The plan shuts down MTFs which destroys readiness – MTFs are the most important variable to training personnel crucial to readiness – Absent large volumes of patient enrollment, a trained and ready medical force is impossible

Following the release of the Commission’s final report in Janu- ary, Navy Medicine participated in the DOD-led rapid and com- prehensive review of the healthcare recommendations. While there is general support for the underlying objectives of the recommenda- tions, I will briefly highlight some of our perspectives and concerns regarding them. In relation to medical readiness, we do support establishing com- mon and service-specific essential medical capabilities, or EMCs, as they could be an effective means to monitor readiness and guide resourcing decisions. We note, however, that EMCs must be developed for more than just surgical trauma skills. Military medicine supports a wide range of operations, including treating disease and non-battle inju- ries during military operations as well as providing humanitarian assistance and disaster relief when called upon in crisis. While there is general agreement to the Commission’s objective to provide an affordable health benefit with additional choice, we must recognize that our medical centers, hospitals, and clinics are our most important readiness training platforms for our military medical personnel and critical to sustaining vital skills and clinical competencies of them. The availability of case mix, volume, com- plexity, and diversity is vital to having a trained and ready medical force. 8 In this regard, care of our beneficiaries is inextricably linked to our readiness mission. Patient enrollment is fundamental to our approach to maintaining the health of our patients. The Military Health System is working hard to recapture workload into our di- rect care system and leveraging initiatives like our Patient Cen- tered Medical Home program to improve access and care. Navy Medicine is leading forward in these areas as they continue to show progress. We believe that the Commission’s approach to offer greater choice through the use of commercial insurance plans presents risk by reducing patient volume and case mix in our sys- tem and positioning MTFs [military treatment facilities] at a sig- nificant disadvantage in attracting patients when competing against commercial insurance plans.