JOINT BASE SAN ANTONIO –
Earlier this year, Deputy Secretary of Defense Ashton Carter directed the establishment of the Defense Health Agency to assume shared functions, services and activities of the Army, Navy, and Air Force within the Military Health System that had previously been managed by each individual service.
Under the agency, the San Antonio Military Health System became an enhanced multi-service market, giving director of SAMHS, Maj. Gen. Jimmie Keenan, authority as market manager Oct. 1.
Keenan, in her role as market manager, will oversee and sustain a high-quality military health system across San Antonio, not just within Army or Air Force facilities.
She will manage budget allocation for the Army and Air Force military treatment facilities in San Antonio, direct teams to adopt common clinical and business functions, optimize military readiness requirements to deploy medically-ready forces, direct personnel and work functions to move among San Antonio military treatment facilities to best support patients and missions as well as direct the movement of workload and workforce among San Antonio military treatment facilities.
These changes are aimed at lowering the costs associated with military healthcare by sharing resources and improving access to care.
"We are delighted with the increases in effectiveness and efficiencies we've gained thus far under the SAMHS umbrella," said Col. Kyle Campbell, Brooke Army Medical Center commander. "We look forward to making even bigger strides improving the quality of care and increasing the number of patients we care for as we move into the new enhanced multi-service market."
The commander said pain clinic consolidation began Oct. 1, where Wilford Hall Ambulatory Surgical Center Pain Clinic integrated with the San Antonio Military Medical Center's Department of Pain Management and is now the Interdisciplinary Pain Management Center.
Consolidation will save costs related to running two separate clinics Campbell said. In addition to improving patient care, it will greatly improve the academic experience of the San Antonio Uniformed Services Health Education Consortium resident and fellow physicians she explained.
Patient transfer service is starting to be implemented Campbell said. Twenty-one patients were transferred in September and each one of those transfers saved thousands of dollars in network care costs the commander explained.
Campbell pointed out labor and delivery as a success story on the inpatient side, explaining that relocation and consolidation of all labor and delivery, postpartum and neonatal intensive care unit inpatient services at SAMMC has resulted in a busy and efficient ward (where occupancy rate fluctuates between 65 percent to more than 80 percent), with the highest patient satisfaction scores of any inpatient labor and delivery service in the Department of Defense.
Wilford Hall Ambulatory Surgical Center saved more than $1.7 million in just five months by converting from name brand to generic prescriptions and roughly $300,000 will be saved annually by expanding the prescription formulary, the commander said, adding that many expensive prescriptions typically filled in the community are being filled through military treatment facilities and pharmacies at a 40 percent cost savings.
The new intensive outpatient mental health care program at WHASC will save nearly $500,000 worth of high-level mental health care that would have been outsourced Campbell said.
The commander highlighted centralized scheduling for all military treatment facilities as more efficient, saving time, costs and manpower while providing better access to care for patients.
Central scheduling for radiology averted referral of more than 600 MRI examinations to the downtown network by filling all available appointments across the health system and decreasing backlogs which equated to roughly $1 million in savings in the first month alone, Campbell said.
"Over the past two years we have shown how an integrated team can provide world-class care while continually achieving major cost savings," said Maj. Gen. Byron Hepburn, 59th Medical Wing commander and deputy director of the SAMHS. "Enhanced authority in the SAMHS will allow us to take the quality of care delivered in San Antonio to even higher levels of excellence."
The San Antonio market is unique to the Military Health System as its private sector costs are less than the direct care costs. What this means is that compared to other areas, more TRICARE beneficiaries have chosen to use military treatments facilities, as opposed to getting their care elsewhere.
This is a trend Keenan says must continue, as it demonstrates that military medicine is fully capable of providing cost-effective care.