A recent Defense Department report finds that the military health system is meeting the needs of its youngest beneficiaries — but raises concerns that Pentagon officials don’t have enough data or information in some areas to make a complete assessment on the quality of care provided to dependent children.
The report, required by the fiscal 2013 National Defense Authorization Act, summarizes policies, programs and personnel related to pediatric care across the services and through Tricare.
“[The military health system] is meeting the needs of the children in its care, including those with special needs,” wrote members of the DoD working group that compiled the report. “The data confirm that the MHS provides comprehensive and high-quality health benefit programs for all children.”
But the working group then identified several issues — including DoD’s lack of a centralized health data system — that make it difficult to draw direct, complete comparisons between care across the services or in military hospitals or clinics versus private care.
The National Military Family Association, which has spent years lobbying for an analysis of Tricare’s services for children, found the report disappointing, said Karen Ruedisueli, the group’s deputy director for government relations.
“We expected a more thorough analysis of children’s access to care,” Ruedisueli said. “We hope this is just a first step in identifying the issues and the move forward.”
The 108-page report, the Study on Health Care and Related Support for Children of Members of the Armed Forces, also known as “Tricare For Kids,” concluded that children have adequate access to primary care and specialty care and that physicians with pediatric certification conduct more than 80 percent of the specialty appointments for kids.
But the gaps in data and need for “areas of clarification” noted in the report have called into question the findings, said a coalition of advocates, including NMFA, the American Academy of Pediatrics, MOAA, the Children’s Hospital Association and 11 other groups, which provided a collective formal response to the Defense Health Agency as the “Tricare for Kids Coalition.”
“An overarching theme woven throughout the report is the lack of data and meaningful utilization of data, or inability to collect data, which then limits the analysis in many of the elements examined,” the advocates wrote.
Among the biggest concerns, the advocates said, is the lack of a standard definition across the services and various health agencies of a child with special needs.
Also not evident is a plan to improve and monitor pediatric care, especially in light of the working group’s findings that Tricare’s “well child care” programs don’t comply with American Academy for Pediatrics guidelines or the Affordable Care Act.
“From the analysis presented in the report, it’s clear to me that DHA is not tracking the right things to be able to determine whether or not children can adequately access care. And they aren’t tracking compliance either,” Ruedisueli said.
Jeremy Hilton, an Air Force spouse whose daughter requires specialty health care, called the report a “starting place” and said it will help set standards for the health care of future military dependents.
“It’s not going to help my daughter,” he said, “but it gets the ball rolling so that someday, we may look back and say ‘What a great system we have for treating military kids thanks to the hard work that’s going on now.’ “
According to Hilton, the next step for advocates is to press for congressional hearings on the report’s findings.
“To borrow a quote from another advocate on this matter: ‘We’ve admired this problem for long enough. It’s time for action,’ ” Hilton said.
