Defense Health Care Reform: Additional Implementation Details Would Increase Transparency of DOD's Plans and Enhance Accountability
GOVERNMENT ACCOUNTABILITY OFFICE WASHINGTON DC
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The MHS is a complex organization that provides health services to almost 10 million beneficiaries across a range of care venues, including the battlefield, traditional hospitals and clinics at stationary locations, and authorized civilian providers. As we reported in 2005, DOD s health care system is an example of a key challenge facing the U.S. government in the 21st century as well as an area in which DOD can achieve economies of scale and improve delivery by combining, realigning, or otherwise changing selected support functions. Additionally, in 2011, we reported that the responsibilities and authorities for DOD s military health system were distributed among several organizations within DOD with no central command authority or single entity accountable for minimizing costs and achieving efficiencies. Under the MHS command structure that existed prior to October 1, 2013, the OASD HA, the Army, the Navy, and the Air Force each had its own headquarters and associated support functions, such as information technology, human capital management, financial activities, and contracting. Additionally, the three services Surgeons General were responsible for overseeing their deployable medical forces and operating their health care systems. OASD HA manages the Defense Health Program budget, but this office does not directly supervise the services medical personnel. See figure 1 for the organizational structure prior to October 1, 2013.
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