other department. Examples of these joint activities are discussed later in this report.

The Lovell FHCC differs from other DoD/VA health care collaborations in several significant aspects. It is intended to be a single organization—a federal health care center rather than a military treatment facility or a VA medical center—that features a single chain of command, a consolidated funding source, and, to the extent possible, health care service delivery that is seamless for the patient, regardless of whether he or she is a VA or a DoD beneficiary. The hope is that the design of the FHCC will overcome some of the barriers to cost reduction and integrated service delivery remaining in even the most functional joint ventures and other sharing and exchange arrangements between DoD and VA health care facilities.

The Lovell FHCC was planned to be a 5-year demonstration of what can and cannot be accomplished with an integrated organization, but pressure to establish additional federal health care centers is strong and increasing. It is driven partly by the desire for a seamless transition of the wounded and injured from the wars in Iraq and Afghanistan who can no longer serve from active duty to veteran status. It is also driven by the desire to reduce the costs of health care for active duty and retired servicemembers and their dependents and for military veterans, a desire that will only increase as the United States struggles to reduce the federal budget deficit.

In 2010, the acting assistant secretary of defense for health affairs asked the Institute of Medicine (IOM) to undertake and report on an evaluation of the Lovell FHCC by December 29, 2012. The formal DoD statement of task is found in Box 1-1.

In response, the IOM established a 15-member committee with the appropriate expertise to determine the following:

  1. if the integrated health care system represented by the FHCC in North Chicago has been beneficial in terms of access to, quality of, and cost of health care; mission readiness of Navy personnel; patient and provider satisfaction; clinical education and training; and research opportunities; and
  2. whether the FHCC would be a good model for similar mergers around the country where VA and DoD medical facilities are in close proximity.

The committee membership includes experts in executive medicine (including former DoD and VA health care executives), clinical medicine and nursing, health care organization and management, health care quality, health information technology, graduate medical education, and health care program evaluation. Short biographies of the committee members and staff are found in Appendix A.



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