A restructuring of Fort Bragg clinics could affect thousands of beneficiaries, retirees
By RACHAEL RILEY | The Fayetteville Observer | Published: March 8, 2021
FORT BRAGG (Tribune News Service) — Plans to restructure some Fort Bragg's clinics and move Tricare beneficiaries to other medical providers are not yet in effect, and could change.
The 2017 National Defense Authorization Act called for restructuring military hospitals to focus on serving active-duty service members.
And that meant 200,000 beneficiaries could face moving into civilian provider networks that accept Tricare, the military's medical insurance.
The Department of Defense identified 50 medical treatment facilities nationwide in its restructuring plan last year.
A report presented to Congress last year recommended that Fort Bragg's Robinson Health Clinic transition to an active-duty only occupational health clinic.
It also recommended that Joel Health Clinic transition from an outpatient facility to an active-duty only occupational health clinic.
And nearly 21,000 military retirees and beneficiaries at Fort Bragg could be affected.
"Our current beneficiaries, we are not disenrolling, nor do we plan to," Col. John Melton, the former Womack Army Medical Center commander, said at the time that the transitions were announce. "And if there are any future changes, they will be notified."
Melton said the two clinics identified are where troop barracks and fitness centers are located, making them more of a central hub for soldiers.
Reports provided to Congress indicate an estimated 13,000 beneficiaries and retirees at Robinson Clinic, and more than 7,800 at Joel Clinic, could be affected.
Following the onset of the COVID-19 pandemic, Fort Bragg officials announced in July that Joel Clinic became the Joel Pediatric Center of Excellence to focus on higher acuity pediatric patients.
"Primary care still sees pediatric patients," Shannon Lynch, a spokeswoman for Womack Army Medical Center, said this week. "Clark and Robinson clinics realigned the units they provide care to, but that is really the only difference."
When proposed changes were announced last year, officials reiterated it could be a process that could take a few years to implement.
Tom McCaffery, who was assistant secretary of defense for health affairs, said the changes could take between two and four years to implement to ensure the local health care market is able to take on the additional patients.
"Before we transition any beneficiary from one of our hospitals or clinics, we will connect them with health care providers in our Tricare network," McCaffery said at a Feb. 19, 2020, news conference.
McCaffery said changes outlined in the report were made at the Pentagon level, but the Defense Health Agency would work with military departments and providers in local communities to help implement the plan.
The Defense Health Agency operates and oversees Tricare, he said
With staffing shortages during the pandemic, agency officials requested the Pentagon put plans for reforms on hold in late March last year.
And, in May, officials with the Government Accountability Office released a report saying the Department of Defense's assessments may be based on incomplete and inaccurate information.
"Until DOD resolves methodology gaps by using more complete and accurate information about civilian health care quality, access, and cost-effectiveness, DOD leaders may not fully understand risks to their objectives in restructuring future (medical treatment facilities)," the report states.
Government Accountability Office officials questioned if civilian health care providers are "of sufficient quality" and if the Department of Defense included providers that don't meet access-to-care-standards in its assessment.
In an August interview with The Fayetteville Observer, Lt. Gen. Ronald Place, the Defense Health Agency's director, said it's the agency's responsibility "to find a way to provide great access to high-quality safe healthcare for every single beneficiary."
That might mean uniformed personnel are replaced with Department of the Army civilian staff or contract staff, or it could mean relationships are developed with managed care facilities outside of Fort Bragg, he said.
The personnel changes, Place said, are based on the Army evaluating the number of uniform medical personnel to increase force readiness capabilities in other areas such as infantry or armored units.
Officials with the Government Accountability Office weren't the only ones with concerns.
In June, members of the House Armed Services' Subcommittee on Military Personnel proposed amending the 2017 National Defense Authorization Act to delay implementing any changes that would move retirees and family members from military treatment facilities to a Tricare-approved provider for a year, until the plan for that process is submitted to Congress.
The committee also sought to delay realignment or reduction of authorized military medical end strength for a year.
The proposal was to allow review "of medical manpower requirements scenarios to include homeland defense missions and pandemic influenza."
The final version of the approved 2020 National Defense Authorization Act still allows for the restructuring of military medical treatment facilities but requires the secretary of defense to include a report on "quality benchmarks" for the beneficiary population that transitions away from the facilities to a Tricare-approved provider; submit a plan to congressional defense committees; and certify that impacted beneficiaries "will be able to access such health care services through the purchased care component of the Tricare program."