The Defense Health Agency in 2015 - My Business Matches · PDF fileThe Defense Health Agency in 2015 COL Scott A Svabek Acting Director of Procurement Defense Health Agency December

The Defense Health Agency in 2015

COL Scott A SvabekActing Director of Procurement

Defense Health Agency

December 2014

“Medically Ready Force…Ready Medical Force”

The “Why”

1

…the “Why Not”

2

Agenda

• MHS Governance Reform

• The Defense Health Agency

• Topics of Interest!

• Current / Pending requirements

“Medically Ready Force…Ready Medical Force” 3

A Changing World

4

“We are only beginning to see the dramatic shifts underway that will define our future and shape our interactions in the world … and require our national security institutions to adapt and to adjust…

We will need to more efficiently match our resources to our most important national security requirements. We can do things better. We must do things better – and we will.”

Secretary HagelCenter for Strategic & International Studies

November 2013


Translation: Adapt or Perish!

Continued cost increases within MHS are unsustainable over time

Includes Normal Cost contributions to the Medicare Eligible Retiree Health Care Fund (MERHCF)


Medical as Percent of DoD Budget

*Source: FY 2012 President's Budget position for DHP O&M

6

Governance Reform: Influencing the Big Rocks

Management Activities represent a small part of DoD’s health care costs

Opportunities exist for a properly organized management HQ to effect change with shared services


DHA Vision and Mission

Key Mission Aspects A Combat Support Agency supporting the military services Supports the delivery of integrated, affordable, and high quality health services to beneficiaries

of the Military Health System (MHS) Executes responsibility for shared services, functions, and activities of the MHS Serves as the program manager for the TRICARE Health Plan, medical resources, and as the

market manager for the National Capital Region (NCR) enhanced Multi‐Service Market Manages the execution of policy as issued by the Assistant Secretary of Defense for Health

Affairs Exercises authority, direction and control over the inpatient facilities and the subordinate clinics

assigned to the DHA in the NCR Directorate.

VisionA joint, integrated, premier system of health, supporting those

who serve in the defense of our country.


MTFs

ArmyOperational

Units

NavyOperational

Units

ArmyMEDCOM

MTFs MTFs

MarineOperational

Units

Air ForceMAJCOMs

Air ForceOperational

Units

CNO CMC

NavyBUMED

CJCS

Secretary of Defense

Sec Army Sec Navy Sec Air Force

CSAFCSA

MHSERUSD(P&R),Vice Chiefs

ASD(HA)SGs, JSS

MDAG

MPOG MOG MBOG

PDASD, Deputy SGs, JSS,DD, DHA

Personnel Operations Budget

MDAG, DASDs, JSS

PAC

SMMAC

USD(P&R)

ASD(HA)


NCR Directorate

MTFs

USUHS

Combat Support Agency

Responsibilities

Policy & OversightExecution

Army SG

Navy SG

Air Force SG

8

Military Health System

Defense Health AgencyMHS Governance Service Medical Organization

Procurement DirectorateDirector

COL Scott Svabek

COD-FC ChiefAndrew Carrington

COD-A ChiefRichard Van Dorn

COD-NCR ChiefMAJ Owen Roberts

COD-SA ChiefKenneth Helgren

Chief Policy & Comp. Advocate

Genesta Belton

Chief of Staff-Vacant-

Deputy DirectorEric Thaxton

Senior Contracting

OfficerJake Lewis

Executive Assistant:

GPC

Systems

DoP Organizational Structure (as of 2 October 2014)

Business Operations Division (BOD)

Ken Helgren

5

10

BLUF: DHA as a Combat Support AgencyTranslation: DHA is to medical as DLA is to logistics or as DISA is to communications

USD(P&R)ASD(HA)

