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McCaffery calls for military medical strategic framework for warfighting readiness

By Military Health System Communications Office | Dec. 7, 2019

National Harbor, Md. —

Assistant Secretary of Defense for Health Affairs Tom McCaffery today called on the Military Health System to continue to “adapt and evolve” to deliver on the system’s mission to prepare a military medical force needed to meet current and future operational requirements. Read the Honorable Thomas McCaffery’s full remarks.

Calling it his priority for the upcoming fiscal year, McCaffery has asked MHS senior leadership to develop and codify a formal strategic framework to guide the integration and optimization of all MHS components to meet his vision.

"We owe to all of you here, and all of your colleagues throughout the MHS, a framework we will use to analyze the demand for current and future operational medical force requirements, identify gaps and risks … and build a corresponding roadmap outlining how the MHS reform efforts can be further leveraged to optimize our mission," McCaffery said.

McCaffery made his announcement at the annual meeting of AMSUS, the Society of Federal Health Professionals, attended by nearly 2,000 military and federal medical professionals. MHS senior leadership is composed of the Army, Navy, and Air Force surgeons general as well as the Joint Staff surgeon; the Defense Health Agency director; and the president of Uniformed Services University of the Health Sciences.

"I am confident the framework will emphasize the new reality: the clear need for tight, supporting synchronization between the components, and expanding partnerships with external entities where advantageous and complementary."

McCaffery noted that "everyone with a role or stake in the MHS" is already engaged in significant change as a result of "truly historic transformation," including the merger of all military hospitals and clinics to the DHA by the end of 2022.

MHS operates 475 hospitals and clinics and 248 dental clinics around the world. A milestone was achieved on Oct. 25, when DHA assumed administration and management of all stateside MTFs.

Additional initiatives in the transformation include plans to realign approximately 18,000 positions from the uniformed medical forces to operational forces over the next five years, a review of medical facility infrastructure to optimize medical readiness, TRICARE reform including the next-generation contract with an emphasis on value-based care, and the continued rollout of MHS GENESIS, the standardized electronic health record.

Noting that change will continue, McCaffery said "just like the military as a whole will need to be dynamic to adapt to the ever-changing security environment, the MHS will need to continue to evolve and adapt" to meet the changing requirements of the combatant commands and the military departments.

McCaffery called MHS the “envy of the world” because it's achieved the highest battlefield survival rates in history, provides world-class health care for millions of beneficiaries, remains at the forefront of cutting-edge research and development, and has built a premier arsenal of military medical combat support capabilities.

But the new security landscape, coupled with the ever-changing health care landscape, presents new challenges to military medicine, McCaffery said.

"We must adapt and evolve if we are to successfully meet these challenges. If we do not, we risk ceding vital advantages to our adversaries, advantages that enable us to protect and care for our warfighters in combat and the patients we serve here at home," he said. "These are advantages built on generations of hard lessons and hard work."

McCaffery said that with change continuing, "one thing is clear: We, the senior leadership of the MHS, must continue to work together to shape our system to meet the challenges of the new environment.  We are the ones that are best positioned to shape that future, and we have a long-standing history of evolving and adapting" to meet the mission in changing times.

"And if we don’t shape our future," he added, "others will step in and do it for us."

McCaffery emphasized that reform is a time to make changes in organizing, managing, and resourcing the MHS to best meet the mission. The mission itself, though, will not change.

"We assure our military a uniformed medical force ready to provide care in any deployed environment, be it in combat or providing humanitarian assistance," he said. "We meet operational needs at anytime, anywhere. We ensure our service members are medically ready to carry out their duties anywhere around the globe and, importantly, we provide quality health care to service members, their families, and our retirees."

McCaffery outlined three priorities for the MHS:

  • Focus relentlessly on the medical readiness of combat forces, and the readiness of medical forces to support them. "We are talking about the entire force," McCaffery said, including trauma and general surgeons, nurses, emergency and primary care capabilities, and embedded medics."Our mission is to provide the team that is needed to support the warfighter before deployment, during deployment, and that when needed at point of injury, during casualty evacuation to resuscitative surgical teams and further en route care to definitive care."
  • Operate as a unified and integrated system that relies on each component's unique contributions to succeed.
  • Make decisions, establish systems, and operate programs with a patient-centered approach. "The patients we serve [are] the primary focus of our efforts," McCaffery said. "We should strive to make the MHS the first choice of our beneficiaries by providing easy access and continued high quality care they desire and deserve."