Author: Joel Schofer, MD, MBA, CPE
NDAA 2017 Section 703 Report on MTF Restructuring
There is no classic post on Thursday because the DHA just released its National Defense Authorization Act (NDAA) 2017 Section 703 report on the Military Treatment Facility (MTF) restructuring. There has been a lot of press and info sent out, so here is what I’ve got:
Health.mil articles:
- Careful, deliberate changes ahead for select MTFs
- DoD to restructure 50 hospitals, clinics to improve readiness
Military Times article:
Health.mil page that has the entire report to Congress:
Here’s the entire report to Congress:
The February message from the Assistant Secretary of Defense for Health Affairs that discusses it:
Here is General Place’s message about it as well as the summary attachment he sent:
Teammates:
Today marks another milestone in Military Health System reform. This morning, the Department delivered a report to Congress outlining results from the MHS’s review of military medical treatment facilities (MTFs) and their contributions to military readiness. The extensive analysis was initiated in response to Section 703(d) of the FY17 National Defense Authorization Act. You can find the report here: www.health.mil/MTFrestructuring.
The report is the culmination of nearly three years of analysis that identified the MTFs critical to maintaining medical and force readiness. In other words, the department evaluated how facilities support service members so they are medically ready to train and deploy. Further, it assessed how well the facilities support our military medical personnel to develop and maintain the right clinical skills and experience required to support global military operations.
The report includes plans for changes in the scope of operations at 50 facilities across the United States. (See excerpt attached.) Some facilities will have expanded services while others will scale down. The largest change is the decision to transition more than 30 facilities to providing care for active duty personnel only. Seven of these facilities may continue to enroll active duty family members on a space-available basis.
We know these changes may cause concern because health care is very personal. Requiring our patients to leave a trusted provider at an MTF for another provider in the civilian network may cause anxiety for some. The DHA’s responsibility is to implement the changes the Department determined necessary, ensuring the least possible disruption for our beneficiaries.
It’s important for you to know restructuring changes will not occur immediately. We will only begin implementing these changes after thoroughly collaborating with local communities, MTF Directors, network providers, senior mission commanders, and others. The DHA will work closely with the TRICARE managed care support contractors to support the patients impacted.
In addition to creating implementation plans, the DHA’s next steps include a massive outreach and information effort. We will provide resources to MTF Directors so they can inform patients of what the changes mean for them. The process will take time and we will not transition any patients until we are confident the applicable local markets have providers available.
I’m committed to maximum transparency at every step so all stakeholders understand how these changes may affect them, and so those who rely on us retain uninterrupted access to health care. Above all, our focus must remain on producing great outcomes. That’s why the Military Health System exists. Together, we can adapt and strengthen the military medical enterprise so it is even more effective for the 9.5 million people depending on us.
rjp
Ronald J. Place, MD
LTG, US Army
Director, Defense Health Agency
Twitter: @DHADirector
Facebook: https://www.facebook.com/DefenseHealthAgency
LinkedIn: https://www.linkedin.com/company/defense-health-agency/
Web: https://health.mil/
MHS Minute: https://www.youtube.com/watch?v=IN4tgyAgWUY
Deadline is Friday for the 149th Medical Corps Birthday Ball – 7 MAR in Coronado, CA
The Medical Corps Ball will be held on the evening of 7 MAR 2020 on North Island in Coronado, CA in celebration of our 149th birthday. The details and registration info are available here:
Please disseminate this as widely as possible to all MC officers. We’re looking for an excellent turnout!
Also note that although uniforms are strongly encouraged, formal civilian attire is permissible as an alternative to dress uniforms for ALL Ranks ALL Services at this event.
Multiple Director Positions Available at NMC/NMRTC Portsmouth in 2020
Please read the below announcements of upcoming Director position vacancies at NMC/NMRTC Portsmouth:
- Director of Strategy & Operations (DSO) Vacancy Announcement June 2020
- Director of Primary Care (DPC) Vacancy Annoucement June-July 2020
- Director of Expeditionary Medicine (DEM) Vacancy Announcement June 2020
The timeline for the selection process is below:
- All applications for DEM, DPC, DSO due by 13 March. Any applicants would need to either be at NMRTC Portsmouth, already have inbound orders, or have Detailer clearance to apply.
