Latest / Military Broadcast Radio | MBR Talk / Oscar Mike Radio Joanne Frederick – Reforming TRICARE & Fighting for Communities

Transcript

Oscar Mike Radio Joanne Frederick – Reforming TRICARE & Fighting for Communities · Military Broadcast Radio | MBR Talk

0:06
Hello and welcome again to OM Radio.
0:08
My name is Travis, Marine Corps veteran and your host OM Radio's
0:13
Co producer sentenced to 1 productions.
0:15
What's your podcast doing? I want to thank my sponsors TNT
0:19
Pin Company and Outright dot AI, and my supporters Case on
0:23
Shaving Company, Exceptional Parent Magazine and Forces
0:27
Brands USA. This year is just coming to an
0:33
end fast. I hope your holiday season is
0:35
going to be great. And my next guest is a different
0:38
kind of guest. I like the fact that I'm getting
0:40
to engage with people who, you know, work in and serve our
0:43
military investors in different ways.
0:45
I want to welcome Joanne Frederick of Government
0:48
marketing strategies to Awesome Micro Radio.
0:50
Joanne, what a pleasure. Thank you, Travis so much.
0:53
I am very happy to be here and and be a different kind of
0:56
guest. Hopefully that's good.
0:58
Well, it is I'm, I mean, you're, you're weren't apparent that you
1:03
are a nonprofit. You, you are a corporate entity,
1:05
but not really a corporation. The strictest sense of the word.
1:08
You know, you're not a, there's just a lot of things you're not,
1:11
but I'm very interested in what you are.
1:13
So, you know, this is all good stuff as we talk about how this
1:18
entity works with government, healthcare, with military and
1:21
veterans. And I'm just excited to learn
1:23
more before we get into all that good stuff.
1:27
Who is Joanne? How did you get involved with
1:29
this kind of work and where did all that originate from?
1:32
And I love the kind of background too.
1:34
Oh yeah, you know, good. I'm glad a little bit of of
1:38
extra entertainment today. So I start really got started in
1:42
the healthcare industry in the late 80s and sort of in a very
1:46
strange, nuanced place of healthcare.
1:48
And that is a company that developed a computer system that
1:53
paid Part B claims for Medicare beneficiaries.
1:56
So sort of an obscure little tiny piece of the the system.
2:00
And back then, the government bought services from private
2:04
companies in a very different way.
2:07
And that was changing. So I had the opportunity to lead
2:11
a project in that time of change.
2:14
And I think it's important, Travis, that I had no idea what
2:16
I was doing, nor did anyone around me.
2:20
But you as a Marine can appreciate that sometimes we
2:23
just need to, you know, raise your hand and go take the hill.
2:27
Right, Sir? So so I did.
2:30
We were successful and sort of over the next couple of years
2:34
that company continued to be successful.
2:36
And then I started my own firm in 1992 to really continue that
2:41
work. And that work is sort of a
2:44
either mediator or a matchmaker between how the government buys
2:48
stuff, services, supplies, software and what private
2:53
industry then delivers to the government.
2:55
So again, mediator, sometimes a matchmaker, sometimes translator
3:01
to make those two things come together in a way that serve all
3:05
of us taxpayers. And I've been very blessed to
3:09
work in the military healthcare system, the Tricare program
3:12
since 1992 and started working on contracts for the veterans
3:17
program a couple years later. So I have spent my career, for
3:21
which I am so grateful, really working to make the programs
3:25
that deliver services to our military and veterans work
3:28
better. Some of us out there now, now
3:33
pardon me for saying this, when we just think that the
3:35
government says, you know what, we're going to go down to the
3:36
proverbial Walmart or Costco and buy the stuff we need and that's
3:41
all there is to it. Somebody tells me there's a lot
3:44
more involved than just picking up vendor and going with it.
3:48
There is a lot more involved and I and I think the complexity is
3:52
part of the challenge and part of the opportunity.
3:56
So there are all kinds of federal rules and laws on how
3:59
the government buys things and there's you know size
4:02
restrictions and small businesses and veteran owned
4:05
small businesses etcetera. But really what it comes down to
4:10
is sort of clarity from the beginning of the kind of chain
4:16
to then what a a veteran or service member experiences when
4:20
they go get healthcare or frankly, when they go to, you
4:23
know, the the to buy supplies or whatever they need at the
4:27
commissary. So there's a whole massive
4:30
machine Gov con, you know, government contracting that
4:35
makes all that happen. And sometimes it works great,
4:38
and sometimes it doesn't work great at all.
4:41
And you know, our job is to make it better.
4:43
That's my mission, make it better.
4:45
Because, well, you you're buying on the federal level, but I also
4:50
have to consider is there implications when you, you know,
4:55
buy something for somebody in Florida versus Iowa or you know,
4:59
Montana? So the state, so it's federal,
5:03
but the state and municipal has to figure into at some point
5:06
too, right? It depends on the the program.
