{"id":47740,"date":"2021-10-21T21:41:36","date_gmt":"2021-10-21T21:41:36","guid":{"rendered":"https:\/\/one.sightlinemg.com\/marinecorpstimes\/uncategorized\/2021\/10\/21\/moving-more-military-patients-out-of-mtfs-could-cause-them-significant-harm-study-finds\/"},"modified":"2026-08-08T09:09:17","modified_gmt":"2026-08-08T09:09:17","slug":"moving-more-military-patients-out-of-mtfs-could-cause-them-significant-harm-study-finds","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/marinecorpstimes\/pay-benefits\/2021\/10\/21\/moving-more-military-patients-out-of-mtfs-could-cause-them-significant-harm-study-finds\/","title":{"rendered":"Moving more military patients out of MTFs could cause them \u2018significant harm,\u2019 study finds"},"content":{"rendered":"\n

Shifting more military patients to local civilian hospitals could result in \u201csignificant harm\u201d to these patients, according to a new study funded by the Defense Department.<\/p>\n\n\n\n

That was the conclusion of researchers after comparing the quality and safety of patient care at military treatment facilities<\/a> with those at local civilian hospitals \u2014 facility by facility. Researchers found that on average, military patients received better outcomes in MTFs, compared to military patients who were treated in local civilian hospitals.<\/p>\n\n\n\n

It\u2019s the first time researchers have conducted a deep dive to compare the quality of care in MTFs and local civilian hospitals, said Tracey Perez Koehlmoos, professor of preventive medicine and biostatistics at the Uniformed Services University of the Health Sciences, and principal investigator in the research.<\/p>\n\n\n\n

And it could put a hurdle in the path of ongoing reform efforts within the Military Health System, which have included moving an unknown number of patients<\/a> to the civilian purchased care system under Tricare.<\/p>\n\n\n\n

The research \u201cis really a good news story that highlights the high quality of care available in our military treatment facilities,\u201d said Koehlmoos, who is director of the USUHS Center for Health Services Research.<\/p>\n\n\n\n

\u201cMilitary treatment facilities as a whole remain among the best performing hospitals for patient safety in the U.S.,\u201d said Koehlmoos. The study also highlights an area where the Defense Health Agency might work to \u201cincentivize a higher quality of care through the Tricare benefit,\u201d she said, which would benefit all patients in the local community, not just Tricare beneficiaries.<\/p>\n\n\n\n

Reducing access to military treatment facilities by as little as 10 percent of the current population could result in \u201csignificantly worse\u201d surgical mortality rates, medical mortality rates and patient safety, the study found.<\/p>\n\n\n\n

The study, titled, \u201cIn Defense of Direct Care: Limiting Access to Military Hospitals Could Worsen Quality and Safety,\u201d was published Oct. 4 in the journal Health Services Research.<\/p>\n\n\n\n

Researchers from Yale and Harvard also worked on the analysis.<\/p>\n\n\n\n

The researchers were tasked to examine how reforms within the Military Health System are likely to affect the quality of care in the system. They examined current data for MTFs and civilian hospitals in the local areas that treated Tricare patients; and also national civilian adult inpatient claims. They included only patients ages 18 to 64 years old.<\/p>\n\n\n\n

Then they conducted simulations on what the quality indicators might look like under various proposed scenarios of reducing access to military treatment facilities.<\/p>\n\n\n\n

\u201cIt\u2019s gratifying to see that MTFs compare favorably with civilian hospitals when it comes to patient outcomes,\u201d said Eileen Huck, government relations senior deputy director for the National Military Family Association. \u201cHowever, the report raises concerns about what will be the impact on beneficiaries as more of them are shifted to the purchased care system.\u201d<\/p>\n\n\n\n

The researchers compared data from 502,252 admissions of adult military beneficiaries at 37 military treatment facilities (326,076 admissions) and surrounding civilian hospitals (179,176 admissions under the Tricare purchased care system). They used Military Health System data from fiscal years 2016 to 2018 to compare patients\u2019 outcomes in MTFs with those of military Tricare patients treated in local civilian hospitals.<\/p>\n\n\n\n

The researchers also compared MTF patients\u2019 outcomes with the broader national civilian adult inpatient admissions, using calendar 2017 hospital data, which fell into that military inpatient data period.<\/p>\n\n\n\n

The researchers conducted simulations for patient outcomes in hypothetical scenarios where defense officials reduced access for patients by 10 percent, 20 percent, or 50 percent nationwide. In the 10-percent scenario, researchers estimated 170,000 to 190,000 beneficiaries age 18 to 64 could be moved out of MTFs to the civilian hospitals.<\/p>\n\n\n\n

They also simulated the outcome if MTF access were restricted to active-duty only, with no retirees, reservists or dependents. In this most extreme scenario, researchers estimated it would be up to 1.9 million adult beneficiaries ages 18 to 64 who would be affected.<\/p>\n\n\n\n

Researchers also simulated the outcome if the worst-performing MTFs were removed. The study doesn\u2019t name those MTFs, but the information could be provided internally only to DoD, if requested, Koehlmoos said.<\/p>\n\n\n\n

\u201cThis research highlights a risk we\u2019ve been concerned about, that when beneficiaries are moved out of MTFs, they may not have access to quality care,\u201d said Karen Ruedisueli, director of health affairs for the Military Officers Association of America. The point that MOAA has been trying to make, she said, is that \u201caccess to care is not the same as access to quality care.<\/p>\n\n\n\n

\u201cIf military families and retirees must be moved out of MTFs in order to improve the focus on readiness, it must only be done in areas where we know beneficiaries can still access quality care in the civilian community.\u201d<\/p>\n\n\n\n

The research \u201cunderscores that this is very complicated, and it\u2019s not something that\u2019s going to be done quickly,\u201d she said.<\/p>\n\n\n\t