Pentagon identifies Fort Bragg clinics that no longer will serve beneficiaries, retirees

By RACHAEL RILEY | The Fayetteville Observer | Published: February 26, 2020

FORT BRAGG, N.C. (Tribune News Service) — Nearly 21,000 military retirees and beneficiaries at Fort Bragg will eventually have to change which medical clinics they go to, officials announced last week.

The Department of Defense delivered its report to Congress about its plan to restructure 50 military hospitals across the nation.

The report recommends that Robinson Health Clinic at Fort Bragg transition to an active-duty only occupational health clinic. It also recommends that Joel Health Clinic transition from an outpatient facility to an active-duty only and occupational health clinic.

"I'd like to reaffirm that the military health system remains committed to ensuring access to quality health care for every beneficiary we serve," said Tom McCaffery, assistant secretary of defense for health affairs. "Additionally, nothing is changing immediately, and we intend to mobilize every resource available to help our beneficiaries and our staff navigate these changes."

A spokesman for Womack Army Medical Center, which operates the clinics, echoed McCaffery's statements.

"We are not dis-enrolling patients and are not kicking anyone out," Womack spokesman Robert Kerns said Thursday. "The reorganization will take at least a couple of years. Nothing is happening at this time."

Focusing military medical treatment facilities' core mission readiness is not a new concept and has been evaluated by internal and external health systems, civilian and uniformed leaders, and Congress, McCaffery said at a news conference Feb. 19.

McCaffery said the recommendation means that the military health facilities ensure service members are medically ready to train and deploy.

"What we found in our review is that many of these facilities do not have the type of patient caseload volume acuity that we need for our providers to have access and to be proficient to do what they do downrange," he said.

The report he provided to Congress showed that Robinson Health Clinic recorded an average of 694 patient encounters per day and Joel Health Clinic, 305 per day.

The restructuring assessment is mandated in the National Defense Authorization Act of fiscal year 2017, he said.

The proposed changes mean about 200,000 beneficiaries using primary care at the facilities will move into Tricare civilian provider networks, McCaffery said.

McCaffery said changes outlined in the report were made at the Pentagon level, but the Defense Health Agency will work with military departments and providers in local communities to help implement the plan.

The Defense Health Agency operates and oversees Tricare, he said.

"We are aware that seeing new care providers may be a big change for families. The doctor-patient relationship is an important one," McCaffery said. "And we recognize the shift ... to civilian care may involve new out-of-pocket costs for some retirees."

Officials did not say what the costs and impacts would be for retirees but said for active-duty service members and their families, there would be no increased costs or additional co-pays unless they fill prescriptions at an off-post retail pharmacy.

Reports provided to Congress indicate an estimated 13,000 beneficiaries and retirees at Robinson Clinic and more than 7,800 at Joel Clinic will be affected.

"Before we transition any beneficiary from one of our hospitals or clinics, we will connect them with health care providers in our Tricare network," he said. "And as you might expect, that process will take time."

He said the changes could take between two and four years to implement because of ensuring the local health care market is able to take on the additional patients.

He said beneficiaries will be guided through each step of the enrollment change process before the plan goes into effect.

McCaffery said the direction for hospitals and clinics to be realigned to meet readiness requirements is separate from a Department of Defense proposal last year for military manpower reductions.

He said a report analyzing how proposed reductions will affect access to care is due to Congress in June.

As officials estimated the plan could mean a savings of $36 million in fiscal year 2021, McCaffery said the focus of the review is about readiness to train the medical force and ensure active-duty service members are medically "ready to do their jobs."

"This really is about making sure we meet our readiness requirements, and we are investing resources accordingly," McCaffery said.

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