DHA's management of hospitals and clinics 'all about the patient'

10/29/19 (Tue)

This is a landmark time in the history of military medicine. All military hospitals and clinics across the United States, operated for decades by the Army, Navy and Air Force, transition to the Defense Health Agency as the single Department of Defense organization to manage all military hospitals and clinics and oversee care provided through our civilian network of providers.

Many are questioning what this change really means.  Let me first tell you what it’s not about: It’s not about ownership. It’s not about control. It’s not about one Service is better than another. As a matter of fact, it’s because of the great work the Services have done to advance and elevate the quality of care for our warfighters and their families that bring us to this day.

This is all about the patient.  It’s about harvesting decades of best practices from across the Army, Navy and Air Force – along with what we can learn from the civilian community – to build a global standard with one focus:  make our system better to improve health outcomes that matter to our patients. 

As the DHA’s director, I’m responsible for ensuring the success of this transition, and the most important yardstick in measuring our success will be the difference we make in the lives of our patients.

Delivering better care is why work groups and task forces have studied many times over decades how best to structure the Military Health System. It’s why the Department of Defense established the DHA. And it’s why Congress directed this transition in the National Defense Authorization Act for Fiscal Year 2017. Leaders inside and outside the Department are looking to all of us collectively to deliver for our patients. And we’re determined to succeed.

What does this transition mean for our patients? For starters, we’re following a rule that’s familiar to all of us in medicine: “First, do no harm.” Implementing an organizational transition like this can be complicated, and we don’t want that to get in the way of patient care. The administrative changes associated with this should be largely invisible to our patients.

But over time, this will make a tremendous difference for our patients. A single agency overseeing health care delivery activates a system approach to administration and management of all hospitals and clinics, which will standardize the business side of delivering health care and improve the experience for all patients. Things like making an appointment or getting a referral for specialty care will work the same way no matter which facility you visit. Common patient safety and clinical quality policies mean the very best practices in one clinic become the norm within every clinic, raising our performance across the board. A single agency accountable for all the health care we provide – whether in one of our facilities or through a civilian provider in our TRICARE managed care network – means we will be more effective in finding the best possible source for the best care for each patient.

In the months ahead, we’ll set up market organizations in regions across the country, allowing hospitals and clinics in the same geographic area – regardless of Service – to share and target resources where our patients need them. In the next year, our work focuses on getting this right in the United States and prepare for the transition of overseas facilities, completing the task of moving all health care delivery to the DHA by October 2021.

All of us at the DHA, in the medical organizations of the military departments, and across the Department of Defense have labored for the past two years to make this transition successful. Like all big projects, there will be some bumps in the road ahead. The administrative and operational tasks in the months and years to come may seem daunting but are absolutely achievable because of the laser-focus the collective team has on getting this right. This transition will not be successful unless it results in more satisfied patients with great health outcomes, in military troops who are healthy and ready for the fight, and in medical professionals ready to support our warfighters from battlefield to home station.

Great outcomes, a ready medical force, satisfied patients – all flow directly from a patient-centered approach. This, above all, is what I have emphasized to the team at DHA. As DHA assumes responsibility for military health care facilities across the entire Department of Defense, we aim to operate each hospital and clinic so that it improves the lives and health of our patients. It’s more than a pledge – it’s our mission.

On Oct. 25, 2019, the Deputy Secretary of Defense (DSD) David L. Norquist signed a memorandum on “Continuing Implementation of the Reform of the Military Health System.” The document authorizes appropriate implementation of the law and lists all MTFs and DTFs transferring to DHA.  For more on the transition of military hospitals and clinics to the Defense Health Agency, visit

About the Defense Health Agency (DHA)

The DHA, established on Oct 1, 2013, is the nation's military medical Combat Support Agency, a joint, integrated organization that enables the Army, Navy, and Air Force medical services to provide a medically ready force and ready medical force to Combatant Commands in both peacetime and wartime. In cooperation with the Joint Staff Surgeon and Military Department medical organizations, DHA leads the Department of Defense’s integrated system of readiness and health through a global health care network of military and civilian medical professionals, including nearly 450 military hospitals and clinics around the world, to improve and sustain operational medical force readiness and the medical readiness of the Armed Forces.  The DHA supports the delivery of integrated, affordable, and high-quality health services for 9.5 million active duty service members, retirees, Reservists and Guardsmen, and their families at military hospitals and clinics or through the TRICARE network.

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