1. Leading the Way Upstream: The Military Health System for 2012 and Beyond June 21, 2011 RADM C.S. Hunter, MC, USN Deputy Director TRICARE Management Activity

2. Program enrollment –5.4 million TRICARE Prime –3.7 million in direct care system –1.7 million in contractor networks –2.1 million TRICARE Standard/Extra –Others use TRICARE Reserve Select, TRICARE For Life USPHS beneficiaries - 30,476 Beneficiaries by category –Active duty: 1.7 million –Active duty family: 2.4 million –Retirees: 1 million –Retiree family: 1.8 million –Medicare-eligible: 2.1 million TRICARE Beneficiaries: Who We Serve Over 9.6 Million Beneficiaries 2

3. A Week in the Life of TRICARE 2.7 million prescriptions* (7,392 PHS) –924,000 direct care –1.44 million retail pharmacies –228,000 home delivery 231,000 behavioral health outpatient services –52,000 direct care –179,000 purchased care 23,300 inpatient admissions –5,100 direct care –18,200 purchased care 1.8 million outpatient visits (5,364 PHS) –810,000 direct care –1.0 million purchased care 2,400 births –1,000 direct care –1,400 purchased care 3.5 million claims processed 12.6 million electronic health record messages Behavioral Health Outpatient Visits Active Duty Family Active Duty * Pharmacy from 6 mo. Period: 10/01/10 – 3/31/11; All others FY10

4. Military Health System Quadruple Aim Aligning Behind a Well-Articulated Goal Readiness –Pre- and Post-deployment –Family Health –Behavioral Health –Professional Competency/Currency Population Health –Healthy service members, families, and retirees –Quality health care outcomes A Positive Patient Experience –Patient and Family centered Care, Access, Satisfaction Cost –Responsibly Managed –Focused on value 4

5. Fulfillment of the Quadruple Aim Across the Military Health System The Quadruple Aim has been successful because it: –Focuses our efforts, yet is broad enough to be inclusive –Is relevant to both military and national health care landscapes –Can be applied across multiple domains Force health protection and prevention Direct care at military treatment facilities (MTFs) Purchased care through civilian partners Electronic health information systems Education, training and workforce development 5

6. How PHS Officers Contribute PHS Officers Fill Key TMA Leadership Positions 6 RADM Thomas McGinnis Chief, Pharmaceutical Operations Directorate CAPT Cheryl Borden Executive Officer Provide continuity Provide deep subject matter expertise Close gaps in care left by deployed DoD providers CAPT Robert DeMartino Director of Behavioral Medicine

7. Providing Critical Psychological Health and TBI Expertise USPHS mental health professionals serve at 46 MTFs DoD-USPHS Memorandum of Agreement (MoA) signed June 4, 2008 7 Disciplines Social Workers62 Psychologists40 Nurses26 Psychiatrists8 Physician Assistants7 Physical Therapists4 Occupational Therapists3 Nurse practitioners2 Speech pathologists2 Clinical pharmacologist1 Co-liaison officer1 Neurologist1 TOTAL157

8. Where is DoD Headed? Prevention Resiliency Diet Fitness Child-rearing Meaningful work Focusing on Upstream Determinants of Health 8

9. Where is DoD Headed? Patient-centered medical home Self management support Health literacy Health information access Empowering Patients 9

10. How is DoD Addressing Costs? Focusing on prevention Reducing ER use Encouraging economical pharmaceutical outlets Reducing hospital readmissions through Partnership for Patients 10

11. How Can Leaders Prepare for the Future? Diversify your reading Be open to opportunities Seek out mentors and mentor others Learn to communicate well Nurture your humanity 11

12. We Are All Part of the Solution 12 Thank You For Your Service