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Balancing TRICARE and Operational Missions

This article discusses the challenges of balancing TRICARE (healthcare) and operational missions in the military, including deployment frequency, repeat deployers, and suggestions for better planning and resource allocation.

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Balancing TRICARE and Operational Missions

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  1. Balancing TRICARE and Operational Missions Michael L. Place, MD USAFP 2007

  2. Assumptions • The GWOT will continue for the foreseeable future • RC augmentation will decline • Low density specialties will deploy in field surgeon or alternate MOS positions • Operational requirements take priority over garrison health care

  3. Deployment Frequency for AMEDD’s Top 20 Officer Specialties“Depicts Only Current Active Duty Force (COMPO 1)”(Does not include officers who are no longer on active duty) AOC = Top 20 AMEDD specialties for deployment. Indicates 180-day deployers. ARMY ASGN = Total Army currently assigned minus Graduate Medical Education (GME) enrolled officers and Trainees, Transients, Holdees, and Students (TTHS) assigned officers. MEDCOM ASGN = Total MEDCOM currently assigned minus GME enrolled officers MEDCOM NON-AVAILABLE = MEDCOM non-available data reported by all MEDCOM units per Army deployability standards and MEDCOM policy. NA indicates data is not available due to automation limitations. # OF TOTAL DEPLOYMENTS= Total number of HFP records, excluding records less than 31 days, since 11 SEP 2001 for officers currently on active duty in given AOC # OF REPEAT DEPLOYERS = Total number of officers currently on active duty in any given AOC with 2 or more HFP records since 11 SEP 2001, excluding records less than 31 days MEDCOM DEPLOYMENTS = Total number and percentage of officers who deployed while assigned to MEDCOM. Indicates the majority of deployments. OTHER MACOM DEPLOYMENTS = Total number and percentage of officers who deployed while assigned to another MACOMs and not MEDCOM AVERAGE DAYS PER DEPLOYMENT = Average number of days deployed per HFP records (excluding records less than 31 days) since 11 SEP 2001. This only includes officers currently on active duty in any given AOC. % OF AOC THAT DEPLOYED = # of officers who received HFP divided by the Army’s assigned strength for any given AOC (excludes GME and TTHS) “Table does not account for substitutability, e.g. Plastic Surgeons often deploy in General Surgeon positions” Data Source: Medical Operational Data System (MODS) as of 10 OCT 06 Unclassified

  4. Army Status #21

  5. Army REPEAT DEPLOYER ANALYSIS(Since 9/11/2001) Deployment Data for Active Component Army Deputy Chief of Staff for Operations and MEDCOM PER OPS compiled the data. Data from DFAS HFP. Army Stats: (as of 1 AUG 06: PAM XXI and DFAS) AMEDD Stats: (as of 14 APR 06: MODS and DFAS) AMEDD Stats: (as of 10 OCT 06; MODS and DFAS) • 60% of Army (34.4% of AMEDD) Soldiers have deployed only once • 19% of Army (15.5% of AMEDD) Soldiers are repeat deployers Current Data Army Deputy Chief of Staff for Operations and MEDCOM PER OPS compiled the data. Data from DFAS HFP. Army Stats: (as of 1 AUG 06: PAM XXI and DFAS) AMEDD Stats: (as of 10 OCT 06: MODS and DFAS)

  6. Observations • PROFIS training requirements built for peacetime status and likely not applicable • ARFORGEN model needs to be applied to medical assets as well • PDS conference every 6mo may improve predictability • Low density provider deployments must be projected >6 months out to have or ensure MEDCOM level planning to fill • Planning, reviewing, and synchronizing required

  7. MTF Staffing Options • GS – timelag and hiring/firing rules make it only moderately responsive/useful • Contract • underserved regions for many MTFs • consider performance based contracts • CSA - MTF fund for MCSC contract with provider or clinical support personnel • RSA (not permitted in Army) • Internal – services provided inside MTF • External – allows MHS providers to work in outside facilities • MHSSI – Military Health System Support Initiatives – similar to venture capital w/ required ROIs by 2 years

  8. Suggestions • Review projected deployers frequently • Make assumptions and attempt to prove or disprove them • Balance financial risk and medical needs of hiring or deferring to network • Seek and reward stability in GS/contract positions • Ensure credentials/privileges and MOS specific training remains UTD for all AD • Understand the “underlap” and plan accordingly

  9. Audience Lessons LearnedandQuestions

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