Former LRMC Commander new TRICARE Deputy Director

New TRICARE Deputy Director Brings Patient Focus to Job

By Donna Miles
American Forces Press Service

WASHINGTON, Oct. 11, 2011 – With a fresh focus on patient care –particularly for wounded warriors and their families -- the new deputy director of the TRICARE Management Activity said today he’s committed to ensuring TRICARE’s 9.6 million beneficiaries worldwide get the care and services they deserve.

Army Brig. Gen. (Dr.) W. Bryan Gamble, who assumed day-to-day oversight of TRICARE earlier this month, brings a long resume of assignments as a physician and commander in the military health system to the job.

Some of the most profound, he said, were his tours as commander of Landstuhl Regional Medical Center in Germany during the height of the surge in Iraq, as surgeon to the U.S. Central Command commander, and for the past two years, as commander of Eisenhower Army Medical Center at Fort Gordon, Ga.

All reinforced what Gamble called his central focus.

“My heart is with our wounded warriors and their families,” he said during an interview with the Pentagon Channel and American Forces Press Service. “And it is not just the wounded, but also their families who have needs and also require our love, attention and concern.”
Gamble demonstrated that commitment during his most recent assignment, where surveys at Fort Gordon revealed a 6 percent increase in patient satisfaction rates, to more than 93 percent. The number of patients who left its emergency room without being seen dropped to less than 1 percent. In addition, Gamble doubled the capacity of the post’s residential treatment facility and enabled its traumatic brain injury clinic to the Army’s first to secure a Category 1 validation.

Meanwhile, Gamble worked closely with the Department of Veterans Affairs, developing a connection he called “really crucial” in providing rehabilitation to wounded, ill or injured warriors.

Now, at the helm of the Defense Department’s comprehensive health care plan, Gamble said he plans to build on the lessons he’s learned as he promotes readiness, preventive care and patient satisfaction – all while controlling costs within an integrated system.
Gamble isn’t a total newcomer to TRICARE. He served with the organization in 1999 and 2000 as it was introducing clinicians throughout its structure. The result, he said, is a more integrated system that’s more focused on delivering comprehensive and quality services to beneficiaries wherever and whenever they might need it.

Active duty service members and their families pay no enrollment fees and no out-of-pocket costs for any type of care under TRICARE Prime as long as care is received from the primary care manager at their military medical facility, or with a referral. All other beneficiaries, such as retirees, pay annual enrollment fees. Despite the first enrollment cost increases in 15 years, Gamble said, TRICARE still represents the best deal around. The increases, expected to be about $5 a month for family coverage, are “fairly modest,” he said, particularly when compared to what’s available in the civilian sector.

“When you look at the value of what the health care benefit is,” he said, “TRICARE really delivers value to [service members] and their families.”

The challenge, he said, will be to maintain this level of care and services through responsible financial management.
Gamble said he will continue encouraging beneficiaries to use the mail-order option rather than retail pharmacies to fill their prescriptions whenever possible. Navy Rear Adm. Christine Hunter, the previous TRICARE deputy director, was a big promoter of the mail-order option, which she estimated could save as much as $1 billion.

Gamble said he also plans to maintain TRICARE’s emphasis on preventive medicine, and the introduction of a patient-centered “medical home” concept that establishes a consistent, long-term relationship between patients and a team of providers.

As it focuses on keeping beneficiaries healthy, this concept reduces use of expensive emergency room services when patients don’t know where else to turn for nonemergency care. “It’s providing people the right care at the right place at the right time,” he said.

Gamble said he wants to hear from beneficiaries – through patient surveys, Facebook or any other means -- to ensure they’re getting the care and services they deserve. But for the most unvarnished appraisals, he said, he needs to look no further than his own family members, who rely on TRICARE for their own health care.

“My wife and children are beneficiaries, … and if something is not going to go right, I am usually the first that hears about it,” he said. “I and my family take part in this system, and I want it to be the best it can be.”