5:09
So really the Veterans Administration or, and the
5:13
military health system, which is managed by the Defense Health
5:16
Agency, that's really run at the federal level.
5:19
And those agencies have a exemption to state law in some
5:23
cases it's called federal preemption.
5:27
So they get to do things a little bit differently because
5:29
the money is federal and it, it comes down through the federal
5:32
system. Now states are involved because
5:36
states have, you know, again, I'm mostly do health insurance
5:40
or health programs. States have state health
5:44
departments and they states have a lot to do with sort of what
5:49
happens on the state level relative to how the healthcare
5:54
system works or maybe it doesn't work so well, etcetera.
5:57
So that's part of the complexity.
5:59
Travis, you're really pointing to is how do we make these
6:03
really large systems all work together and align in the right
6:06
way? So the veteran or the military
6:09
member or the military family member that goes to, you know,
6:13
an urgent care center or a physician in the community is
6:16
getting what they want, need and want and at the right time.
6:19
And that's a challenge. Let me if I may use an example
6:24
from a guest that was on earlier this year.
6:28
It was ACEO of PDS Optical and what that gentleman does is he
6:34
has two plants, one in Florida, one in Kentucky and they make
6:38
eyeglasses for the VA. OK.
6:43
Now just curious how, how would your organization interface with
6:48
PDS Optical because he was describing it as it was not a
6:51
straightforward process initially getting into, you
6:55
know, that system and becoming a VA preferred provider.
6:59
And I was just incredulous. I thought how hard could it be?
7:03
So explain some of the relationship and how that works.
7:07
Yeah. So remember, massive system, the
7:10
Veterans Administration, the massive system, right?
7:12
It employs hundreds of thousands of people.
7:15
It has a very large central office in DC.
7:18
It currently operates on 18 visions or veteran integrated
7:23
service networks. They're collapsing that 18 to 5.
7:28
So there's a combination of centralized and decentralized
7:33
power spending contracts, etcetera.
7:35
That happened years ago that was more decentralized.
7:41
This VA Secretary King Kaiser really conceived of the this
7:45
sort of decentralized system because Healthcare is local and
7:49
really we need to be able to to make those decisions at the
7:52
local level that best serve the people that are, you know,
7:55
getting health care from that that area.
7:58
As time has gone on, you know, that's not always the most
8:02
efficient way to do things. So if you buy if, if every VA
8:06
Medical Center buys eyeglasses individually on an individual
8:11
contract basis, perhaps there's not a great opportunity for
8:15
economies of scale. So at some point along the way
8:19
in the last 15 years or so, VA we're really on a, on a strategy
8:25
to start a consolidating centralized some of that
8:28
purchasing. So all VA medical centers and
8:31
all veterans would then benefit from, you know, better pricing,
8:34
which is good for taxpayers and good for, you know, the country,
8:37
the whole and the right quality veterans deserve their very best
8:42
quality products and services we can deliver.
8:44
So we want to make sure at the federal level that that we're
8:48
giving those contracts to the folks that deserve them the
8:50
best. So in that system, in that
8:54
transaction between the government needs to buy
8:56
something and a private company needs to sell something, that's
9:00
where I work. OK.
9:03
So and it, and the reason why I'm needed, frankly, is in my
9:07
company and my team is because it's complicated and it's
9:10
complex and it changes over time.
9:13
Congress comes down, they have a great idea.
9:15
They pass a new law and that sort of sends the whole system
9:18
topsy turvy and we have to go back and and adjust and adapt to
9:22
whatever the latest, you know, incremental new thing on top of
9:26
the existing wall is. So it frankly requires folks
9:29
that really understand all of those regulations, understand
9:33
what the company wants to deliver.
9:36
So in your case, the eyeglasses company would get under a supply
9:41
schedule and and have be an approved vendor exactly right to
9:44
deliver those eyeglasses to any number of veterans or or VA
9:49
medical centers. It's not always been that way
9:52
and it's not that way for everything.
9:55
So that's. Yeah, exactly.
9:59
So we've been talking about veterans, but there's also a
10:03
relationship, as I understand with military healthcare, you
10:07
know, active duty service members, if I understand
10:10
correctly, correct me if I'm wrong.
10:12
How does that relationship work? Because as you said, the VA is
10:16
the largest single healthcare provider in the United States.
10:18
That's a massive system. But then you also are taking
10:21
care of all the, there's also acquisition and purchasing
10:26
medically for our, our service members who are serving right
10:29
now. How does that work?
10:31
And that can that's his own, you know, bag of complexity right
10:34
there. Absolutely.
