A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System

Joseph W. Galvin, Joshua C. Thompson, Amy M. Thompson, Stephen Arthur Parada, Josef K. Eichinger, Jonathan F. Dickens, Bruce L. Gillingham

Research output: Contribution to journalArticle

Abstract

Introduction With the continued rise in the cost of U.S. health care, there is an increased emphasis on value-based care methodologies. Value is defined as health outcomes achieved per dollar spent. Few studies have evaluated the role of value-based care in the Military Health System (MHS), especially in a format which physicians and providers can understand. The purpose of this article is to provide a guide to understanding current reimbursement systems and value-based care in the MHS and discuss potential strategies for improving value and military readiness. Materials and Methods We outlined the current value-based care methodologies in the MHS, and by using musculoskeletal care as an example, offer strategies for further improvement. Results The MHS has been a leader in the health care industry in adopting value-based care strategies. Current value-based systems in the MHS are primarily designed to incentivize process measure compliance. Initial steps toward measurement and reporting health outcomes have been made, however, with the military's use of the Integrated Resourcing and Incentive System (IRIS), National Surgical Quality Improvement Program (NSQIP) database, and the Joint Outpatient Experience Survey (JOES). Conclusion As this article will describe, universal reporting of health outcomes, adoption of integrated practice units, and a focus on determining outcomes of illness over the entire care cycle offer a significant opportunity to accelerate the MHS journey to providing true value-based care. The universal measurement and systematic improvement of outcomes based on this measurement will contribute to military medical readiness and warfighter effectiveness.

Original languageEnglish (US)
Pages (from-to)E205-E210
JournalMilitary medicine
Volume184
Issue number3-4
DOIs
StatePublished - Mar 1 2019

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Health
Musculoskeletal System
Health Care Sector
Process Assessment (Health Care)
Quality Improvement
Health Care Costs
Compliance
Motivation
Outpatients
Joints
Databases
Physicians

Keywords

  • Military Health System
  • military readiness
  • musculoskeletal injuries
  • value based care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Galvin, J. W., Thompson, J. C., Thompson, A. M., Parada, S. A., Eichinger, J. K., Dickens, J. F., & Gillingham, B. L. (2019). A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System. Military medicine, 184(3-4), E205-E210. https://doi.org/10.1093/milmed/usy206

A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System. / Galvin, Joseph W.; Thompson, Joshua C.; Thompson, Amy M.; Parada, Stephen Arthur; Eichinger, Josef K.; Dickens, Jonathan F.; Gillingham, Bruce L.

In: Military medicine, Vol. 184, No. 3-4, 01.03.2019, p. E205-E210.

Research output: Contribution to journalArticle

Galvin, JW, Thompson, JC, Thompson, AM, Parada, SA, Eichinger, JK, Dickens, JF & Gillingham, BL 2019, 'A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System', Military medicine, vol. 184, no. 3-4, pp. E205-E210. https://doi.org/10.1093/milmed/usy206
Galvin JW, Thompson JC, Thompson AM, Parada SA, Eichinger JK, Dickens JF et al. A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System. Military medicine. 2019 Mar 1;184(3-4):E205-E210. https://doi.org/10.1093/milmed/usy206
Galvin, Joseph W. ; Thompson, Joshua C. ; Thompson, Amy M. ; Parada, Stephen Arthur ; Eichinger, Josef K. ; Dickens, Jonathan F. ; Gillingham, Bruce L. / A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System. In: Military medicine. 2019 ; Vol. 184, No. 3-4. pp. E205-E210.
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