A recently released report from the Government Accountability Office (GAO) found shortfalls in the implementation of military health system (MHS) reforms focused on enhancing medical readiness.
The report, Actions Needed to Define and Sustain Wartime Medical Skills for Enlisted Personnel, assesses progress against an MHS reform requirement to better define and assess critical wartime readiness skills of health care providers.
GAO found DoD could do more to define, track, and assess wartime medical skills of enlisted personnel and made 30 recommendations for improvements, including that military departments fully define wartime medical skills for enlisted medical subspecialties, track skills training, and establish performance goals and targets for training completion.
GAO also recommended that DoD develop metrics to assess how military treatment facility (MTF) workload and civilian partnerships sustain these skills. DoD concurred with GAO’s recommendations.
Congress directed comprehensive MHS reform with dozens of provisions in the FY 2017 National Defense Authorization Act (NDAA) addressing almost every element of the direct and purchased care systems. Congress’ stated goals for MHS reform include system efficiencies; cost savings; and improved beneficiary access, care, and patient experience. Many provisions were directed at achieving an enhanced focus on the MHS’s readiness mission, a top priority for Congress.
The massive overhaul of the MHS will take years to fully implement. As Congress continues oversight of MHS reforms, a Senate report accompanying a bill for the FY 2020 NDAA included a provision for GAO to review DoD's efforts to maintain enlisted personnel's wartime medical skills.
The GAO report does not indicate decrements to wartime medical skills or new problems with DoD’s process for identifying/tracking key skills for medical personnel readiness, but rather assesses DoD’s progress against implementing MHS reform legislation (FY 2017 NDAA, Section 725) intended to improve the way DoD defines wartime readiness skills of health care providers and requirements for improved measurement and tracking of critical skills.
More than 73,000 enlisted medical personnel serve in roles key to delivering health care in the operational environment including providing point-of-injury care, serving as members of mobile surgical teams, and working in field hospitals and hospital ships.
MOAA supports MHS reform efforts intended to improve the readiness of uniformed medical providers. We appreciate the progress made toward better defining and tracking wartime medical skills and will continue to monitor DoD’s implementation of GAO recommendations.
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