Public Health and Legislation Effect on Military
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Coronavirus may halt proposed changes to military retiree health care
16 March- The worldwide coronavirus pandemic has led one U.S. senator to push back against Pentagon plans that call for military retirees and family members to receive medical care at civilian health care facilities.
During a meeting of the Senate Armed Services Subcommittee on Personnel, Sen. Kirsten Gillibrand (D-New York) noted the Department of Defense has been working to downsize health personnel. "The closure of military medical treatment facilities, the shifting of retiree, military family members; care to Tricare," she said. "In many of these areas, treatment facilities may not be capable of handling the increased patient load." She noted the cuts are happening while the coronavirus continues to spread and "and will obviously put a lot of pressure on our system."
Last month, Assistant Secretary of Defense for Health Affairs Tom McCaffrey said that 200,000 family members and retirees would likely be moved from military treatment facilities to Tricare providers. The move is part of the transition of military treatment facilities from service branch control to Defense Health Agency management.
In testimony before the subcommittee, McCaffrey noted work on the proposal was done before the coronavirus outbreak. "But, what we've said it is conditions-based," he said. "Part of that will be if, in the future, our assumptions that went into the proposal have changed then we will need to change what we proposed."
Gillibrand also asked McCaffrey to provide weekly updates to the committee so legislators can ensure the military has adequate testing labs, and manpower to respond to the coronavirus pandemic.
Military Hospitals to Cancel Appointments, Shift to Telehealth in COVID-19 Response
Military treatment facility patients will likely see some of their scheduled appointments canceled and moved to telehealth instead as Defense Health Agency (DHA) officials look to "scrub" the schedule and clear the way for coronavirus patients.
"What we have asked the military treatment facilities [MTF] to do ... is to go in and what we call 'scrub the templates,'" Regina Julian, who oversees coordination between the DHA and the military services, said during a Facebook-based town hall with Pentagon health officials. "That means look out forward at our scheduled appointments and see what can be done virtually."
Other patients may be notified of new precautions for visits that can be done only in person, she said.
"Some visits are only feasible face-to-face, and so if the military treatment facility wants to limit people coming in because of potential exposure, they will give you processes and procedures for dealing with that," she said.
Officials are also looking to offer telehealth appointments to active-duty patients.
"If you're active duty, you're expected to receive care from [the] direct-care system so we're able to set you up with a virtual visit from your own provider or another primary-care provider in your military treatment facility," she said. "If you need to go to urgent care in the [civilian] network, you will need a referral first because this is tied to your own medical readiness. You can receive a referral through the nurse advice line or you can obtain it, preferably, through your own provider."
MTF patients who have elective procedures on the upcoming schedule may be asked to postpone those, said Col. Neil Page, deputy of DHA's clinical support division. Those delay decisions will be made based on the current coronavirus patient load on a facility-by-facility basis, he said.
"These procedures and appointments are your benefits. You worked for them; you earned them. And recognize that we don't take it lightly to cancel them," he said. "However, in this current environment, some of those appointments are not as necessary as, say, taking care of a whole bunch of sick people up on the ward or diverting equipment and personnel to the emergency rooms. ... Over the coming weeks, we'll see that evolve, and there will be more and more cases and MTFs that will sort of restrict some of those routine appointments and routine and elective surgeries in consultation with you."
In some cases, Julian said, those with canceled appointments could instead be reassigned to providers outside the MTF.
"If we do have to cancel an appointment for any reason ... we will reschedule you for your appointment," she said. "If it's something you need sooner, we can always refer you to the network if necessary."
Tricare users can also receive doctor help via telehealth app services or from their community-based civilian provider, she said. Although users will have a copay, Tricare covers consultations from apps that provide HIPPA-compliant and video-based care, she said.
Consultations from apps or community-based providers that are via text or phone only are not covered, she added.