The Military Health System last month activated the Defense Health Agency to streamline business processes and deliver improved health care, safety and outcomes to its 9.6 million beneficiaries. As part of that overall effort, six of the military’s regional medical markets are leading the effort to standardize services, clinical practices and business rules.

The enhanced multiservice markets, as they are known, are geographic areas where at least two medical treatment facilities from different services have overlapping service areas, as defined by TRICARE. There are 15 multiservice markets around the world, 11 in the United States and four abroad.

Six of these existing markets were selected for enhanced authorities by the deputy secretary of defense based on several factors, including overall size, medical mission and graduate medical education capacity. The six markets are the National Capital Region; Tidewater, Va.; Colorado Springs, Col.; San Antonio, Texas; Puget Sound, Washington; and Oahu, Hawaii. Combined, these markets account for about 30 percent of all the care delivered in military hospitals and 22 percent of all care purchased in the private sector.

The multiservice markets crafted five-year business plans, encompassing strategies for the entire market area, rather than individual military hospitals or clinics. The plans focus on the standardization of clinical and business practices, as well as maximizing resources in an integrated way in order to provide better care and become more efficient.

“These markets are the leaders for the future of the MHS,” said Rear Admiral Donald Gintzig, who led the enhanced multiservice market transition team before his retirement at the end of last month. “As our primary readiness and care platforms, the coordination of care demonstrated by these markets will help set the example for the rest of the MHS to follow.”

The markets also work with one another, sharing challenges and best practices to find enterprise-wide solutions. “In the past, the services have worked within their individual service silos within a market,” Gintzig said. This lack of coordination would often result in redundancy and unnecessary overlap.

“Coordination and integration create opportunities for realizing efficiencies and improving both readiness and care,” Gintzig continued, “and the new market-centered business plans allow market managers to leverage the unique capabilities and resources of all three services.”

The initial five-year business plans have been approved and market managers assumed their new authorities Oct. 1. These efforts will inform adjustments to future business plans. “This isn’t an overnight change,” Gintzig said. “It’s an evolving process. But the goals - increased interoperability, increased value to our line leadership, and improved service to our beneficiaries - are the primary drivers of everything the markets will do.”

As the markets implement and adjust their business plans, market leaders will meet on a regular basis to share best practices and work collaboratively on challenges. This market leadership group consists of the six enhanced multiservice market directors as well as the market leaders from the Ft. Bragg and San Diego medical markets, two single-service markets similar in size and scope to the enhanced multiservice markets.

The enhanced markets also support a broader military health initiative to recapture care by bringing beneficiaries receiving care in the private sector back into military treatment facilities.

“Each market has a plan for inviting our beneficiaries to come back to our military clinics and hospitals for their care,” Gintzig said. “These initiatives will be the primary drivers of increasing the competency and currency of our medical force, improving access and service to our patients and enhancing the value of military medicine to commanders.”

Recapturing care that has migrated to the private sector will directly benefit military health care providers. By bringing care back into medical treatment facilities, Military Treatment Facility commanders ensure that military providers and staff get to see the kinds of clinical work necessary to maintain their skills.

“Our No. 1 mission is to be ready to go to war,” Gintzig said. “Ensuring that our surgeons, nurses and clinical staff get to see interesting and complex cases on a regular basis is how we keep those skills sharp.”