File:Military Health System Reform (IA 05dec19hascmpmilitaryhealthsystemreformgillinghamfinal).pdf

Chairwoman Speier, Ranking Member Kelly, distinguished Members of the Subcommittee, on behalf of our mission-ready Navy Medicine team which keeps Sailors and Marines healthy and ready around the world, I want to thank you for continued confidence and support. I am honored to be here with my colleagues to provide you an update on an important issue for all of us - Military Health System (MHS) transformation.

As we move forward with important changes in the MHS, I want to assure you that the foundation of Navy Medicine is readiness. We will not waiver from our highest priority of keeping our service members healthy and ready to deploy and ensuring they get the best care possible from trained and confident providers when they are wounded or injured.

Building an Integrated System of Health and Readiness

The imperative to implement substantive reforms within the MHS is reflected in several key provisions contained in the Fiscal Years (FY) 2017 and 2019 National Defense Authorization Acts (NDAAs). Collectively, this legislation represents an important inflection point for military medicine and catalyzed our efforts to strengthen our integrated system of health and readiness. Within the Department of the Navy, our leadership – the Secretary of the Navy, Chief of Naval Operations and Commandant of the Marine Corps – recognizes the tremendous opportunity we have to refocus our efforts on medical readiness while transitioning health care benefit administration to the Defense Health Agency (DHA). While significant organizational change in health care is inherently complex, all of us know we have shared responsibilities to ensure that both the Services and the DHA are successful, and our efforts continue to reflect this overarching tenet as we move forward. With our collective transformation goal foremost in mind, we must continue to drive change and approach these reform efforts with deliberate planning, solid analytics and sound decision-making.

Integral to system-wide organizational transformation is the transfer of the military treatment facilities (MTFs) to the DHA. In October 2018, Navy Medicine transitioned Naval Hospital Jacksonville to the DHA, at which point they assumed administration and management of this MTF. The following year, in October 2019, our MTFs in the continental United States (as well as Alaska and Hawaii) transitioned to the DHA as directed by the Deputy Secretary of Defense. In order to support this significant transition and mitigate risk, the Bureau of Medicine and Surgery (BUMED) established a memorandum of agreement with the DHA which delineates our direct support role as they move to full operating capability. This memorandum of agreement was preceded by a period during which Navy Medicine detailed both military and civilian personnel to the DHA headquarters to directly assist their organizational transition. Similarly, the direct support relationship between BUMED and the DHA provides a bridge as the DHA establishes the MHS-wide organizational structure and acquires the necessary personnel and expertise to accomplish the mission of directly administering and managing the MTFs.

In addition, Department of Navy personnel participated in the Department of Defense-led efforts regarding the assessments and recommendations of health services and infrastructure within the MHS as required by FY2017 NDAA, section 703 (Military Medical Treatment Facilities). We understand that the Report to Congress will be provided in the near future.

Associated with the transition of MTFs to the DHA and Navy Medicine’s refocus on readiness, Navy is establishing Navy Medicine Readiness and Training Commands (NMRTCs) which will provide critical command and control structures to meet Navy and Marine Corps missions. This organizational construct will – at the local MTF level – facilitate and reinforce the mutually supportive relationship between Navy Medicine and the DHA.