Preface |
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iii | |
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vii | |
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ix | |
Summary |
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xi | |
Acknowledgments |
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xv | |
Acronyms |
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xvii | |
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Introduction and Background |
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1 | (4) |
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Overview of the Military Health System |
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2 | (1) |
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The System's Dual Missions |
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2 | (3) |
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Options for Organizing the Military Health System |
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5 | (20) |
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Option 1: Current Organizational Structure |
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5 | (8) |
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MHS Organization for TRICARE |
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7 | (1) |
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MHS Organization for Readiness |
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7 | (5) |
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12 | (1) |
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Option 2--5: Alternative Organizational Structures |
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13 | (12) |
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Option 2: Modification of the Current Structure |
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14 | (3) |
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Options 3--5: Joint Command Structures |
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17 | (6) |
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Level of Consolidation of Operational Medicine |
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23 | (1) |
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Joint Command Versus Defense Health Agency |
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23 | (2) |
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Organization in the Private Sector and Tricare |
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25 | (18) |
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Organization of Managed Health Care |
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26 | (10) |
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How Managed-Care Organizations Are Structured |
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28 | (4) |
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Accountability, Performance Evaluation, and Incentives |
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32 | (3) |
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35 | (1) |
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Summary of Lessons from Civilian Health-Care Organizations |
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36 | (2) |
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How the TRICARE Organization Compares with Civilian Organizations |
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38 | (5) |
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Accountability, Incentives, and Information |
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40 | (2) |
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Lessons for TRICARE from the Private Sector |
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42 | (1) |
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Medical Readiness and Operational Medicine |
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43 | (14) |
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44 | (4) |
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Operational Medicine and Joint Doctrine |
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48 | (3) |
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51 | (3) |
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Readiness Objectives of the MHS Organization |
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54 | (3) |
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Other Assessments of the MHS Organization |
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57 | (12) |
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Previous Studies of Military Health System Organization |
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57 | (4) |
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Past Reorganization Objectives |
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61 | (1) |
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Interviews with Current Officials |
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62 | (6) |
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Reasons for Considering Reorganization |
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63 | (2) |
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Opinions on MHS Organization |
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65 | (2) |
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Other Organizational Issues |
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67 | (1) |
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Assessment of MHS Organization Over Time |
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68 | (1) |
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Assessing the Organizational Alternatives |
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69 | (20) |
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Examining the Alternatives |
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69 | (5) |
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74 | (1) |
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Measuring Performance and Providing Incentives |
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75 | (2) |
Appendix |
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A. Unifying the Training Curriculum |
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77 | (4) |
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B. Principles of Organizational Structure |
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81 | (6) |
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87 | (2) |
Bibliography |
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89 | |