Photo: Russell Sellers
By Jerry Harben (Army Medicine)
(Sept. 9, 2010) — Active-duty family members who live near some Army installations soon will have an additional option for health care, without traffic, waiting time, expense and frustration that may sometimes be involved with going to on-post medical facilities or TRICARE network providers.
Medical Command plans to open community-based primary-care clinics close to where beneficiaries live. Current plans call for 16 clinics near 11 installations: Forts Bragg, N.C.; Hood, Texas; Campbell, Ky.; Jackson, S.C.; Leonard Wood, Mo.; Lewis, Wash.; Sam Houston, Texas; Sill, Okla.; Shafter, Hawaii; Stewart, Ga.; and Benning, Ga.
Twelve clinics are expected to open for patient care between early November and late January, with the remainder later in 2011. If the concept proves beneficial, clinics may be added at other locations in the future.
The clinics will be in leased space with civilian employee staffing. They will be an expansion of available care, not a shifting of care from the post hospital.
"We expect to improve access, reduce emergency room visits, improve patient and provider satisfaction, and improve the quality of care both on and off post," said Col. Marcus Cronk, deputy chief of staff for resource management for Medical Command.
"This effort will improve the readiness of our Army," he added.
Each clinic will be able to enroll more than 8,000 active-duty family members.
"Beneficiaries who are enrolled in TRICARE Prime won't have to re-enroll, just say they want to get care at that clinic. It is totally their option, they can still get care at the post medical treatment facility, or can go to a TRICARE network provider," said Maj. Chad Rodarmer, who is working on the project in Medical Command's directorate of resource management.
Rodarmer said the clinics will provide pharmacy and laboratory services focused on a primary-care setting. Obstetrics/gynecology and pediatric services may be provided when needed, with a specialist from the installation's medical treatment facility coming to the off-post clinic.
"We're trying to keep things convenient for the patient," Rodarmer said.
Some building leases have been signed and equipment ordered. Staffers are being hired. An operations manual has been drafted.
Rodarmer said these clinics will be part of the Army direct-care system, an extension of the medical treatment facility on the installation. One advantage is that when a family transfers to another post, electronic medical records will be forwarded to the facility at the new assignment, facilitating continuity of care through the move.
The community-based clinics will employ a patient-centered medical home model of health care.
"The concept emphasizes continuity of care and a culture of trust through developing a strong patient-provider relationship," Rodarmer said.
According to a DoD memo about the medical home model, patients have primary-care managers (PCM) who may be physicians or other licensed health-care professionals, who serve as beneficiaries' first contact with the health-care system. PCMs may refer patients for specialized care when needed, while providing ongoing continuity and coordination.
Rodarmer explained that patients will be considered integral parts of the health-care team, rather than passive recipients of care. The model depends on patients and providers being proactive in developing and ensuring compliance with the treatment plan, and in communicating with other members of the team.
"We want a person to feel this is his or her personal health-care team," he said.