10:36
So I think a lot of people, and it is completely rational to
10:41
believe that this is true, that the military health system that
10:44
takes care of our service members and the VA health system
10:47
are the same. In fact, they are entirely
10:49
different and one could argue redundant in some cases.
10:53
So the military health system, and you're right, takes care of
10:57
the active duty service members. It also provides health services
11:02
to those active duty, the family members of those active duty
11:06
service members, and then retirees of the of the Tricare
11:12
program for folks who have been 20 years or more in service.
11:17
So if you do 20 years of military service, then you're a
11:20
military retiree and you get additional benefits, including
11:24
healthcare benefits as a military retiree.
11:27
But again, that is completely redundant to the VA healthcare
11:32
system. So both systems have hospitals,
11:35
clinics, etcetera. Both systems employ physicians,
11:39
nurses and you know all the all the people that make a
11:42
healthcare system run, they have a different mission.
11:47
The military health systems mission is readiness to make
11:50
sure that our that we are ready to answer the call when the call
11:54
comes. And the veterans health care
11:56
system, really their mission is to honor the service of those
11:59
who have raised their right hand and gone in, gone in harm's way.
12:04
So again, it's but to your point, it's redundant.
12:10
There are acquisition and purchasing on both sides and
12:12
they buy the same thing. And of late, there's some more
12:16
sharing happening and there's been sort of demonstration
12:18
projects where sharing happens. And there's a Medical Center in
12:21
Lovell that actually has a single Medical Center that takes
12:25
care of both military and, and veterans.
12:27
And they share an electronic health record, you know, all
12:29
those. So, so we're getting there.
12:32
But it, it's, you know, the, the complexity is multiplied.
12:37
So the systems are duplicated. And people have been talking for
12:42
a very long time. Let's combine them.
12:44
But they're very powerful. Both of them are very powerful
12:49
systems and no one can agree who should be subordinate to the
12:54
other, so as a consequence they remain separate today.
12:58
But you're still an intermediary.
12:59
I have to think that there's not very many entities, corporate
13:04
non profit or otherwise, that could necessarily do what you do
13:08
and only say. The reason I say is because
13:10
you've been around for a long time.
13:11
You've seen the changes in technology, the changes in
13:14
administrations, and the desire for Americans to see their their
13:18
veterans taken care of. How, how have you been able to
13:23
account for this change but deliver the service that you
13:26
want throughout this time, Joanne?
13:30
Yeah, I think that's a great question, Travis.
13:31
I appreciate that. So, so let's kind of harken back
13:35
to the beginning of the process, right?
13:36
Congress is a law, and that law, you know, can say any number of
13:40
things and some of them are good and some of them are not.
13:42
We, we can debate that another day.
13:45
That law gets turned into statute and regulation, and that
13:50
statute and regulation then often turns into a contract
13:54
requirement. And that contract requirement
13:57
may or may not be aligned with the original goal of what that
14:04
law was to be. So it's sort of like a game of
14:07
telephone. If you were played telephone,
14:10
right, you have one and it gets passed to here and it gets
14:13
passed to here and it gets passed to here.
14:14
And in some cases, these laws are thousands of pages long.
14:19
So by the time it makes its way all the way down to the agency
14:22
and to a contracting officer who's writing a contract
14:25
requirement to go buy whatever is needed in order to fulfill
14:30
the letter of the law. Sometimes what gets purchased is
14:34
not completely aligned with the goal.
14:40
And it's not really anyone's fault.
14:42
It really is the complexity that that sort of happens in a system
14:46
of, you know, thousands and thousands of people and that
14:48
takes months and months of time, etcetera, etcetera.
14:52
So there are other folks that do what I do and there's, you know,
14:58
some of the big consulting firms do what I do, but what they
15:00
don't have is doing this before there was the Internet in the
15:04
e-mail. So I started this in the early
15:06
90s, right, Right. There was no e-mail then, right?
15:09
So, you know, we were faxing things because we had to.
15:13
Now unfortunately a lot of the healthcare system still faxes
15:16
things, which we absolutely have to fix.
15:19
But you've to to be able to see now the 6th or 7th generation of
15:25
some of these contracts and how we buy things is very useful
15:30
frankly. And to be able to say, I know
15:34
you think you want this, but we tried this 15 years ago and here
15:39
are the ways we should adapt and change in order to not fall into
15:42
that, you know, same tar pit that we fell in then.
15:46
And that's a lot of the work we do is sort of just as I said,
15:48
mediating to say, OK, the words say this, the goal is something
15:53
else. And how we get there might be
15:55
some different combination than the folks who are sort of
15:59
sitting down and writing the requirement would think of.
16:02
And that's it's a puzzle. And I guess that's, you know,
16:05
appeals to my nature is to figure those puzzles out.
16:09
So that's really what we do. It's a puzzle, but it's people's
16:12
lives who are impacted by the by the work that you do.
