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

Publication ,  Journal Article
Galvin, JW; Thompson, JC; Thompson, AM; Parada, SA; Eichinger, JK; Dickens, JF; Gillingham, BL
Published in: Mil Med
March 1, 2019

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.

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Published In

Mil Med

DOI

EISSN

1930-613X

Publication Date

March 1, 2019

Volume

184

Issue

3-4

Start / End Page

e205 / e210

Location

England

Related Subject Headings

  • Strategic, Defence & Security Studies
  • Reimbursement, Incentive
  • Quality of Health Care
  • Quality Improvement
  • Military Health Services
  • Humans
  • 4203 Health services and systems
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
  • 1106 Human Movement and Sports Sciences
 

Citation

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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. Mil Med, 184(3–4), e205–e210. https://doi.org/10.1093/milmed/usy206
Galvin, Joseph W., Joshua C. Thompson, Amy M. Thompson, Stephen A. Parada, Josef K. Eichinger, Jonathan F. Dickens, and Bruce L. Gillingham. “A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System.Mil Med 184, no. 3–4 (March 1, 2019): e205–10. 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. Mil Med. 2019 Mar 1;184(3–4):e205–10.
Galvin, Joseph W., et al. “A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System.Mil Med, vol. 184, no. 3–4, Mar. 2019, pp. e205–10. Pubmed, doi:10.1093/milmed/usy206.
Galvin JW, Thompson JC, Thompson AM, Parada SA, Eichinger JK, Dickens JF, Gillingham BL. A Guide to Understanding Reimbursement and Value-Based Care in the Military Health System. Mil Med. 2019 Mar 1;184(3–4):e205–e210.

Published In

Mil Med

DOI

EISSN

1930-613X

Publication Date

March 1, 2019

Volume

184

Issue

3-4

Start / End Page

e205 / e210

Location

England

Related Subject Headings

  • Strategic, Defence & Security Studies
  • Reimbursement, Incentive
  • Quality of Health Care
  • Quality Improvement
  • Military Health Services
  • Humans
  • 4203 Health services and systems
  • 3202 Clinical sciences
  • 1117 Public Health and Health Services
  • 1106 Human Movement and Sports Sciences