Pentagon Downsizes Military Healthcare Access

Military families and retirees across the country, including some nearby in Virginia and Maryland, would lose access to military hospitals and clinics under a Department of Defense (DOD) plan, according to a report from the Military Officers Association of America (MOAA).

Here are the facilities nearby on the list to be affected, according to the MOAA:

In Maryland

These are slated to begin serving only active-duty military:

• Barquist Army Health Clinic outpatient facility (Fort Detrick)
• Branch Health Clinic Indian Head outpatient facility
• Kirk Army Health Center outpatient facility (Aberdeen Proving Ground)
• Naval Health Clinic Patuxent River outpatient facility

In addition, Kimbrough Ambulatory Care Clinic (Fort Meade) will transition from an ambulatory surgery center to an outpatient facility.

In Virginia

These are slated to begin serving only active-duty military:

• Kenner Army Health Clinic outpatient facility (Fort Lee)
• Naval Branch Health Clinic Dahlgren outpatient facility

In addition, JB Langley-Eustis: 633rd Medical Group-Langley to become an ambulatory surgery center and outpatient clinic. McDonald Army Health Clinic is transitioning from an ambulatory surgery center to an outpatient facility “with significant specialty services.”

Overview of Why the DOD is Downsizing Healthcare Facilities

The initiative is designed to free up capacity in these facilities to better prepare them for wartime readiness for active-duty military personnel and to improve clinical training for medical forces who deploy around the world to support combat operations. Critics believe the primary purpose of this “rightsizing” proposal is to cut costs. However, a few facilities will actually see their services expand.

Individuals affected would be off-loaded from the military health care facilities where they now receive care to find private practice doctors and providers who accept TRICARE, the health insurance network for the military. The proposal was met with growing scrutiny and considerable opposition.

It was sent to Congress in February but paused soon thereafter in the wake of the coronavirus pandemic. The federal Government Accountability Office (GAO), which provides auditing and evaluation for Congress, found shortcomings that have further delayed implementation.

What Are the Possible Repercussions of the Reorganization Plan?

A total of 50 facilities would be “rightsized” under the proposal, which would affect 84,000 active duty family members and 110,000 military retirees nationwide. Of those, 37 facilities would begin only seeing active duty personnel and 3 would close. DOD operates a total of 343 medical facilities across the country.

For military families and retirees the following are repercussions of the DOD’s downsizing plan;

• an immediate effect would be higher out-of-pocket costs such as co-pays and longer round-trips to get access to services.
• a more concerning issue is the potential for family members and retirees to find it difficult to gain timely access to doctors and facilities that will accept their TRICARE insurance.

The proposal aims to allow for average appointment wait times in a given region to not exceed a week for routine care and four weeks for specialty care. Drive time for patients should not exceed 30 minutes to reach a primary care doctor. Specialists should be no further than one hour away.

Military officers and other interest groups doubt that these parameters are realistic. They contend that this military health care downsizing effort will result in the quality of care that is inadequate. It may mean longer wait times to get a doctor’s appointment. In addition, if access to care turns out to be an issue, the proposal would place military families and retirees at greater risk when serious medical conditions arise.

As a result, advocacy groups want to see the restructuring stopped, not just delayed. DOD counters that the transition will be measured and slow, giving each market time to assess the changes and make adjustments.

The GAO found the following shortfalls and others in the proposal:

• It was prepared in haste at the direction of Congress and is based on incomplete or inaccurate information. There has been no congressional oversight and no opportunity for comment by those affected.
• Estimates on drive times failed to consider traffic, bridges and tunnels that clog highways and slow traffic. As a result, families and retirees may face longer commutes for care.
• It is based on the flawed assumption that the number of doctors in the United States will increase. In reality, a shortage exists now in many medical specialties, which is expected to be a major problem by 2032.
• The cost analysis under-projected expenses and over-projected revenues.
• Market dynamics vary widely across the country and depend on each provider’s book of business. Those with a strong base of patients on commercial insurance would have little incentive to accept TRICARE patients. On the other hand, in markets where the patient base includes few with commercial insurance and many on Medicare and Medicaid, TRICARE patients could be an attractive revenue stream.
• It provided limited assessments on the readiness impact to military primary care physicians and non-physician medical providers including nurses, physician assistants, and enlisted medical and surgical specialists.

The coronavirus pandemic has had the unintended consequence of delaying the DOD plan. It has laid bare the federal government’s inability to provide reliable guidance and adequate resources, giving rise to speculation that this rightsizing effort might result in a system that fails to meet the needs of the people it’s designed to serve.

House and Senate Bills to Address Downsizing

The concerns that have been raised are being addressed in Congress. The House bill includes two provisions that would halt the planned cuts. The Senate bill does not include this provision.

Now that both bills have been passed by their respective chambers, members of the House and Senate meet in a conference committee to resolve any differences.

What to Do if This Affects You or Someone You Love

Do you have health issues that may be worsened by the DOD’s military health care downsizing? Do you have concerns about your ability to get access to civilian medical care in a timely manner?

You’re not alone. We at Bertram & Murphy are following these developments and are concerned that they may have grave consequences for military families and retirees.

We focus on medical malpractice cases involving medical errors, unsafe devices, and medical negligence. Cases like these are extremely complex and require specific skills and resources. Our team has the experience and the focus to aggressively advocate for military members and their families who have been unjustly harmed.

We value the contributions of members of our armed forces and the sacrifices their families make for our country’s freedom. At Bertram & Murphy, we will fight fiercely for the answers and the justice you deserve.

Contact us now for a free claim review and discussion about your legal rights and options.