16:16
You might not be seen as a direct provider of that service
16:19
or that, you know, object that they might need, but still it
16:23
has to get there. And I guess I'm harkening back
16:26
to the old phrase for one to the nail, the shoe was lost and you
16:32
know it. Without you, shoes get lost all
16:34
the time. Which leads me to my, my, I'm.
16:40
I'm very curious. Then you have this length of
16:44
experience, this breadth of perception.
16:46
How do you lead your team to align to what you want to get
16:51
the outcomes you're trying to do for the the the active duty
16:54
service member or veteran? Yeah.
16:56
That's a great question too. So it has to be mission first,
17:00
right, Mission 1st. And sometimes you know it in a
17:05
contract working for, we work with some of the country's
17:08
largest companies. The missions don't always align.
17:14
So, and I'll give you an example.
17:15
So we have, you know, the healthcare system in the United
17:18
States is comprised of for profit publicly traded
17:22
companies. Whether that's a good or bad
17:24
thing, we can debate that another day completely.
17:27
But their mission, publicly traded companies, for profit
17:30
entities, their mission is to return value to shareholders,
17:34
full stop. That's what they're there for.
17:36
So we have these companies delivering service to veterans
17:41
and military service members. And frankly, we need them
17:45
because there aren't, there are a few others who can actually
17:47
provide those services. And by and large, they do a
17:50
really good job, good hearted people.
17:53
But sometimes there's tension between the mission and the
17:58
mission is the very best healthcare we can deliver to
18:01
that veteran or service member. Again, full stop.
18:04
Sometimes that tension arises where, well, we could do it a
18:08
little less expensively and make more money, or we could do it a
18:12
little differently, maybe make less money, but the outcome for
18:15
the veteran would be good. And I sometimes find myself in
18:20
conversations sort of trying to call us all to the better angels
18:24
of our nature, like, OK, it's OK to make profit.
18:27
Companies in this country have to make some profit.
18:29
That's the, you know, makes the world go round.
18:33
But where's that line between mission first, Let's provide the
18:38
very best service we can and still stay in business, you
18:43
know, in order to continue the mission and continue that
18:45
forward, that way forward. So that has happened several
18:48
times in my career. It's like, well, we could do it
18:51
that way. We might make more money, but
18:54
it's not really kind of back to the intention and back to that
18:58
mission and that calling for me, it's a way to serve.
19:02
I didn't serve in the military, but, you know, I feel like
19:08
having the opportunity to serve in this way and to make sure
19:11
that these programs are really delivering the the right
19:15
services is my small way to contribute.
19:19
And again, I'm honored and honored to do so.
19:22
You raise a very good point where more and more Joanne, I'm
19:25
I'm I'm finding out how much I don't know.
19:28
And one thing is that I'm discovering that I really enjoy
19:30
getting to find out is how many women didn't serve, but now have
19:37
a nonprofit, a company like yours or their own product and
19:44
they didn't serve. They love their country.
19:46
They love the the people that serve our country and want to
19:50
make sure they're taken care of. I'm curious though, where, where
19:53
did that come from? Because everybody's different.
19:56
So I'm curious where that desire to serve really came from in
19:59
your personal professional life. You know, family members who
20:03
serve grandfather and you know, hearing stories and photos,
20:08
etcetera, uncles served in Vietnam.
20:10
So understanding that, you know, as you know, as your listeners
20:14
know, there is something in some of us that that we feel
20:21
compelled to answer that call. And in some cases it's raising
20:24
your right hand and and serving in the military.
20:26
In some cases it's, you know, being a family member or a
20:29
spouse of a military member, and in some cases it's, you know,
20:35
having a company that does this. And I think we could do a lot
20:39
more as a nation to help the spouses of serve active duty
20:43
service members, start companies and, and find employment,
20:48
etcetera, Because there's, you know, PCs season, right?
20:51
So it's really hard to, to start and maintain a career if you're
20:55
moving every two years or under, you know, the, the, the having
20:59
the opportunity to move every two or three years.
21:01
And there are certainly programs out there that that really are
21:04
focused on spouse employment and what those programs are, we
21:08
could do better. We should do better because
21:12
those folks, again, we're all serving in some way.
21:16
And it's how do we optimize the system so we can, you know, be
21:21
our best, be our best selves in that service?
21:25
Change is constant and you've had to see change over the
21:29
course of your career and your company growing.
21:32
Now I, I don't know, you know how it works in, in your world,
21:36
but sometimes in my world changes, changes.
21:40
Change is bad. It, it, it's, it's unknown,
21:42
Joanne and no one wants to do it.
21:45
But sometimes you have to make change.
