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Military Health System: The Defense Health Agency in 2016
VADM (Dr) Raquel Bono
Director, Defense Health Agency December 1, 2015
“Medically Ready Force…Ready Medical Force”
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The Defense Health Agency Fully Operational / Continuity of Mission
1 “Medically Ready Force…Ready Medical Force”
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2
“The imperative of successful MHS Governance reform requires a sustained
commitment by all components to adapt an enterprise focus, including the renewed
priority of quality, patient safety and access throughout the entire MHS and the challenge
of transitioning to a new, state-of-the-art electronic health record. Jointness, cost effectiveness and healthcare integration
remain the guiding vision.” -DepSecDef Work September 2015
“Medically Ready Force…Ready Medical Force”
The Defense Health Agency Fully Operational / Continuity of Mission
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Why We Are Here
• It’s on every slide… • Medically Ready Force
• Ready Medical Force
3 “Medically Ready Force…Ready Medical Force”
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Our 2016 Priorities
• Support to the Services
• Support to Combatant Commanders
• Optimizing the DHA for the Future
4 “Medically Ready Force…Ready Medical Force”
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Defense Health Agency Leadership Team
5
Vice Admiral Raquel Bono Director
Mr. Guy Kiyokawa Deputy Director
CMSgt Vottero Acting Sr. Enlisted Advisor
MG Richard Thomas Director
Healthcare Operations
RADM Bruce Doll Director
Research & Development
Brig Gen Robert Miller Director
Education & Training
MG Jeffrey Clark Acting Director
NCR-Medical Directorate
Mr. David Bowen Director
Health IT
Mr. Darrell Landreaux Acting Director
Business Support
“Medically Ready Force…Ready Medical Force”
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6 6
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Defense Health Agency Global Operations / Global Support
TRO West TRO South METC Health IT
DHA - Aurora
TRO North Defense Health Agency
TRICARE Pacific TRICARE Europe:
MMSO Great Lakes
“Medically Ready Force…Ready Medical Force” 7
Armed Forces Med Examiner
Armed Forces Hlth Surveillance Center Natl Museum of Hlth and Medicine Walter Reed Natl Mil Med Center Ft Belvoir Cmty Hospital
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8
DHA as a Combat Support Agency
“Medically Ready Force…Ready Medical Force”
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DHA Shared Services
9
1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
“Medically Ready Force…Ready Medical Force”
10
9
8
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Pharmacy
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1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
“Medically Ready Force…Ready Medical Force”
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9
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Note: DHP Compound Pharmacy Expense represented by under age 65 beneficiaries
$0
$100,000,000
$200,000,000
$300,000,000
$400,000,000
$500,000,000
$600,000,00010
/1/2
012
11/1
/201
212
/1/2
012
1/1/
2013
2/1/
2013
3/1/
2013
4/1/
2013
5/1/
2013
6/1/
2013
7/1/
2013
8/1/
2013
9/1/
2013
10/1
/201
311
/1/2
013
12/1
/201
31/
1/20
142/
1/20
143/
1/20
144/
1/20
145/
1/20
146/
1/20
147/
1/20
148/
1/20
149/
1/20
1410
/1/2
014
11/1
/201
412
/1/2
014
1/1/
2015
2/1/
2015
3/1/
2015
4/1/
2015
5/1/
2015
6/1/
2015
7/1/
2015
DHP
MERHCF
Tota
l Spe
nd
11
Compound Drugs Cost Trend and Impact from Screening
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Note: DHP Compound Pharmacy Expense represented by under age 65 beneficiaries
$0
$100,000,000
$200,000,000
$300,000,000
$400,000,000
$500,000,000
$600,000,00010
/1/2
012
11/1
/201
212
/1/2
012
1/1/
2013
2/1/
2013
3/1/
2013
4/1/
2013
5/1/
2013
6/1/
2013
7/1/
2013
8/1/
2013
9/1/
2013
10/1
/201
311
/1/2
013
12/1
/201
31/
1/20
142/
1/20
143/
1/20
144/
1/20
145/
1/20
146/
1/20
147/
1/20
148/
1/20
149/
1/20
1410
/1/2
014
11/1
/201
412
/1/2
014
1/1/
2015
2/1/
2015
3/1/
2015
4/1/
2015
5/1/
2015
6/1/
2015
7/1/
2015
DHP
MERHCF
Tota
l Spe
nd
Compound Drugs Cost Trend and Impact from Screening
12
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Note: DHP Compound Pharmacy Expense represented by under age 65 beneficiaries
Compound Drugs Cost Trend and Impact from Screening
13
0
0.2
0.4
0.6
0.8
1
1.2
Nov-11
