Buckeye Federal Healthcare Consortium Agreement: Q&A with the 88th Medical Group commander

  • Published
  • By Amy Rollins
  • Skywrighter Staff
Wright-Patterson Air Force Base --  An agreement was signed May 1 at Wright-Patterson Air Force Base in an effort to dramatically improve the timeliness of medical care to veterans throughout Ohio and optimize the training and readiness of personnel at the Wright-Patterson Medical Center (WPMC).

Col. Timothy Ballard, commander of the 88th Medical Group (88 MDG), and Jack Hetrick, network director for Veterans Integrated Service Network (VISN 10) signed the agreement to create the Buckeye Federal Healthcare Consortium, charged to optimize the utilization of Department of Defense and Veterans Affairs medical resources in Ohio, Indiana and Kentucky. The agreement will allow the VA to send veterans to WPMC for inpatient or outpatient services, expanding the current relationship between VISN 10 and DOD.

Q. Col. Ballard, what does this agreement mean to the Wright-Patterson Air Force Base community?
A: To be honest, WPMC has been on a "watch list" from a review called the "Modernization Study" with recommendations for downsizing. Part of the concern is that we have an abundance of underutilized clinical specialties and inpatient capacity. Unfortunately we don't always have enough TRICARE beneficiaries in the region to meet the productivity or "currency" requirements to justify our staffing.

For clarification, "currency" entails an exposure to medical case complexity that optimally prepares our medics for what they can expect to see in a combat environment. This agreement provides more subspecialty throughput and currency exposure to our staff. This ultimately allows us to justify our existence in the eyes of the Modernization Study and therefore maintain a robust medical presence for the Wright-Patterson AFB community.

What may also not be realized is that we have significant partnerships with the Greater Dayton Area Hospital Association (GDAHA) and Wright State University through our Graduate Medical Education program. At any given time, we have roughly 150 physicians in residency training embedded throughout virtually all of the Dayton area hospitals receiving specialty training. We gain better-trained physicians, while local hospitals gain critical staffing support - for free. Obviously if WPMC were to be downsized, the domino effect could jeopardize all local hospitals.

Q. Will it make it harder to get appointments and care for people who are not from the VA? Will it be harder to make an appointment to see a primary care physician? Will there be less access to the base pharmacies now?

A: The new Buckeye agreement is solely for specialty care, not primary care. All patients enrolled to WPMC will still have the same access to their primary care manager. There will be no VA care provided in our primary care clinics.
For specialty care, we are required to prioritize the care for our enrolled beneficiaries over the VA. There will still be specialty care available at WPMC under the same access standard of 28 days or less for an appointment. In reality, we are utilizing excess capacity in our inpatient side and with our specialty clinics and providing it to the VA. We do not expect any change in the ability of our TRICARE beneficiaries to be seen at WPMC.

Q. How will the veterans get their care? When does that begin?

A: We had already been providing care for veterans prior to the approval of this agreement. What this agreement does is expand our availability across the entire VISN 10. Additionally, as federal partners, this agreement allows us to provide a discount to the cost of their overflow purchased care. It ultimately incentivizes VISN 10 to look to us first if they either do not have capability or timely access to care within their system. Veterans will get their care via referrals and care coordination between the VISN 10 hospitals/clinics and WPMC.

If a veteran needs either inpatient or specialty care that isn't available within their system, their staff will consult us to see if we can provide that care. Once we accept it, we're obliged to provide that episode of care. We are able to do that within the VA's access care standard of 30 days or fewer. WPMC's standard is 28 days. We provide more timely access than is required through the Choice Act.

Q. How will the 88 MDG benefit from the agreement?

A: First, our staff will gain tremendous experience by managing more complex patients than we typically see in our facility. TRICARE Prime beneficiaries are among the healthiest in the nation. Seeing VA patients allow for more case complexity, which translates into currency. Second, by partnering with the VA we can show increased productivity and throughput that are essential to justifying our existence for the Modernization Study review.

We have 57 inpatient beds; the expectation of the DOD is that on any given day, our census is 50 percent of that. We've been averaging 25 beds filled. By having just five VA patients a day in-house to exceed 30 via the Buckeye agreement, we will hit our mark and reach a critical milestone.

There are very specific business-related issues we are concerned about that this partnership helps address. We're opening up hundreds of appointments during the next six months, and we're hoping to admit hundreds of patients to our specialties after the veterans have consulted their primary care physician. Our surgical specialty product line - dental; orthopedic; urology; ear, nose and throat (otorhinolaryngology); neurosurgery and more can benefit, as well as our medical specialties - endocrinology; cardiology, rheumatology; neurology; obstetrics and gynecology and the like, having capacities to see patients.

Examples of ancillary areas that may be accessed by VA patients, depending on our capacity, include physical therapy and optometry. Emergency services will be involved minimally.

Product lines that won't be involved in the agreement include primary care, family practice, internal medicine, pediatric medicine and flight medicine.

Q. Any other thoughts?

A: Unfortunately, there's a misperception that if you are a TRICARE beneficiary, you could get better care in the civilian sector. There is a misperception that Air Force or DOD medicine is substandard. We follow all of the protocols that the "downtown" hospitals follow. We were recently given a three-year accreditation by the Joint Commission, which is the same accrediting agency that provides that service to all civilian hospitals. Our quality of care is comparable to any other hospital out there. We've been No. 1 in the DOD for three years in a row for inpatient satisfaction.

Our primary care clinics received Level III certification - the best possible rating - from the National Committee for Quality Assurance. I am very proud of our incredibly motivated staff here. Our providers offer as high or higher quality with reference to quality of care than our civilian counterparts.

Our staff is excited about this agreement. How often do you get to talk to a veteran about his or her wartime experiences? Veterans have phenomenal stories that our junior Airmen need to hear.