- 16 March – 1 April – 1st Round interviews – Directorate Level board
- Week of 6 April – 2nd Round Interviews – top 3 selections for DEM, DPC and DSO will interview with XO, CO, PXO
Please direct any questions to the POCs for each position (contact info in the global):
CDR James M. Nogle, MSC, USN
Director, Expeditionary Medicine, Navy Medicine Readiness and Training
Command, Portsmouth
CAPT Jose G. Pedroza, DC, USN
Director, Primary Care and Branch Clinics, Naval Medical Center, Portsmouth/
Navy Medicine Readiness and Training Units, Portsmouth
CDR Shauna O’Sullivan
Director, Strategy and Operations, Naval Medical Center, Portsmouth
Occupational Medicine Fundamentals Provider Course – April 20-24 – NMC Portsmouth
The info is in this document:
Personal Finance for the Military Physician – A 2020 Update
Here are the slides I used for this podcast, in both PDF and PPT format:
Personal Finance for the Military Physician – A 2020 Update – PPT
Personal Finance for the Military Physician – A 2020 Update – PDF
My Research on Crowdfunded Real Estate Investing
I periodically suffer from investment boredom because good investing is boring. Investing in all the world’s stocks and bonds through low cost index funds is effective but not very exciting.
Whenever I get financially bored, I consider adding a 5th asset class to the 4 that are already in my investment portfolio (US stocks, international stocks, US bonds, international bonds)…real estate. While I know for sure that I have ZERO interest in becoming a landlord, crowdfunding real estate investing has opened up a new way to passively invest in real estate.
While I ultimately decided (once again) NOT to add a 5th asset class and keep my financial life as simple as possible, anyone interested in researching this can benefit from my thorough investigation. Here are all of the blog posts I read during my research in outline form. Enjoy!
- Real Estate
- 16 Different Ways to Invest in Real Estate
- Taxes
- REITS
- Assessing the inclusion of alternatives in target-date funds (this Vanguard research is why I don’t overweight REITs like a lot of other people do)
- Real estate crowdfunding
- Crowdfunding Debt vs Equity vs Syndications
- The Best Real Estate Crowdfunding Sites
- Tips For Real Estate Crowdfunding
- Real Estate Crowdfunding vs REITs
- The Best Real Estate Crowdfunding Sites for Non-Accredited Investors
- Is THIS the Holy Grail of Real Estate Investing?
- How to Build a Real Estate Crowdfunding Ladder
- When it Makes Sense to Utilize Private Real Estate Investments
- 10 Things To Know Prior To Purchasing an “Accredited Investor” Investment
- The Guide to Real Estate Syndications, Part I
- The Guide to Real Estate Syndications, Part II
- The Life Cycle of a Real Estate Fund
- Investing in Opportunity Zones: What’s This Amazing Opportunity All About?
- Is Real Estate Crowdfunding in Trouble?
- The Sad Demise Of RealtyShares: What’s Next, Alternatives, And Lessons
- Should I Invest in a Real Estate Syndication or Fund?
- Why It’s So Important to Diversify Your Real Estate Portfolio
- Is It Better to Invest Early or Late in a Real Estate Fund?
- 3 Important Things to Know About a Sponsor Before Investing
- Different Ways to Make Five Million Dollars in Real Estate
- Active vs Passive Real Estate Investing
- 5 Major Things To Look For In a Real Estate Fund
- Your Fear of Investing In Real Estate Is Totally Normal
- 6 Ways to Invest in Apartment Buildings
- Sites that review crowdfunding companies:
- Companies:
The FY21 O6 Promo Board Convening Order Emphasizes Operational Medicine and Readiness
What better way to spend a Valentine’s Day evening when your wife is out of town than this…
There are some new things in the FY21 O6 convening order. Grab both the FY20 and FY21 below and let’s take a look page by page:
FY-20 O6 Staff Corps Convening Order
FY-21 O6 Staff Corps Convening Order
The Method to My Valentine’s Day Madness
I went through both convening orders and noted the pages in the FY21 order that represent a substantial difference from last year’s order. I focused only on impact on the medical community (MC, NC, MSC, DC). In other words, if something was different for the JAG Corps or Supply Corps, I didn’t highlight it. Any pages not highlighted are functionally the same.
Page 2 of FY21
- The promotion opportunities changed:
- Medical Corps went from 81% to 91%
- Dental Corps from 89% to 90%
- Medical Service Corps from 60% down to 50% (bummer)
- Nurse Corps stayed the same at 50%
Page 8 of FY21
This is where the meat starts, the section entitled “Medical Community Considerations”:
The bold portions highlighted below are new from FY20:
Knowledge and proven performance/experience in a variety of settings including operational medicine, joint medical operations, and current garrison health care and fleet/FMF support is necessary.
Additionally, Navy Medicine greatly values joint experience and formal education, including JPME, with knowledge and experience in a variety of settings including joint medical operations and current garrison health care delivery and operational support initiatives.
Do you see a pattern here?
KEY MESSAGE – Navy Medicine is increasing its focus on fleet/FMF/operational support. Everyone needs to be operationally relevant to promote to O6.
Pages 9-10 of FY21
The following sentence is brand new:
Excellence in operational support settings should receive special consideration as Navy Medicine shifts greater focus to readiness and operational support.
Which brings me back to…
KEY MESSAGE – Navy Medicine is increasing its focus on fleet/FMF/operational support. Everyone needs to be operationally relevant to promote to O6.