Monthly Compound Expense
June $10.4 MJuly estimated $10.5 at current spend
$0
$50,000,000
$100,000,000
$150,000,000
$200,000,000
$250,000,000
$300,000,000
$350,000,000
$400,000,000
$450,000,000
$500,000,000
$550,000,000
$600,000,000
Nov-11
Jan-12
Mar-12
May-12
Jul-12
Sep-12
Nov-12
Jan-13
Mar-13
May-13
Jul-13
Sep-13
Nov-13
Jan-14
Mar-14
May-14
Jul-14
Sep-14
Nov-14
Jan-15
Mar-15
May-15
Jul-15
Sep-15
May 1-May 11 (Initial Screen): $75M May 12-May 31 (Enhanced Screen) : $5M
Spend peaked in April 2015 - $545M Last week in April alone over $200M
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Addressed Fraud; Assisted Criminal Activity Justice Dept will prosecute fraud
14 “Medically Ready Force…Ready Medical Force”
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Shared Service: Pharmacy Programs Implementing Home Delivery
• Enterprise effort to move patients to the right source for prescription medications at the lowest cost to the patient and the government • TRICARE For Life – seamless migration to Home Delivery
for chronic medications in February 2014 • All TRICARE beneficiaries – began migration on October 1
of this year • Introduced ability for civilian providers to electronically
request prescription drugs from nearby MTF • Continued to adjust Rx co-pays to incentivize quality, cost-
effective options 15
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TRICARE
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1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
“Medically Ready Force…Ready Medical Force”
10
9
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TRICARE 2017
• Comprehensive reassessment of how we deliver / coordinate care -- more than just “the benefit”
• How we organize and administer TRICARE – to include TRICARE contracts • Patient-centered: Modernization and
simplification of contracts and service • Expand contemporary means to access
health services beyond the physical office visit
“Medically Ready Force…Ready Medical Force” 17
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Acute Care Campaign April 2015
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DHA: Listening to Our Customers
“Medically Ready Force…Ready Medical Force”
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Based on our [NMFA] findings, we ask that the Defense Health Agency and Congress consider the following steps to improve access to acute care for military families:
• Develop and implement metrics that accurately assess acute appointment demand
• Expand clinic hours and the number of acute appointments
• Monitor progress on access initiatives
• Standardize the network urgent care referral process and monitor compliance at the MTF level
• Waive the network urgent care preauthorization requirement for a limited number of urgent care visits
• Limit the policy of directing beneficiaries to MTF emergency rooms
• Re-examine the referral policy
19
DHA: Listening to Our Customers
“Medically Ready Force…Ready Medical Force”
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Access 3rd Available Appt - 24hr
1.8
1.0
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
Target MHS NCRMD
LOW
ER IS BETTER
“Medically Ready Force…Ready Medical Force”
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TRICARE Reform Transparency - Internal & External • The Secretary of Defense demanded it; the MHS committed to it; the law
(NDAA 2016) now describes exactly what is expected
• CMS / Hospital Compare requires it • Tied to Medicare reimbursement • VA participates in it, and shares it on its website
• Leading high reliability organizations embody it, even when it is below
benchmarks, and can rapidly drive improvement
• The media has access to the data, without needing to “ask” us (and if they ask, we are obligated to share it)
• Patients expect it
“Medically Ready Force…Ready Medical Force” 21
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- 22 -
For Official Use Only
MHS Transparency…It’s Coming!
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Health IT
23
1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
“Medically Ready Force…Ready Medical Force”
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Shared Service: Health IT DoD Electronic Health Record
• July: Announcement of next generation Electronic Health Record (Leidos / Cerner / Accenture)
• Strategic enabler for the military medical mission
• Innovation built in to acquisition. Commercial off-the-shelf (COTS) product with 10 years of upgrades at no additional cost.
