Leveraging National Healthcare Reform to Improve Army National Guard Readiness

Abstract

Abstract : National health care reform provides the Department of Defense with a unique opportunity to revise the Defense Health Program to improve the medical readiness of Army National Guardsmen while decreasing long-term health care costs. After discussing the organizational culture of the Guard and the barriers this culture creates to medical readiness, this paper describes the challenges of operationalization and past strategies utilized by the National Guard Bureau to improve medical readiness. Following a review of the national health care environment and reform proposals, this study will suggest policy changes to TRICARE to incorporate the value-based design and the individual health insurance mandate embedded in current legislation. Specifically, monitoring Soldier use of TRICARE Reserve Select (TRS) to meet the health insurance mandate and changing the TRS benefit by developing incentives for healthy behaviors and eliminating cost sharing for preventive services, will help control health care costs while improving readiness. Regardless of the outcome of the current national debate, leveraging these aspects of proposed legislation and the unique culture of the Guard to implement change will result in a more medically ready, cohesive force.