Here is some more brand new stuff in bold:
Best and fully qualified officers for the rank of captain will be those with proven leadership experience who have demonstrated experience and expertise across the spectrum of military medicine, especially inclusive of operational experience and operational platforms. With Navy Medicine’s renewed focus on operational support and readiness, our future leaders must have shown leadership excellence in those activities.
Oh boy! I feel like I’m beating a particular drum…
KEY MESSAGE – Navy Medicine is increasing its focus on fleet/FMF/operational support. Everyone needs to be operationally relevant to promote to O6.
Read that again, people:
With Navy Medicine’s renewed focus on operational support and readiness, our future leaders must have shown leadership excellence in those activities.
MUST have shown. That’s a strong statement!
The Bottom Line
KEY MESSAGE – Navy Medicine is increasing its focus on fleet/FMF/operational support. Everyone needs to be operationally relevant to promote to O6.
TSP Changes and Finance Friday Articles
According to the January/February 2020 Thrift Savings Plan (TSP) Message from the Executive Director, a few important changes are coming:
- 5-year Lifecycle (L) Funds—Later this year, we’ll offer more investment options when we introduce new L Funds in 5-year increments. You’ll be able to pick an L Fund with a target date that more closely matches your intended retirement date. Each L Fund will continue to vary your investments automatically to adjust your exposure to risk as you get closer to retirement and give you the potential for long-term growth. Learn more about our Lifecycle Funds and individual fund options.
- Automatic enrollment percentage increase—Beginning October 1, 2020, new participants will be automatically enrolled in the TSP at 5% of their pay. This change also includes Blended Retirement System (BRS) participants automatically re-enrolled in the TSP on or after January 1, 2021. The increase will allow new participants to get the full matching contributions from their agency or service. If you are currently an active participant and are not contributing at least 5%, then you’re missing out on free money. Increase your percentage today by logging into your agency’s or service’s electronic payroll system and upping your contribution amount.
Here are my favorites this week:
10 things I wish I’d been told in my 20s
Investing Basics for Physicians With Little Time or Experience, Part II
Here are the rest:
A Real Estate Goal Every Investor With Kids Should Consider
Asset Protection for Physicians Through the Life Stages
Banks, Bitcoin, bond funds: Where is your money safe in an era of cyberattacks?
FY 2021 DOD Budget Request Seeks 3% Pay Raise for Service Members
How Real Estate Investments Go Bad
Make Spending Money Music to Your Ears: Spending Equalizer
Not So Common Student Loan Debt Forgiveness Programs
Start of tax season 2020 is prime time for scammers
The 4% Rule, HSAs, and Healthcare Costs in Retirement
Troops would see another big pay raise under White House budget plan for 2021
Three Years Retired from Surgery and all’s Well with my FIRE Life
What You Can Learn From Your 1099 Forms
Throwback Thursday Classic Post – Why I Started This Blog and How You Can Help Me
After the recent O6 results came out, I received an e-mail that went something like this:
“You don’t know me, but I was selected for promotion. Without your website and promotion board prep, I never would have promoted. I just wanted to thank you for all the work you put into it.”
I received a few more messages that were similar in nature. All I can say is, “You’re welcome. Now it is your turn to help me.”
The Origin of the Blog
In 2014, I became one of the Medical Corps Detailers. It didn’t take long for me to realize a few things:
- There was a lot of good career information out there, but it was on 20+ different websites.
- If I didn’t do something, I was going to be responding to the same questions and typing the same e-mails over and over again.
- There had to be an easier way.
There was. I created this blog. Then I created the promotion prep document. Then the fitrep prep document.
191,374 web hits later (that would be 484,260 now), the rest is history.
The Next Phase of the Blog
As I assume more senior leadership roles in the Navy, I find that my time is the bottleneck in the continuous process of trying to improve this blog. I’ve just got too much going on.
And this is where you come in…I need your help.
I Need People Who Want to Get Involved in the Blog
I periodically get guest posts, but they are few and far between. If you are interested in writing for the blog, send me ideas for guest posts. We will likely publish them.
Did something good happen to you in the Navy? That’s a guest post.
Did something bad happen to you in the Navy? What did you learn from it? That’s a guest post.
Did you figure something out that would benefit others? That’s a guest post.
Get the point yet?
Do you have ideas for where we should take the blog or ways we could improve it? Let me know.
Improving the Navy by Helping Each Other Out
This is really why this blog and all its resources were created. To help each other out and make our lives just a little bit easier. I don’t make any money off of it. In fact, it costs me $99/year to run.
If you’d like to get involved and try to help out your Naval colleagues, making their lives easier and improving their personal and professional lives, contact me and let me know. Maybe we can make this blog better together.
Joel Schofer's Career Planning Blog 