Defense Health Agency Director

Deputy Director Sr. Enlisted Advisor

POLICY DEVELOPMENT & OVERSIGHT

POLICY EXECUTION Combat Support Agency Responsibilities

Admin & Mgt EEOO

TRICARE Health Plan Facility Planning

Medical Logistics

Budget & Resource Management

Walter Reed NationalMilitary Med Center

Ft. BelvoirCommunity Hospital

Joint Pathology Center

Comptroller

DHA OGC

Special Staff

Manpower

EHR Functional Champion

METC HQ

DMRTI

Program Integrity

Portfolio Mgmt and Customer Relations

Innovation and Advanced Technology Dev (CTO)

Infrastructure & Operations

Solution Delivery

JMESI

Defense Health Agency Director

Deputy Director Sr. Enlisted AdvisorIPO PEO DHMS

Defense Health Service System (DHSS)

Defense Health Clinical Systems (DHCS)

Information Delivery

Secretary of Defense

Chief of Staff

Component Acquisition Executive

Analytics

Communications

Prog Integration

Small Business

Def Health BoardStrategic Mgt

HA / DHA Liaison

Procurement

Innovation

DoD/ VA PCO

Cyber Security

CJCS

NCR MedicalDirectorate

Business Support Directorate

Health IT Directorate (CIO)

Research Development & Acquisition Directorate

Healthcare Operations Directorate (CMO)

Education & Training Directorate


Academic Review& Oversight

Prof Development , Sustainment, & Prog Mgmt

Pharmacy

Clinical Support

Public Health

Readiness

Warrior Care Program

Advanced Development

Science & Technology

Clinical Infrastructure Program

Veterans Affairs R&D Liaison

11

Our Leadership Team

12

Lt Gen Douglas RobbDirector

Mr. Allen MiddletonDeputy Director

CMDCM Terry PrinceSenior Enlisted Advisor

MG Richard ThomasDirector

Healthcare Operations

RADM Bruce DollDirector

Research & Development

Brig Gen Robert MillerDirector

Education & Training

RADM Raquel BonoDirector

NCR Medical

Mr. David BowenDirector

Health IT

Mr. Joseph MarshallDirector

Business Support


Defense Health Agency:Global Support

TRO West TRO SouthMETCHealth IT

DHA - Aurora

TRO NorthDefense Health Agency

TRICARE PacificTRICARE Europe:


10 Shared Services

14

1

TRICARE Health Plan

2

Pharmacy Programs

3

Medical Education & Training4

Research, Development & AcqHealth Information Technology

Facilities Budget & Resource Management

Medical Logistics Procurement/Contracting

Public Health

9

5

7

6


8

10

Shared Services SavingsFive Year Defense Plan (2015‐2019)

Shared Service IOC FY14 Net Savings FY15-19 Savings

FACILITIES 1 OCT 13 $537 M

MEDICAL LOGISTICS 1 OCT 13 $189 M

HEALTH IT 1 OCT 13 $265 MHEALTH PLAN 1 OCT 13 $456 MPHARMACY 1 OCT 13 $1,224 MCONTRACTING 1 MAR 14 $136 MBUDGET & RESOURCE MGMT 1 FEB 14 $279 MMEDICAL RESEARCH & DEV 1 JUN 14 $98 MMEDICAL EDUCATION & TNG 10 AUG 14 $ 5 MPUBLIC HEALTH 1 OCT 14 $293 M

TOTAL $3.482 BILLION


Shared Services SavingsFive Year Defense Plan (2015‐2019)

Shared Service IOC FY14 Net Savings FY15-19 Savings

FACILITIES 1 OCT 13 $18.4 M $537 M

MEDICAL LOGISTICS 1 OCT 13 $13.5 M $189 M

HEALTH IT 1 OCT 13 $33.1 M $265 MHEALTH PLAN 1 OCT 13 $25.5 M $456 MPHARMACY 1 OCT 13 $160.5 M $1,224 MCONTRACTING 1 MAR 14 ($2.9 M) $136 MBUDGET & RESOURCE MGMT 1 FEB 14 $0 M $279 MMEDICAL RESEARCH & DEV 1 JUN 14 $0 M $98 MMEDICAL EDUCATION & TNG 10 AUG 14 $0 M $ 5 MPUBLIC HEALTH 1 OCT 14 $0 M $293 M

