Review Finds the Military’s Health System Is Good, But Far from ‘World-Class’

The good news: One year after the rollout of the Pentagon’s enormous Military Health System, Defense Secretary Chuck Hagel said the network of clinics and hospitals performs largely on par with private sector health care.

The bad news: In a system of more than 600 clinics and 50 hospitals, some facilities perform below the private sector average in terms of providing timely access, quality care and overall safety—and administrators from those facilities now face what defense officials called “aggressive timelines” to turn things around.

Hagel ordered the review in May, shortly after the wait list scandal rocked the Department of Veterans Affairs health system.

“The bottom line finding is that the military health care system provides health care that is comparable in access, quality and safety to average private sector health care. But we cannot accept average,” Hagel said Wednesday at the Pentagon. He was joined by Defense Department health officials including surgeons general from the Navy, Army and Air Force.

The audit is a serious door-stopper that lays out hundreds of pages of metrics and comparisons with three “high-performing” civilian sector healthcare systems—Geisinger Health System, Intermountain Healthcare and Kaiser Permanente—in search of what the auditors call “outliers,” or facilities that fail to meet various standards in access, quality and safety.

Facilities where patients are kept waiting longer than the national average will have 30 days to submit an action plan. Facilities failing to meet the national average for quality and safety face a 45-day deadline.

Some of the hospitals named in the report will not come as much of a surprise due to the large number of service members served at those locations. For example, Fort Hood’s Darnall Army Medical Center in Texas and Walter Reed National Military Medical Center in Bethesda, Md., made the outlier list for lengthy appointment times on more than one occasion. At least 20 facilities will have to meet the access-related 30-day timeline.

“There are a lot of very important and aggressive timelines,” said Deputy Defense Secretary Robert Work, who presided over the audit.

The Pentagon plans to unify standards of care across all of its healthcare facilities, including specialized care that comes from referrals to the private sector. It’s also working to create a response system so that its 9.6 million patients can share their feedback.

“And to enhance transparency,” Hagel said, “I am requiring that all currently available data on our health care system be made publicly available.”

One of the findings that puzzled auditors was a discrepancy between their overall data on access to care and surveys from numerous beneficiaries that told what Work said was “a slightly different story—that there were access challenges. So we don’t understand the discrepancy in those two information streams, but we’re going to.”

Navy Surgeon General Vice Adm. Matthew Nathan said the Pentagon has a very ambitious goal of raising the Military Health System to the status of “world-class” care. “We want to strive to be that on the tip of your tongue,” he said. “We want to take efforts to take what we think is a good system now and make it great and make it greatest.”

By the end of the year, Hagel said he expects to have a detailed plan on his desk so that “the military healthcare system becomes the top performing system we all expect it to be and want it to be.”

“We cannot accept average when it comes to caring for our men and women in uniform and their families,” Hagel said. “We can do better. We all agree we can do better.”

Read the full report here.