Evaluation of the Lovell Federal Health Care Center Merger Findings, Conclusions, and Recommendations (2012) / Chapter Skim
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2 History and Context
2 History and Context
Pages 27-46
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Military Health System The Military Health System (MHS) , which includes TRICARE, provides health care services to 9.6 million people, including 1.5 million active duty servicemembers, 2.1 million active duty family members, 5.1 million military retirees and their dependents, and 1.0 million reservists and their 27
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Therefore, all enlisted recruits and students at Naval Station Great Lakes are enrolled in TRICARE Prime at the Captain James A Lovell Federal Health Care Center, as are active duty staff members who live within a 40-mile radius.
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Active duty family members not enrolled in TRICARE Prime 5. All other eligible persons (CRS, 2009)
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These closures, the possibility of making the remaining MTFs more efficient by serving VA as well as DoD patients, and other cost trends provide an incentive for MHS facilities to seek cooperative arrangements with VA health care facilities. Another trend is the shrinking share of the MHS workforce accounted for by active duty members, down from 58 percent (70,000 of the total workforce of 120,000)
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While women veterans are still a small minority of VHA patients, their rapidly increasing numbers and gender-specific health needs are creating challenges for the VA's health system. VAMCs and MTFs have an incentive to combine health care services for active duty and veteran women to support a broader range of coordinated services and avoid referring patients to community health care providers for more specialized services such as mammography.
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Naval Hospital Great Lakes The Navy opened a base in North Chicago in 1911 to train enlisted recruits from the Midwest. What is currently called the Naval Station Great Lakes (NSGL)
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The most realistic options were either to build an ambulatory care center on the base and refer patients needing hospitalization to area hospitals, or to build a joint ambulatory care center next to the NCVAMC and use the facility for inpatient care. The advantages for the Navy of consolidation with the NCVAMC, in addition to avoiding the cost of building and maintaining a new hospital facility, included the lower cost of direct care compared with care provided by community facilities, the ability to keep injured and ill recruits in a military-like setting, and the opportunity for Navy clinicians to maintain their skills.
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Instead, the VA spent $9.3 million on construction and equipment to upgrade the acute medical/surgical capability at the NCVAMC. In late 1979, the Navy surgeon general and the VA's chief medical officer formed a working group of local, regional, and central office officials from both departments to explore the possibility of consolidating inpatient care at the naval hospital.
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The VA could close two 50-year-old psychiatric inpatient buildings that were expensive to maintain and operate and move the patients into the main hospital facility, Building 133, which was 20 years old, after renovation that would be less costly than upgrading the building to acute-care standards. VA and Navy officials also noted that such a major sharing agreement could set a precedent and provide a model for additional VA/DoD sharing arrangements.
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In 1995, the VHA adopted a new organizational structure. All veterans health care services in North Chicago were organized and regionally managed under the Veterans Integrated Service Network (VISN)
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. 1999–2000: Saving the North Chicago Veterans Affairs Medical Center Within weeks of the leak of the VISN 12 options report in September 1999, Durbin and others in the Illinois congressional delegation developed a plan to save the NCVAMC.
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. The 2001 Veterans Integrated Service Network 12 Capital Asset Realignment for Enhanced Services Report In response to the intense negative reaction of the various Chicago stakeholders to the 1999 VISN 12 options study, the House Committee on Veterans' Affairs Subcommittee on Health asked the VA to develop and adopt objective, measurable criteria for formulating and evaluating options for restructuring the delivery of health care (U.S.
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If that agreement were reached, the acute medical and surgi cal workload provided by the Navy, currently estimated to be about two wards or 60 patients, when added to the VA acute care workload, would provide a critical mass of acute care beds sufficient to justify ongoing acute inpatient care. Even if a VA/DoD sharing agreement is not reached, all four options propose keeping a small acute medical service.
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According to the VISN 12 CARES study, the VA and the DoD signed an agreement in March 2000 permitting active duty servicemembers and their dependents to receive specialty care at the VA and veterans to receive care at the NHGL (Booz-Allen & Hamilton, 2001, pp.
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(VA, 2002a) William Winkenwerder, the assistant secretary of defense for health affairs, explained the purpose of the agreement as follows: With this agreement, the Navy gains a modern ambulatory care center at a cost less than building a new hospital.
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Some of the trends facilitating collaboration included the following: • Shifts in beneficiary utilization. Demand for inpatient services was falling off sharply, reflecting changes in health care delivery, but that was offset by increases in the number of active duty enrollees due to the global war on terror, the number of veterans eligible for VA health care due to the Veterans Millennium Health Care and Benefits Act of 1999, and the demand from retirees and their dependents with the implementation of TFL in 2001.
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Chicago Tribune, Novem ber 19. http://articles.chicagotribune.com/1999-11-19/news/9911190240_1_veterans hospital-world-war-ii-veteran-outpatient (accessed July 26, 2012)
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Lovell Federal Health Care Center)
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Chicago Tribune, November 11. http:// articles.chicagotribune.com/1999-11-11/news/9911110257_1_va-community-veterans day-va-patients (accessed July 27, 2012)
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