21:47
So I'm curious what happens when you say like, you know what this
21:50
way is not working or it could be better, better outcome for
21:54
the company taxpayer and the veteran we got to make this
21:58
change and you get you meet that resistance.
22:01
How do you how do you challenge that?
22:04
We're doing that right now actually, Travis.
22:07
So I mean, I do that a lot. I I'm known as the disruptor
22:09
actually. So if I see a wall and like
22:12
we're going through that wall. So, you know, come along or
22:15
watch your decision. But for example, right now the
22:20
military health system, the Tricare program, which is really
22:23
the health plan, right, that provides healthcare services to
22:27
active duty service members, family members and retirees, has
22:31
been essentially the done the same way since 1992 when I
22:35
started. There's been a couple changes
22:39
along the way, but by and large, the contracts and the way we
22:42
deliver the service hasn't really changed in 34 years.
22:46
So about a year ago, my team and I, blank piece of paper, started
22:51
redesigning it because it's frankly not working as well as
22:55
it should. Now good intentioned, good
22:58
hearted people, both on the government side and on the in
23:01
the contractor community trying to do their best, but it's still
23:05
falling short. So we just started as a, you
23:08
know, either a fit of stubborn or curiosity or something.
23:13
Let's, let's redo it. Let's figure out what it would
23:15
look like. And because I have that history,
23:19
it was hugely helpful in that endeavor.
23:21
So we created a a kind of reform, a transformation of the
23:26
the Tricare program we call Patriot Health and have
23:29
published white papers and have met with leaders in the agency,
23:34
Defense Health Agency. And here's what I get.
23:38
This is really bold. This is a great idea.
23:42
Now you need to go talk to this person.
23:45
So that's what I do. I keep talking to people.
23:47
So I we've been to Defense Health Agency, been to the
23:50
Pentagon, been to the Hill, Capitol Hill, like, OK, we can
23:55
do this. We can, we can muster the
23:58
courage to actually start making this happen.
24:02
So that's how you breakthrough change.
24:04
It's you know, OK, let I'll who do you need me to talk to?
24:08
I'll go, let's let's go. Let's have that conversation
24:10
because it's only through those conversations that the concept
24:13
gets better. It's not perfect.
24:15
I wouldn't claim it's perfect, but until we sit down and look
24:19
at it and say, you know what? I had lunch yesterday and long
24:22
time colleague of mine said, you know, if you did this and I was
24:26
like, God, that's brilliant. Tiny little change, huge impact.
24:30
We're like, oh, you're right. Let's let's bring that in as
24:33
well. So that's that's how we do a
24:35
change. It's you.
24:36
You keep talking. You keep having a conversation.
24:40
Especially when you bounce against people who don't agree,
24:43
right? Those are the people I want to
24:44
talk to. I want to talk to the people who
24:46
say no, that'll never work. I'm like, OK, come on, let's
24:49
let's have a conversation about it.
24:51
And what happens when you start having that conversation and you
24:55
start seeing the the the alignment?
25:01
Well, it's exciting. You know, it's exciting at the
25:04
beginning and then it, it doesn't move fast enough, right?
25:07
So, yeah, this is a really great idea.
25:09
We should talk about this more. And then three weeks later,
25:11
you're still trying to get another meeting.
25:13
And so, so it's a bit of a roller coaster ride, but we're
25:19
committed to to, to continuing the conversation.
25:23
Change has to come to that system.
25:27
You know, the, the, the military treatment facilities, the bricks
25:31
and mortar facilities that are training our military medical
25:34
personnel are not seeing enough patients now in some locations
25:39
to ensure that those military medical personnel are ready to
25:44
provide care on the battlefield when they get called.
25:48
You're right, it's not if it's when and they just don't see
25:52
enough patients today because of all sorts of things.
25:55
But you know, by and large, you know, budgets, the way the
25:59
budget was structured, it's easier to, you know, send care
26:04
out to to the community than it perhaps it is to make sure you
26:09
have all the right staff in the facility to do a particular
26:13
procedure, etcetera. But that's harming the readiness
26:17
mission. And that's something we can't
26:18
afford as a nation or or as a military.
26:21
We can't afford to degrade the readiness mission.
26:25
So part of Patriot Health is how is it, how does it work in
26:30
service of the readiness mission?
26:31
And how can we get the visits, get the patients back in the
26:36
military treatment facilities to ensure our military medical
26:39
personnel have the knowledge, skills and abilities they need.
26:43
So when that call comes in, they will provide flawless care
26:49
downrange. And that's that's the goal of
26:51
the military health system. So from your perspective as you
26:56
know your agency, how do you see improvement to make that happen?
27:03
I mean, what what are you doing as you know, government
27:06
management, government marketing strategy to, you know, help
27:09
facilitate that? Yeah, I think it's part of the
27:12
the Patriot health model, right. So the one of the ways the
27:15
system works today is, you know, there are multiple contracts
27:19
that sort of deliver the entire benefit.
