 179,000 purchased care 23,300 inpatient admissions 5,100 direct care 18,200 purchased care 1.8 million outpatient visits (5,364 PHS) 810,000 direct care 1.0 million purchased care 2,400 births 1,000 direct care 1,400 purchased care 3.5 million claims processed 12.6 million electronic health record messages Behavioral HealthOutpatient Visits Active Duty Family Active Duty * Pharmacy from 6 mo. Period: 10/01/10 – 3/31/11; All others FY10

4. Aligning Behind a Well-Articulated Goal 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 Military Health System Quadruple Aim

5. Fulfillment of the Quadruple AimAcross the Military Health System • The Quadruple Aim has been successful because it: • Focuses our efforts, yet is broad enough to be inclusive • Is relevant to both military and national health care landscapes • Can be applied across multiple domains • Force health protection and prevention • Direct care at military treatment facilities (MTFs) • Purchased care through civilian partners • Electronic health information systems • Education, training and workforce development

6. How PHS Officers Contribute PHS Officers Fill Key TMA Leadership Positions RADM Thomas McGinnis Chief, Pharmaceutical Operations Directorate • CAPT Robert DeMartino Director of Behavioral Medicine • CAPT Cheryl BordenExecutive Officer • Provide continuity • Provide deep subject matter expertise • Close gaps in care left by deployed DoD providers

7. Providing Critical PsychologicalHealth and TBI Expertise • USPHS mental health professionals serve at 46 MTFs • DoD-USPHS Memorandum of Agreement (MoA) signed June 4, 2008

8. Where is DoD Headed? Focusing on Upstream Determinants of Health • Prevention • Resiliency • Diet • Fitness • Child-rearing • Meaningful work

9. Where is DoD Headed? Empowering Patients • Patient-centered medical home • Self management support • Health literacy • Health information access

10. How is DoD Addressing Costs? • Focusing on prevention • Reducing ER use • Encouraging economical pharmaceutical outlets • Reducing hospital readmissions throughPartnership for Patients

11. How Can Leaders Prepare for the Future? Diversify your reading Be open to opportunities Seek out mentors and mentor others Learn to communicate well Nurture your humanity

12. We Are All Part of the Solution Thank You For Your Service 12