TOTAL $248.1M $3.482 BILLION


Multi‐Service Markets:2 or more Services, large beneficiary population, 45% direct care dollars, large GME & readiness platforms

The Eight Largest Markets (and Service/Department Leads)

= eMSM

= Single Service

National Capital Region (DHA)

Tidewater (Navy)

Ft. Bragg (Army)

San Antonio, Texas (rotate Air Force/Army)

Oahu, Hawaii (Army)

San Diego (Navy)

Puget Sound, Washington (Army)

Colorado Springs, Colorado (rotate Air Force/Army)

17


Enhanced Multi‐Service Market (eMSM) Performance Overview

Medical Modernization:Match medical resource allocation to demand signal

• DoD Comptroller initiated study in fall 2012: Focus on lessons learned from 13 years of war Right‐size MHS to align with restructuring of active force Reevaluate how to best maintain ready medical forces

• Core Priorities: Quality of care Patient safety Clinical skills of uniformed medical professionals

• Adapt to changing American medical practices: Migration to outpatient/ambulatory care Shorter inpatient lengths of stay Technology and telehealth

• Approach: Department‐wide, data‐driven study with civilian and military, line and medical leaders involved

• Question: Does business plan support readiness plan or does readiness plan support business plan…the answer is yes!


DHA in 2014

• Put the pieces in place• All shared services “in” as of September 30, 2014• All senior leaders are permanent, not “acting”• Multi‐Service Markets are functioning; business plans

approved

20 “Medically Ready Force…Ready Medical Force”

DHA in 2015

• Maturation and focus on increasing synchronization, reducing variation across the enterprise• Not everything that is an enterprise issue requires a “shared service”• This is not about taking people or products – it’s about a process by

which we identify opportunities for enterprise standardization; examples include:• Analytics• Credentialing• Telehealth system

• Sustaining momentum on process efficiencies, service delivery, service improvement, and cost savings (in FY15 our proposed savings are booked into the budget)


Final Thoughts

• This is a once‐in‐a‐generation opportunity to shape the future of military medicine

• Local health delivery and Multi‐Service Markets are central to our strategy and a core element of our reform efforts

• There are millions depending on us to get this right


DHA Current Acquisitions

∎ T2017 (re‐compete of the Managed care support contracts)

∎ Information Management (Capabilities, Analysis & Governance Support (CAGS))

∎DHMS Engineering, Cybersecurity and Configuration (ECCM) currently under Protest

∎Assessment & Authorization (previous CA)∎Other Health Insurance ∎ Performance & planning Management for (DHA IT I/O division)

23

DHA Current Acquisitions (CONT)

∎Marketing and Education Support Services ∎Audit Readiness (financial support)∎ALTHA/ CHCS sustainment ∎ Rx Refill ∎ Privacy & Civil Liberties (PM Support)∎ Joint Outpatient Experience Surveys (JOES)∎Web based Inpatient clinical support∎Next Gen USAF “SME” support for clinical workflow

24

DHA Current Acquisitions (CONT)

∎ Tricare Claims Review Services (TCRS)∎ Clinical Quality Support Services (CQSS)∎ Tricare Overseas Program∎ Tricare Dental Program ∎DHA Global Service Center ∎DHITS GEN 1∎Army AHLTA Trainers∎ Service Oriented DOD Enterprise management Ctr∎ Enterprise Virtualization Solution

25

…the “Why Not”

26

BACK‐UP


Documents

The Defense Health Agency in 2015 - My Business Matches · PDF fileThe Defense Health Agency in 2015 COL Scott A Svabek Acting Director of Procurement Defense Health Agency December