27:21
So there's a pharmacy contract that's separate from the medical
27:24
contract, that's separate from the dental contract.
27:26
And then there's some other ancillary contracts that go
27:28
along with it. Each of those contractors has
27:33
essentially that they, they have to build redundant systems and
27:37
IT solutions. They, they do exactly the same
27:40
thing and then everybody builds it.
27:43
So that's a multiplier in expense for essentially no
27:48
upside, right? If, if 10 companies have to
27:52
build and deploy the same piece of software, that's 10 expensive
27:57
pieces of software and some of them don't always work that
28:01
well. So, you know, the, then the, the
28:04
beneficiaries suffer when things don't go.
28:07
There's been some things in the news recently about referrals
28:10
not working and and people really not being able to get
28:13
access to the care they need. And that's because new contract
28:16
got awarded, new systems had to be built.
28:19
They weren't quite ready for a whole host of reasons, both on
28:23
the government and the and the contractor side.
28:26
So our question is, you know, why can we build once and deploy
28:31
many? And when you do that, you have
28:34
to do it well because there's some benefit in redundancy,
28:38
right. There's a back up plan in case
28:39
something goes wrong. But we think we know there's a
28:43
way to sort of balance that, balance the the economics of
28:50
build once, deploy many with the required redundancy.
28:53
So we don't have all our eggs in one basket.
28:56
And it's that kind of that's the depth of the conversation like,
29:01
well, can we really do that? What does the law say?
29:04
Well, the law does not prohibit us from doing that.
29:07
What is there a regulation? Is there a manual somewhere that
29:11
says we have to do this X or Y? But back to your point, after,
29:15
you know, 34 years of this, I know what the manual says.
29:18
And importantly, I know what it doesn't say.
29:21
And we find out. I find myself in those
29:23
conversations a lot. No, it doesn't actually say
29:25
that. Here's what it says.
29:27
Now what can we imagine? Not well, this is the way we've
29:33
always done it. I mean, that's like waving a red
29:35
flag in front of me, right? OK, that's, that's good.
29:40
And we have to remain curious. And we have to keep asking that
29:43
next question and lean into change, not back away from it.
29:48
That's how things get better. You lead in this way.
29:54
You know the rules. You know what aren't the rules?
29:57
I have to thank them. You have a good idea of where
30:02
military medicine and, you know, the care providers should go to
30:07
future state. So what I'm trying to ask is in
30:12
Joanne's world, if you had the way to architect this better,
30:17
how would that look compared to what it is now?
30:19
Yeah. Absolutely.
30:21
So you know, actually folks can go to our website at Market
30:25
Strategies online slash Patriot Health and read all about it for
30:28
yourselves. So essentially again, right now
30:32
there's all these silos, we do all these contracts
30:34
individually. And what we've done with Patriot
30:37
Health is pulled the commonality into sort of an integrated
30:41
chassis, if you will, that all the commonality gets built on an
30:44
integrated chassis. And then on top of that is a
30:49
single national federal provider network.
30:54
And right now in today's world, all the different contractors
30:59
each have their own contracted network of providers.
31:02
And you people here in the news all the time, you know, so and
31:05
so hospital isn't going to be in this network.
31:07
And all of us have faced challenges with a providers out
31:10
of network. So the government buys a
31:12
contracted network in each of the individual silos.
31:16
No need for that. Buy all of that in the single
31:19
consolidated, we call it Fedmed in the single consolidated
31:25
contract runs for 10 years and then all the health plans that
31:33
provide support then use that single network.
31:36
So it eliminates a huge amount of cost.
31:41
Contracting a provider network is extraordinarily expensive.
31:43
You wouldn't think it was, but it is.
31:46
And on top of that, in today's system, the Tricare providers
31:52
are paid at a discount off of the Medicare fee schedule.
31:56
So if Medicare pays $100 for a visit, it often times for a
32:01
Tricare patient, that provider will get $80, sometimes $60.00
32:07
of that hundred to treat that Tricare patient.
32:10
So what that means is those providers are less willing to
32:14
see Tricare patients, not because they're not patriotic,
32:18
but because they have a business to run as well.
32:22
So if that physician can see a Medicaid patient and get 40,
32:28
sixty, $70 more for that same exact type of care, they're
32:35
going to take it. Yeah, yeah.
32:37
So the reason, another reason for the Fed Med contract is to
32:41
get that discount out of the system.
32:44
So we treat providers, to quote a colleague of mine, we treat
32:49
the medical providers as the most valuable athlete on the
32:52
field. So when our military
32:55
beneficiaries go to them, then, then they get, they have access
32:59
and they get the care. And that mental model, most
33:03
valuable athlete, right, applies then to the military physicians
33:09
and nurses and ancillary providers, all the folks that
33:11
make that system run. It's, it's honoring that
33:15
relationship between a patient and their healthcare provider
33:19
and making it as seamless and supportive as possible.