• Interoperability with federal and private sector health systems – where over 60% of our health care is delivered.
• Research support tool. EHR expands opportunity for DoD to engage in large-scale / big data research
“Medically Ready Force…Ready Medical Force” 24
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Shared Service: Health IT DoD Electronic Health Record
• DHA will serve critical role in ensuring infrastructure, security, and clinical needs.
• RADM (Ret) Dr Bill Roberts is Functional Champion -- Important all perspectives are represented in deployment: clinicians, business leaders, support staff, and patients.
“Medically Ready Force…Ready Medical Force” 25
• My focus – ensuring that the EHR supports the clinical practice of medicine and enhances access, quality and safety!
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Facilities
26
1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
“Medically Ready Force…Ready Medical Force”
10
9
8
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6
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• Standardized demand signal and prioritization process for Medical Construction requirements
• Standardized the Sustainment, Restoration, and Modernization programming models
• Providing facilities support to e-MSMs for future capital requirements
Shared Service: Health Facilities
“Medically Ready Force...Ready Medical Force” 27
• DHA onsite project management of Rhine Ordinance Barracks replacement project (Above right)
• BUILDER implementation (Enterprise-wide Facility Condition Assessment)
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MedLog
28
1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
“Medically Ready Force…Ready Medical Force”
10
9
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6
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• Expanding Defense Medical Materiel Standardization Program from supply/consumables to include equipment/medical devices.
• Increasing coordination with Uniformed Services and DLA focused on improved efficiency and lower delivered material costs
• Coordinating with DHMSM Deputy PMO on medical device/equipment interface and standardization policy.
• Reducing purchase card usage, materiel costs, and risk by increasing product lines to DLA’s Electronic Catalog (ECAT).
Shared Service: Medical Logistics
“Medically Ready Force...Ready Medical Force” 29
• Good MEDLOG practices support Services and COCOMS!
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Budget & Resource Management
30
1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
“Medically Ready Force…Ready Medical Force”
10
9
8
7
6
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• Implementing ABACUS • Third Party Collections (TPC) for
outpatient and Medical Affirmative Claims (MAC)
• Initial implementation of guidance for a new common cost accounting structure (CCAS) to support consistent & transparent accounting transactions
Shared Service Budget & Resource Management
“Medically Ready Force...Ready Medical Force”
• Standardize medical record coding policies/procedures for all three Military Services & continue development of a HIPAA-compliant remote medical record coding capability
31
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Procurement/Contracting
32
1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
“Medically Ready Force…Ready Medical Force”
10
9
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7
6
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Shared Service Procurement/Contracting
• Integrated contract service to support the full range of products and services needed throughout the organization
• Key Enablers • Simplified processes for customers • Accelerated timelines for everyone • Increased transparency for vendors • Enhanced professional acquisition workforce
“Medically Ready Force...Ready Medical Force” 33
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Research, Development and Acquisition (RDA)
34
1
TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
5
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• Integrated Joint Program Committees for oversight of $2.2B medical research enterprise
• Established Clinical Investigation Research Office for multiservice clinical studies
• Integrated Armed Forces Medical Examiner System (AFMES) and Natl Museum of Health and Medicine
Shared Service Research Development & Acquisition
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Public Health
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TRICARE Health Plan FOC 29 Sep 15
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Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
4
Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
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• Standardized Periodic Health Assessment…~$210M annual cost avoidance
• New Joint Staff Surgeon Quarterly Health Surveillance Report… Evolution of DHA/PHD Combat Support Agency role
“Medically Ready Force…Ready Medical Force”
Shared Service Public Health
• Collaborated w/ DLA to redistribute ~ 48.4K Doses of “expiring” Japanese Encephalitis Vaccine to MTFs with immediate need…averted $3M loss
• Armed Forces Health Surveillance Center (AFHSC) became part of DHA in August 2015
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Education and Training
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TRICARE Health Plan FOC 29 Sep 15
2
Pharmacy Programs FOC 29 SEP 15
3
Medical Education & Training * Pending 90-Day Review
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Research, Development & Acq FOC 29 SEP 15
Health Information Technology FOC 29 SEP 15
Facilities FOC 3 March 15
Budget & Resource Management FOC 29 SEP 15
Medical Logistics FOC 3 March 15
Procurement/Contracting FOC 29 SEP 15
Public Health FOC 29 SEP 15
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• One Stop Learning Management System • Joint Knowledge Online (JKO) new home
for on-line tools • Joint Executive Skills Institute complete
• METC Strategic Partnerships • Bridge programs with 43 schools in 23
states that recognize military training for credit (WH Initiative)
• “Military Combat Medic to RN” in 13 months a reality
Education and Training Shared Service Highlights
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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)
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DHA Support to Markets
• Analytic support for decision-making • Dashboard • Performance
• Tools and resources to advance • Access • Quality • Safety
• Important center of gravity for TRICARE Reform
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MHS Performance Dashboard STRATEGIC ALIGNMENT
PERFORMANCE MEASURE DEV. STATUS MHS PERFORMANCE
THRESHOLDS COMPONENT PERFORMANCE
AIM OBJECTIVE RED GREEN BLUE A N AF NCR MD PSC AS OF DATA ENTRY
Readiness
Medically Ready Force (PLS1) Individual Medical Readiness (IMR) I 87% <75% ≥85% 90% 84% 90% 89% N/A N/A Jun 15 Sept 15
Ready Medical Force (PLS2) TBD --- --- --- --- --- --- --- --- --- --- ---
Better Health
Healthy People (PLS3) TBD --- --- --- --- --- --- --- --- --- --- ---
Improve Healthy Behaviors (IP5) HEDIS Cancer Screening Index I 63% 50% 70% 90% 88% 94% 73% 79% 36% May 15 Sept 15
Better Care
Improve Clinical Outcomes and Consistent Patient Experience (PLS4)
▼ Risk Adjusted Mortality (All Cause) E .82 TBD TBD TBD .89 .74 .63 .98 Mar 15 Sept 15 Inpatient: Recommend Hospital (Satisfaction) I 75% <71% ≥73% ≥75% 71% 75% 80% 85% 73% Mar 15 Sept 15
Overall Satisfaction w/Healthcare (Outpatient) I 94% Service Specific Service Specific Service Specific 92% 95% 96% 93% 92% Mar 15 Sept 15
Improve Safety (IP9)
▼ **HAI (CLABSI) I 14 N/A N/A 0 9 4 1 0 N/A Jun 15 Sept 15
▼ **PSI 5 - Retained Surgical Item or Unretrieved Device Fragment Count (Per Year) I 11 N/A N/A 0 10 1 0 0 N/A Dec 14 Jun 15
▼
National Surgical Quality Improvement Program (NSQIP) (30 Day) All Case Morbidity Index I 82% of
