A report highlighting unfilled medical billets and access-to-care challenges across the military health care system provides new data for MOAA’s ongoing advocacy efforts on behalf of your service-earned health benefit.

The management advisory issued by the DoD Office of Inspector General (OIG) highlights several trouble spots, supported by at least seven hotline complaints over the last year from beneficiaries and providers about military treatment facility (MTF) staffing shortages and barriers to access within MTFs and the TRICARE network.

MOAA will leverage this data in our advocacy efforts to halt proposed MTF restructuring unless sufficient civilian capacity is available in the TRICARE network. We will also continue to advocate for Defense Health Program budgets that allow the MHS to fulfill operational demands and provide beneficiary access to care in an evolving health care environment.

The report also relays concerns from service inspectors general regarding access to care at smaller MTFs, as well as staffing shortages at MTFs both stateside and overseas. The numbers back up those concerns: More than 2,100 MTF contractor full-time equivalent positions were unfilled as of June 4, 2023, per the report, which detailed the gaps in care caused by these openings and ensuing negative effects on retention.

[FROM THE REPORT: Watchdog Warns of Systemwide Issues With Military Health Care]

There are a variety of factors driving access challenges across the military health system:

• Congressionally directed reforms have shifted authority, direction, and control of MTFs from the services’ medical commands to the Defense Health Agency, a move that has fundamentally transformed how these facilities are staffed … and led to challenges balancing personnel assignments between care at MTFs and outside the facilities to preserve operational readiness.
  
  
• Electronic health record implementation has resulted in fewer appointments at military hospitals and clinics as MTF staff devote time to mastering the new MHS Genesis system and workflows.
  
  
• Outside of military hospitals and clinics, the entire U.S. health care system has suffered from workforce instability and clinician shortages, leading to access to care problems for patients.

Lawmakers Seek Answers

The Senate Armed Services Committee (SASC) noted challenges to MTF staffing in its report accompanying the Senate markup of the FY 2024 National Defense Authorization Act (NDAA). It directed a Comptroller General review of military medical personnel staffing at MTFs, including:

• Policies and procedures for assigning active duty medical personnel to MTFs and ensuring their availability to meet staffing requirements.
  
  
• The historical and projected active duty medical workforce staffing trends at the MTFs.
  
  
• The extent to which DoD has identified and assessed factors that affect the availability of military medical workforces (i.e., physicians, nurses, and enlisted technicians) to deliver care at MTFs.

The Comptroller General must provide a briefing to both the SASC and the House Armed Services Committee by Feb. 29, 2024, with a report to follow.

[RELATED: Largest Pay Raise in 2 Decades Part of Final Defense Authorization Bill]

MOAA’s Role

MOAA appreciates congressional and DoD oversight on beneficiary access to care as part of our work on a variety of related issues.

Along with efforts to ensure medical billet cuts and MTF restructuring do not weaken this earned benefit, MOAA has advocated for a more effective problem reporting system to allow beneficiaries to seek help when they encounter access-to-care challenges. We have also supported greater flexibility in switching to TRICARE Select for beneficiaries who face barriers to access within their MTF.

Most recently, MOAA supported the REWARD Experience Act, a bill which would allow MTFs to retain experienced civilian nurses as they become more skilled, improving access to care patients at military hospitals and clinics.

[TAKE ACTION: Help MTFs Retain Skilled Nurses]

MOAA will continue these efforts while also advocating for Defense Health Program budget levels that support a high quality benefit, including robust networks of high quality providers. Please continue to watch The MOAA Newsletter and visit our Advocacy News page for opportunities to contribute to these efforts.