33:24
Because when people are healthy and, and feeling well, then
33:27
everything works better, the military, our communities,
33:30
etcetera. So that's sort of part of this
33:33
system as well. Now, what's the likelihood or,
33:36
or I'm going to say likelihood, but if you would have to phase
33:40
this in and I, I agree with you, it, it, it doesn't.
33:44
I've always wondered why, you know, I, I had the military
33:48
care. I wasn't Tricare because I
33:49
didn't have, you know, children. I wasn't in long enough.
33:53
But I always wondered why there was such a disconnect between
33:56
the care received in the military and the care received
33:59
from the VA, why my records didn't just port over when I got
34:05
out and I had to do this stuff all over again.
34:09
So I, I do agree with you that, I mean, I mean, if it was a
34:12
single stream, it would be OK. I'm just going to go from Yuma,
34:16
AZ, where I serve to, you know, wherever they're going to type
34:20
in my, you know, service number and there's all his records
34:24
right there. And I, and I've never gotten a
34:26
good answer for that. I've been told, well, you know,
34:28
we got to have, you know, guard rails and stuff like that.
34:31
But it, it, it doesn't make sense to me, Joanne.
34:34
And I'm curious if other people are thinking the same way.
34:37
Absolutely. And we've been talking about
34:38
that issue, Travis, for as long as I've been in this world,
34:41
right. And you know, having chatted
34:45
with a lot of service members and, and some of the wounded
34:49
service members, you know, the burden we put on them to
34:52
remember all of their medical information when transitioning
34:56
between those two systems is absurd.
34:58
Frankly, it's absurd. It's still not 100% fixed.
35:01
I'll tell you, it's still a problem today.
35:03
Now it has gotten remarkably better in the last few years,
35:08
858 years or so, remarkably better.
35:13
And they're, one of the things that's happening right now is
35:17
the, the VA system is adopting the Oracle Cerner electronic
35:21
health record. And that's the same software
35:24
that the military health system has.
35:27
So once the VA finishes their implementation and they got
35:31
started and then there was a pause and they're started again.
35:34
And things are sort of on a great track right now.
35:37
Once that's done, then there actually is a single medical
35:41
record. Nah, it's going to take a couple
35:44
of years for us to get there. But, but the reason it has
35:48
happened is 2 reasons. One, they were two separate,
35:52
they are two separate systems, two separate budgets, 2 separate
35:56
cabinet secretaries, 2 separate kingdoms and power.
36:01
You know, money is power. So if you neither system was
36:07
willing to capitulate and say we'll let you take the, you
36:11
know, have the medical record for all of us because that's a
36:14
huge budget and dollars and and money is power.
36:17
So that never really worked out. Now we've sort of gotten
36:21
ourselves past that. Now there's more opportunity to
36:24
do that, to have a look at how those systems would work
36:27
together. But there's it's technology is
36:32
not the problem. Will is not the problem.
36:36
It is, you know, business, business decisions in the way of
36:41
making that easy is, is has been historically the problem and
36:44
hopefully we're working our way through those right now.
36:47
Your own company, you've been the only company for a long
36:49
time. You have people working for you,
36:51
but beyond you know, you know GMs and what it does and what
36:56
you do. What is next for Joanne the
37:00
person? Oh, Travis, I don't know.
37:05
You know, I I'm here. Fortunately I have I'm on my
37:09
grand great grandparents farm, which had been out of the family
37:12
for some years and I was able to get back in the family.
37:16
So that's an honor needs lots of work.
37:20
They were dairy farmers. I am not.
37:23
And, you know, tangentially related to the farm is the fact
37:28
that, you know, we're currently under threat of losing some of
37:31
the farm due to eminent domain for a power line in order to
37:37
feed the data centers in Virginia.
37:39
So some portion of my life has been consumed by sort of
37:44
fighting for the, the, what I will say is injustice of
37:50
condemning private land, conserved forest and and
37:54
preserved farmland in service of data centers.
37:59
Now we need data centers. I'm not saying that, but I am
38:03
saying that there are better ways to power those data centers
38:08
then condemning in this particular case, this 167 mile
38:13
line is 1200 acres of Maryland that will be destroyed for it.
38:17
So what's current and next for me is continuing that fight
38:22
because we're all under threat of having our land condemned for
38:28
a transmission line for the the energy that's needed to feed the
38:33
the demand growth across the nation and that's not OK.
38:37
Close this loop have has your experience in, you know, working
38:42
in the government giving you an edge with how to do this fight
38:48
in this room? Yeah, for sure, very helpful.
