GAO Report on Military Medicine

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There was a recent Government Accountability Office (GAO) report released that talks about the structure and deployment of military medicine. Here are the 1 page summary and full report, but a summary of its findings is:

The military departments each have their own processes to determine their operational medical personnel requirements; however, their planning processes to meet those requirements do not consider the use of all medical personnel or the full cost of military personnel. Specifically:

  • The Department of Defense (DOD) has not assessed the suitability of federal civilians and contractors to meet operational medical personnel requirements. Federal civilians and contractors play key roles in supporting essential missions, i.e. providing operational assistance via combat support. Military department officials expressed a preference for using military personnel and cited possible difficulties in securing federal civilian and contractor interest in such positions. An assessment of the suitability of federal civilians and contractors could provide options for meeting operational medical personnel requirements.
  • When determining the balance of active and reserve component medical personnel, the military departments’ processes generally do not consider full personnel costs, including education and benefits. Specifically, officials stated that the Army and the Navy do not consider personnel costs in their assessment of the appropriate balance between active and reserve personnel, and the Air Force’s analysis had some limitations. DOD policy states that workforce decisions must be made with an awareness of the full costs. Further, in a 2013 report, DOD identified the cost of unit manning, training, and equipping as one of five factors that play a key role in decisions concerning the mix of active and reserve component forces. By developing full cost information for active and reserve component medical personnel, DOD can better ensure an appropriate and cost-effective mix of personnel.

The military departments have taken actions, such as establishing policies and procedures, to assess the appropriate workforce mix for beneficiary care within Military Treatment Facilities (MTFs), but challenges remain. The military departments distribute military personnel across the MTFs and then use policies and procedures to consider risks, costs, and benefits to determine how to fill the remaining positions with federal civilians and contractors. However, a number of challenges, including lengthy hiring and contracting processes and federal civilian hiring freezes affect DOD’s ability to use federal civilians and contractors. For example, senior officials at each of the six MTFs that GAO spoke with cited challenges with the federal civilian hiring process, and five of six MTFs cited challenges with the contracting process. As a result, senior officials from five of six MTFs reported discontinuing some services and referring patients to DOD’s TRICARE network of private sector providers or Veterans Affairs facilities. The Military Health System (MHS) is also preparing for the phased transfer of administrative responsibility for MTFs to the Defense Health Agency (DHA), including management of the MTF workforce. According to GAO’s report on agency reform efforts, strategic workforce planning should precede any staff realignments or downsizing. However, according to a senior official, the DHA has not developed a strategic workforce plan. Without developing such a plan, the DHA may continue to face the same challenges experienced by the military departments in executing an appropriate and efficient workforce mix at its MTFs.

Finance Friday

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Here are this week’s personal finance articles:

Counting Down (a discussion about end of the year financial housekeeping)

Daylight Robbery (real life stories of bad things financial advisors have done to clients)

Financial CME #8: Test Your Knowledge

Is it Time to Take Some Money Off the Table?

Some Advanced 2018 Continuing Financial Education Reading

The View From Here (a discussion of how you should react to the recent stock market drop)

Vanguard Shareholders To Save Estimated $80 Million Through Broader Access To Low-Cost Admiral Shares

Update on the New Fitrep System

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The Navy released a NAVADMIN on the upcoming revamped fitness report and evaluation system. Here are the highlights:

  • ­The new evaluation system will place emphasis on merit over seniority or tenure. It eliminates forced distribution with relative ranking against peers in categorized groups within a command and instead rates the performance of a Sailor on paygrade­ based objective standards. These standards are captured in trait categories that reflect key attributes of professional competence and character.
  • Sailors are evaluated on value statements within these trait categories using an expanded 9­ point scale for greater accuracy and distinction. The evaluator responds intuitively during a short, timed window when providing a score for each value statement. This approach will apply to both the proposed coaching and evaluation processes.
  • The plan is to introduce this new design concept across the entire Fleet with an updated coaching phase while still using the current fitness report and evaluation system before they transition to the new evaluation process. They will deliver the coaching portion of the new system in mid­-2019 and the evaluation portion soon after.
  • There’s also a PPT slide deck that shows you some screen shots of what the new tool looks like and how it works.