Defense Health Care: DOD Needs to Address the Expected Benefits, Costs, and Risks for Its Newly Approved Medical Command Structure
Highlights
The Department of Defense (DOD) operates one of the largest and most complex health systems in the nation and has a dual health care mission--readiness and benefits. The readiness mission provides medical services and support to the armed forces during military operations. The benefits mission provides health care to over 9 million eligible beneficiaries, including active duty personnel, retirees, and dependents worldwide. Past Government Accountability Office (GAO) and other reports have recommended changes to the military health system (MHS) structure. GAO was asked to (1) describe the options for structuring a unified medical command recommended in recent studies by DOD and other organizations and (2) assess the extent to which DOD has identified the potential impact these options would have on the current MHS. GAO analyzed studies and reports prepared by DOD's Joint/Unified Medical Command Working Group, the Defense Business Board, and the Center for Naval Analyses, and interviewed department officials.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Defense | To improve visibility over its decision-making process related to the establishment of a unified medical command structure, the Secretary of Defense should direct the Deputy Secretary of Defense to demonstrate a sound business case for proceeding with its chosen option, including detailed qualitative and quantitative analyses of benefits, costs, and risks associated with implementing the transformation. |
While DOD concurred with our recommendation, stating that an implementation team will conduct comprehensive planning to include an assessment of implications for doctrine, organization, training, material, leadership, personnel, and facilities, no implementation team was ever formed. Due to other governance studies that have taken place in the mean time, DOD is moving forward with other options so this recommendation has been overtaken by events and is not applicable any more.
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| Department of Defense | To improve visibility over its decision-making process related to the establishment of a unified medical command structure, the Secretary of Defense should direct the Deputy Secretary of Defense to provide Congress with the results of the assessment of the business case for proceeding with its chosen option. |
While DOD concurred with our recommendation, stating that Congress will be provided with the results of the analysis, the analysis has not been done and there is no intent to do such an analysis on the part of DOD. Due to other governance studies that have taken place in the mean time, DOD is moving forward with other options so this recommendation has been overtaken by events and is not applicable any more.
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| Department of Defense | To monitor whether the transformation is meeting its goals of eliminating unnecessary duplication; streamlining organizational structures; and aligning authority, responsibility, and financial control, the Secretary of Defense should direct the Deputy Secretary of Defense to establish and monitor outcome-focused performance measures to help guide the transformation. |
While DOD concurred with our recommendation, noting that it will implement specific outcome-focused performance measures, DOD is moving forward with other options so this recommendation has been overtaken by events and is not applicable any more.
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