Sciences Engineering and Medicine Principles for Datadriven Decision Making Principle 2 Know your population and ask if the data matches Christopher Meyer Center for Naval Analyses ID: 671041
Download Presentation The PPT/PDF document "The National Academies of" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
The National Academies of Sciences, Engineering, and MedicinePrinciples for Data-driven Decision MakingPrinciple 2: Know your population and ask if the data matches
Christopher Meyer
Center
for Naval
Analyses
Sept 14, 2017Slide2
2
Military Health Care Benefit Design
Military Health System (MHS) Quadruple Aim
Increased Readiness
Better Care
Better Health
Lower Cost Slide3
3
Military Health Care Benefit Design
Military Health System (MHS) Quadruple Aim
Increased Readiness
Better Care
Better Health
Lower Cost Slide4
4
Military Health Care Benefit Design
Military medical facilities
Inpatient Hospitals: 54 (41 in U.S.)
Clinics: 377 (312 in U.S.)
Dental Clinics: 250 (202 in U.S.)
Veterinary Clinics: 251 (206 in U.S.)Slide5
5
Military Health Care Benefit Design
Military medical facilities
Inpatient Hospitals: 54 (41 in U.S.)
Clinics: 377 (312 in U.S.)
Dental Clinics: 250 (202 in U.S.)
Veterinary Clinics: 251 (206 in U.S.)Slide6
6
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55 BillionSlide7
7
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55 Billion
The 9.4 million is broken into three categories
Eligible (9.4)
Enrollees (4.8)
Users (7.9)Slide8
8
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55 BillionSlide9
9
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55 Billion
Prime is the Managed Care TRICARE option
Just over of half Ret/FM <65 are enrolled in PrimeSlide10
10
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55 Billion
A user can be defined in many different ways. Slide11
11
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55 BillionSlide12
12
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55
Billion
How much health care does this buy?Slide13
13
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55 Billion
Budget Categories: Most of the health care is delivered with O&M, MERHCF, and MILPERS funding Slide14
14
Military Health Care Benefit Design: Lower Cost
Total eligible beneficiaries: 9.4 million
FY 17 Funding: $52.55 Billion
The cost of the health care delivered
Where did the $17 B go? Slide15
15
Military Health Care Benefit Design: Lower Cost
FY 17 Funding: $52.55
Billion:
Where did the money ($17B) go? Slide16
16
Military Health Care Benefit Design: Lower Cost
FY 17 Funding: $52.55
Billion:
Where did the money ($17B) go? Slide17
17
Military Health Care Benefit Design: Lower Cost
FY 17 Funding: $52.55
Billion:
Where did the money ($17B) go? Slide18
18
Military Health Care Benefit Design: Increased Readiness
Military Health System (MHS) Quadruple Aim
Increased Readiness
Better Care
Better Health
Lower Cost Slide19
19
Military Health Care Benefit Design: Increased Readiness
Military Health System (MHS) Quadruple Aim
Increased Readiness
Better Care
Better Health
Lower Cost
MHS leaders are evaluating a wide-ranging set of options to afford military medical personnel additional opportunities to maintain the clinical skills they will need in an operational environment. Convincing beneficiaries who are located within driving distance of an MTF to seek care there first is chief among those solutions. Slide20
20
Military Health Care Benefit Design: Increased Readiness
Military Health System (MHS) Quadruple Aim
Increased Readiness
Better Care
Better Health
Lower Cost
It will help provide military surgeons with an active clinical practice to sustain skills, and lowers costs for the entire system by more efficiently using military hospitals and clinics
.
