The U.S. Department of Defense (DoD) announced plans to restructure 50 military hospitals and clinics to better support wartime readiness of military personnel and to improve clinical training for medical forces who deploy in support of combat operations around the world.

Image credit: Military Health System

Military readiness includes making sure MTFs are operated to ensure service members are medically ready to train and deploy," said Tom McCaffery, assistant secretary of defense for health affairs. "It also means MTFs are effectively utilized as platforms that enable our military medical personnel to acquire and maintain the clinical skills and experience that prepares them for deployment in support of combat operations around the world.”

The restructuring effort focused on strengthening on the prime responsibility of military medical facilities for training medical personnel and “for keeping combat forces healthy and ready to deploy according to readiness and mission requirements – all while ensuring the MHS provides our beneficiaries with access to quality health care,” McCaffery added.

These plans were described and explained in a report sent to Congress, titled "Restructuring and Realignment of Military Medical Treatment Facilities."  This report was required by law under Section 703(d) of the National Defense Authorization Act of 2017, which directed the DoD to analyze its hospital and clinic footprint and submit a plan to Congressional defense committees.

Of the 343 facilities in the United States initially screened for this report, 77 were selected for additional assessment, with 21 identified for no changes.

Of the 50 facilities ultimately designated for restructuring, 37 outpatient clinics now open to all beneficiaries will eventually see primarily only active-duty personnel. Active-duty family members, retirees and their families who currently receive care at those facilities will transition over time to TRICARE's civilian provider network. The report states that seven of these clinics may continue to enroll active duty family members on a space-available basis.

In addition, many active duty-only clinics will continue to provide occupational health services to installation civilian employees related to their employment.

The report acknowledges that transitioning patients from MTFs to the TRICARE network will take time – in some cases several years – and if local TRICARE networks cannot provide access to quality care, DoD will revise implementation plans.

During his keynote address at the December 2019 annual meeting of the Society of Federal Health Professionals, known as AMSUS, McCaffery offered a broad overview of intentions for changing the scope of operations at certain MTFs in what is known within the MHS as the Direct Care System. Direct care refers to military hospitals and clinics, also known as “military treatment facilities” and “MTFs.”

"In optimizing the operation of the Direct Care system to most effectively support the MHS readiness mission, we need to identify those areas where we could expand capacity at MTFs that offer potential for sustaining the skills and knowledge of our medical force," McCaffery said during his AMSUS speech. "But we also must examine those areas where facilities do not offer now, and likely will not be able to offer in the future -- a platform for maximizing capabilities to support medical readiness. In those situations, we need to be open to right-sizing MTF services and capabilities so as to ensure that we are using finite resources most efficiently... while not compromising our ability to meet mission."

The final report delivered to Congress contains a summary of all the changes, a description of how each change was made, and supporting data.