File:Defense Health Program (Senate Appropriations Committee 2015) (IA 19764C3HSSACD25MAR15MilitaryHealthVADMNathanNSGFinal2).pdf

STATEMENT OF VICE ADMIRAL MATTHEW L. NATHAN, MC, USN, SURGEON GENERAL OF THE NAVY BEFORE THE SUBCOMMITTEE ON DEFENSE OF THE SENATE COMMITTEE ON APPROPRIATIONS.

"The core mission of Navy Medicine is inextricably linked to that of the United States Navy and the United States Marine Corps. We protect the health of combat-ready Sailors and Marines in support of global expeditionary missions. Navy Medicine operates underway in all warfare domains and in all environments. This mission requires us to be agile to support the full range of operations and be ready to respond where and when called upon. The Chief of Naval Operations has maintained this imperative through his Sailing Directions: (1) Warfighting First; (2) Operate Forward; and (3) Be ready. These tenets are impactful as we sustain our readiness posture to meet these demanding missions.

Within Navy Medicine, we are staying the course with our 2015 strategic priorities of readiness, value and jointness. Specifically:
Readiness: We provide agile, adaptable, and scalable capabilities prepared to engage globally across the range of military operations with maritime and other domains in support of the national defense strategy.
Value: We provide exceptional value to those we serve by ensuring highest quality through best health care practices, full and efficient utilization of our services, and lower care costs.
Jointness: We lead Navy Medicine to jointness and improved interoperability by pursuing the most efficient ways of mission accomplishment.

Individually and collectively, these mutually-supportive focus areas are instrumental in shaping our decision-making, internal processes and organizational capacity. We are continuing to drive progress in several key objectives including delivering ready capabilities to the 2
operational commanders and ensuring clinical currency of our medical force. Within the context of providing best value for our beneficiaries, we are sustaining efforts to decrease enrollee cost and increase recapture of private sector purchased care, as well as standardize our clinical, non-clinical and business processes. Navy Medicine continues to leverage joint capabilities to improve interoperability and efficiencies. Our priorities are strengthened because everyone in Navy Medicine has a distinct and important role in contributing to the success of these efforts.

We are advancing joint efforts through the Defense Health Agency (DHA) and its supporting role to the Services’ medical departments. Our collective goal is to facilitate greater integration of clinical and business processes across the Military Health System (MHS) through the implementation of shared services. This portfolio of services, all on track to reach full operating capability by October 2015, includes: facilities; medical logistics; health information technology; health plan; pharmacy; contracting; budget and resource management; medical research and development; medical education and training; and, public health. They will be important in building a sustainable business model for the DHA, creating system-wide efficiencies and reducing process variation.

Our collaborative work is evident in response to the comprehensive review of the MHS directed by the Secretary of Defense in May 2014. The 90-day review was directed to assess whether (1) access to medical care in the MHS meets defined access standards; (2) the quality of health care in the MHS meets or exceeds defined benchmarks; and (3) the MHS has created a culture of safety with effective processes for ensuring safe and reliable care of beneficiaries. This review applied evidence to what we had previously only been able to presume with regard to quality, safety, and access. We can now assertively conclude Navy Medicine performs comparably to civilian health care systems. This rigorous self-assessment demonstrated that we have areas of excellence and areas that could benefit from further improvement. The review afforded us the opportunity to drill down on these opportunities for improvement. In response, we are systemically and aggressively addressing all lagging outliers within Navy Medicine, with demonstrable results already achieved. We are also working with the other Services and the Assistant Secretary of Defense for Health Affairs (ASD (HA)) to transform the MHS into a high reliability organization (HRO) and build a robust performance management system. The review served as an important catalyst to support performance improvement through better analytics, greater clarity in policy, improved transparency, and alignment across training and education programs. I am committed to these transformation efforts and confident that we have a sound and actionable strategy to support our way forward."