In 2014, The Secretary of Defense, Mr. Chuck Hagel, challenged the MHS to review their performance in access to care, quality of care, and patient safety.

"Overall, MHS performance mirrors what we see in the private sector, a good deal of mediocrity, pockets of excellence, and some serious gaps.”
Janet M. Corrigan, Ph.D. Distinguished Fellow, The Dartmouth Institute for Health Policy and Clinical Practice

"We cannot accept average when it comes to the care of the men and women in uniform and their families."
Mr. Chuck Hagel, Former Secretary of Defense

If you'd like to see more of the details, here are a few links that will help:
- Summary Website
- The MHS Review Final Report
- Quality of Care Data Used in Report

• National Committee of Quality Assurance (NCQA) HEDIS Measures
• Joint Commission (JC) ORYX Measures
• Agency for Health Related Quality (AHRQ) Indicator Measures
• National Perinatal Information Center (NPIC) Measures
• National Surgical Quality Improvement Program (NSQIP) Measures

The reality is quality measurement has proliferated over the past decade, which has made tracking and monitoring performance a complicated affair.

• There are ~300 quality measures endorsed by the National Quality Forum
• They cover federal, state, and private organizations
• They cover the heathcare of approximately 120 million Americans

• Developed by the National Committee of Quality Assurance
• There are 81 quality measures across 5 different domains
• They are used by 90% of American health plans
• NCQA requires accreditation of results before public reporting
  
  
• The MHS routinely measures 18 of the 81 measures

This graphic uses 2015 data which is publicly available at this website

The final project will be a Shiny R application that utilizes the dataset in the previous slide. The application will have several parameters that can be used to show patterns of variation that might be of interest.

• There are important caveats to this information:
  • Data quality often plays a role in some of the variation noted
  • The MHS is a combined direct care (military facilities), and purchased care (civilian facilities) system so some of the variation is from the civilian sector care
• The intention is to look at variation, which means we will not be comparing against benchmarks - so I caution against interpretation independent of the benchmark for comparisons.
• Finally, the opinions expressed in this briefing are that of the author alone, and do not reflect the opinions, beliefs, or policies of the US government.