MTFs green 10th percentile 11th - 89th percentile 90th percentile Multiple scores per service N/A Dec 14 Sept 15
CAUTI 14 TBD TBD TBD 12 1 1 0 N/A Jun 15 Sept 15 Wrong Site Surgery 11 TBD TBD TBD 7 0 1 3 N/A Jun 15 Sept 15
Improve Condition-Based Quality Care (IP7)
**HEDIS Diabetes Index I 54% 50% 70% 90% 68% 80% 76% 80% 20% May 15 Sept 15 **HEDIS Appropriate Care Index (Low Back Pain, Pharyngitis, URI) I 47% 50% 70% 90% 41% 67% 63% 61% 31% May 15 Sept15
▼ NPIC Post-Partum Hemorrhage* E 3.9% 2σ above NPIC avg.(3.3%)
within 2σ of NPIC avg. (3.3%)
2σ below NPIC avg.(3.3%) 3.8% 3.6% 4.3% 5.6% N/A Dec 14 Sept 15
▼ NPIC Vaginal Deliveries w/Coded Shoulder Dystocia Linked to a Newborn ≥ 2500 grams w/Birth Trauma* I 10.9.% 2σ above NPIC
avg.(12.5%) within 2σ of NPIC
avg. (12.5%) 2σ below NPIC
avg.(12.5%) 11.2% 7.1% 16.7% 0% N/A Dec 14 Sept 15
HEDIS (30-Day) Mental Health Follow-Up I 79% 50th percentile (74%)
75th percentile (81%)
90th percentile (85%) 87% 86% 78% 85% 61% May 15 Sept 15
▼ HEDIS All Cause Readmission E 1.45 50th percentile (0.79)
75th percentile (0.73)
90th percentile (0.68) 1.46 1.39 1.27 1.80 N/A Nov 14 Jun 15
ORYX Transition of Care Index (Asthma, VTE, Inpt Psy(2)) I 50% 60% 75% 100% 44% 56% 50% 63% N/A Sept 14 Jun 15
AHRQ Prevention Quality Indicator (PQI) Index I 94% 70% 80% 90% 94% 94% 94% 94% N/A Dec 14 Sept 15
Improve Comprehensive Primary Care (IP8)
PCM Continuity I 61% 55% 65% 81% 61% 63% 61% 54% N/A Apr 15 Jun 15 PCM Empanelment E <1,100:1 1,100:1 >TBD
▼ Primary Care Leakage I 25.3% >24% 24% to > 20% ≤ 20% 22.8% 26.6% 27.5% 26.3% N/A May 15 Sept 15
▼ **Avg. No. of Days to Third Next Available Future Appointment (Primary Care) I 7.6d >7d 7.0d 2.2d 6.4d 6.8d 8.8d 11.0d N/A Aug 15 Sept 15
▼ **Avg. No. of Days to Third Next Available 24 Hour Appointment (Primary Care) I 1.7d >1d 1.0d 0.8d 1.9d 0.9d 2.0d 2.5d N/A Aug 15 Sept 15
Optimize & Standardize Access & Other Care Support Processes (IP10)
**Percent of Direct Care Enrollees in Secure Messaging I 37% <50% ≥50% ≥60% 29% 45% 42% 40% N/A July 15 Sept 15
**Satisfaction with Getting Care When Needed (Service Surveys) I 86% Service Specific Service Specific Service Specific 83% 90% 91% 83% 90% Mar 15 Sept 15
Lower Cost
Improve Stewardship (PLS5)
▼ PMPM I $370 10.6%
>2.8% yearly growth
2.8% to > 0% yearly growth ≤ 0% yearly growth 13.2% 5.4% 9.4% -3.9% 11.6% Mar 15 Sept 15
▼ Total Purchased Care Cost E $-47.7M -2.5% Service Specific Service Specific Service Specific -7.0% -0.8% 0.3% -3.6% N/A Dec 14 Mar 15
▼ Private Sector Care Cost per Prime Enrollee I $194 17.3%
>2.8% yearly growth
2.8% to > 0% yearly growth ≤ 0% yearly growth 33.0% 22.2% 17.3% 2.8% 13.2% Mar 15 Sept 15
OR Utilization E
**Total Enrollment I 3.58M -0.1% <0% yrly growth 0% to < 5% yrly
growth ≥ 5% yrly growth -0.9% 3.1% -2.0% 1.4% N/A Aug 15 Sept 15
▼ Pharmacy Percent Retail Spend I 54.7% >40% 40% to > 35% ≤35% 57.1% 57.4% 51.3% 41.0% N/A Apr 15 Sept 15 Productivity Targets I 93% Service Specific Service Specific Service Specific 94% 93% 93% 80% N/A Jun 15 Sept 15
Report as of 10 SEPT 2015
Developmental Status: A = Accountability; I = Improvement; E = Exploratory *NPIC calculates + provides the MHS w/ MHS, Service + MTF status relative to the NPIC database average
**Indicates Process Improvement Priority ▼ Lower is better Indicates measure
under development
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The DHA in 2016
• Driving Value to Services and COCOMS
• Demonstrable service and support to the mission
• I Need Your Feedback and Input
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Defense Health Agency
44 “Medically Ready Force…Ready Medical Force”
http://www.health.mil
http://www.tricare.mil
https://twitter.com/dhadirector
Inside the MHS (CAC required) http://mhs.health.mil/
Learn more about the Military Health System?
Learn more about TRICARE?
Follow on Twitter
Follow on Facebook https://www.facebook.com/MilitaryHealth
https://twitter.com/MilitaryHealth
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