Slide21
Military Health Care Benefit Design: Increased ReadinessSource: MHS Modernization Study
Volume of Readiness related care in the MTF
The MHS has set a workload volume (RVU) goal of achieving volume equal to 40% of the Medical Group Management Association (MGMA) median. Slide22
Military Health Care Benefit Design: Increased ReadinessSource: MHS Modernization Study
Volume of Readiness related care in the MTFSlide23
Military Health Care Benefit Design: Increased ReadinessSource: MHS Modernization Study
Volume of Readiness related care in the MTFSlide24
Military Health Care Benefit Design: Increased ReadinessSource: MHS Modernization Study
7,981
Annual RVUs
3,192Annual RVUs
78%
22%Slide25
25
Military Health Care Benefit Design
Military Health System (MHS) Quadruple Aim
Increased Readiness
Better Care
Better Health
Lower Cost
Question 1:
Does the current MHS
construct
meets the needs of the current military force and mission
set? Slide26
26
Military Health Care Benefit Design
Military Health System (MHS) Quadruple Aim
Increased Readiness
Better Care
Better Health
Lower Cost
Question 2:
Does the current MHS
provide an affordable, agile, and evolving health care benefit to current AD family members, and eligible retirees and their families? Slide27
27
Military Health Care Benefit Design
Military Health System (MHS) Quadruple Aim
Increased Readiness
Better Care
Better Health
Lower Cost
Question 3: If we were building a military medical force and a personnel health care benefit, would we construct a system similar what we have today? Slide28
Contact informationChristopher MeyerDirectorHealth Research and PolicyMeyerc@CNA.org703-824-2784Slide29
Back Up/DiscussionSlide30
30
14% increase in total cost
Military Health Care Benefit Design: Lower Cost
Inflation and risk-adjusted annualized costs for
MTF
and network enrollees were fairly stable over the three-year period.
Total annualized costs rose by $711 for those who switched to
MTF
enrollment
.
MTF costs rose by $1,146; purchased care payments fell by $435.Slide31
Survival – Casualty – Fatality Rates: Dates
Mission and Dates
1
:
Operation Enduring Freedom (
OEF
)
7 October 2001 – 28 December 2014
Operation Iraqi Freedom (
OIF
)
19 March 2003 – 31 August 2010
Operation New Dawn (OND) Iraq Transition Force
01 September – 15 December 2011
Operation Inherent Resolve (OIR)
15 October 2014 – Current
N
ew
military operations in Iraq and Syria against the Islamic
State of
Iraq and the Levant
Operation Freedom Sentinel (OFS)
01 January 2015 – Current (Follow-on Mission)
T
raining
, advising, and assisting Afghan security forces
.
31Slide32
Data Driven
Decisions: Use Data
“The
survival rate for the conflict in Afghanistan is
90.1%... The survival rate in WWII was about 70%; in Korea and Vietnam it rose to slightly more than 75%.”:
8 March 2012: US House Committee on Appropriations; Subcommittee on Defense
“Our
medical teams have achieved the highest combat survival rates in history
. …all-time
high survivability rate of 91% during Operations Enduring Freedom and Operations Iraqi Freedom despite more severe and complex wounds
.”:
02 April 2014
:
US House Committee on Appropriations; Subcommittee on Defense
32Slide33
Data Driven Decisions:
Interpret Data
33
Survival Rate = WIA / (WIA + KIA + DOW)
Vietnam: 153,303 WIA + 150,341 WIA, but not requiring hospitalization.
3Slide34
Data Driven Decisions: Interpret Data
34
Survival Rate = WIA / (WIA + KIA + DOW)
Vietnam: 153,303 WIA 150,341 WIA, but not requiring hospitalization.
3
Fallujah: 161 WIA
442 WIA But RTD.
11Slide35
Data Driven Decisions: Need More Data 35PRT score categorySailors (%)
Sailors who did not report to sea (%)
Completed
180 days of sea duty (%)
Failure
2
18
50
MS--satisfactory
21
12
64
MS--good
51
11
65
Exceeds standard
26
10
68
# of observations
574,046
4,119
33,364
Of the Sailors who left early, 26%* left for a medical reason
23% had an orthopedic diagnosis (lower back pain)
22% had a mental health diagnosis (including substance
use/abuse)
Source: CNA analyses of PRIMS and manpower data
Need more predictive measures