38:51
I'm used to, you know, a lot of times in my quote day job, we'll
38:56
get a call, a company wants to take on a big, you know, very
39:00
complex project or win a very complex contract.
39:03
And we sort of go in and, you know, issue orders and get the
39:06
team organized and all start moving out in different areas.
39:10
And when this power line project came up, I had less than 24
39:13
hours notice of sort of the first announcement.
39:18
I did the same thing, Travis. I'm like, OK, we're going to
39:21
need groups of people. They're going to need to do
39:24
different things. We're going to need to end up at
39:26
this place. And it is proven to be very
39:28
useful. It is also very time consuming
39:32
and you know, I feel greatly for there's about 409 properties
39:36
subject to condemnation if this line gets approved.
39:40
So it's been a very significant battle.
39:43
And you know, we're all put in a place at a time for a reason.
39:48
Who knew that me coming back here would then end up with
39:53
starting a nonprofit organization and, and fighting
39:56
for my neighbors and that's and for what's right and justice.
40:01
So that's check back with me after I win that fight and then
40:06
we'll talk about what comes after that because right now I
40:08
do not know. You know, it's a serious issue
40:10
and I don't mean to make a lot of it, but I have to say, you
40:13
know, I don't know you that well.
40:14
I've only just met you, but you know, in, in, in many ways,
40:17
Joanne, you, you sound very U.S. Marine Corps like, like there's
40:22
a, there's a little Marine Corps in you somewhere, a little devil
40:24
dog and, and Joanne and you know, I, I, well, it's just nice
40:28
to see someone like yourself find hard for those who are
40:31
serving and have served. Travis, thank you.
40:36
That is one of the most special things anyone has ever said to
40:40
me. That is such an honor I really
40:41
appreciate. That I mean that sincerely
40:44
because you know, you're funny behind the scenes and I, I
40:47
understand administrative violence.
40:49
I do, if I can say it like that, it, it takes something out of
40:53
you to do it. And it's just as it's just as
40:56
the stakes are just as real as if I'm holding my, you know,
41:01
control panel for my Hawk missile.
41:02
So much respect. But that leads me to, you know,
41:09
we're looking at threats in China.
41:11
We have situation in Iran. We have other things going on in
41:13
the world. And, you know, you could argue
41:17
that we're we're having fewer and fewer veterans every year
41:20
due to the World War 2 veterans dying off.
41:23
And we're not in these big huge, you know, worldwide wars
41:28
anymore. They're small conflicts.
41:30
What's the future of military medicine for active duty and
41:35
veterans look like, like purposes.
41:38
It was a shocking to me to understand when I was in the,
41:41
you know, and I didn't serve in combat, but where where I
41:44
served, if you got hurt out in the desert, you were probably
41:48
dead because they couldn't get to you in time to get you back
41:51
to Yuma regional or to, you know, the base to get you worked
41:55
on. By the time they got a
41:56
helicopter out there, you're probably dead.
41:58
We had, but now I'm seeing through, you know, these
42:01
different conflicts where, you know, a person gets hurt on the
42:05
battlefield and if they get him back or her back within 90
42:08
minutes, that life is saved Like it.
42:12
I, I didn't think that was possible.
42:15
And it just makes me want to ask, like, what do you think the
42:17
future of of battlefield care and veteran medicine looks like,
42:22
Joanne? Yeah, actually this is a hot
42:24
topic and I go to military conferences and etcetera.
42:30
So you know that the people in Ukraine and the conflict in
42:35
Ukraine and while we're not obviously directly involved in
42:38
that has from the folks that I talked to again, I have not been
42:43
there, but has really demonstrated the coming change.
42:48
And I think the change we're seeing even now potentially in
42:51
Iran on the battlefield and that is the drones and the the damage
42:57
the drones can do. So you're absolutely right.
43:00
The golden hour was the measure, right?
43:02
If we could get that service member off the from the point of
43:06
injury and get a medic to them and get them evaced and back to
43:11
the next level of care and the next level of care.
43:13
That first hour was critical. And our military is really good
43:18
at that. Amazing to your .9 minutes.
43:21
You've got someone, you know, getting the care they need.
43:24
Unbelievable, unbelievable. And credit to all the folks who
43:28
made that happen. Here's the problem.
43:30
Now we don't have air superiority anymore because of
43:34
the drones. So now you have someone wounded
43:39
and you can't get to them or you can't get them out because
43:43
there's drones in the air and it's not safe.
43:47
So the military's spending a lot of time and very, very smart
43:51
people working on that issue. That's an issue.
43:55
So I think that will be solving that issue.
43:59
And it could mean that that the golden hour is how do we get to
44:05
the patient or how do we keep near that frontline the things
44:10
that those individuals might need if we can't get them out or
44:14
get the things in. So how do we re you know,
44:17
consider what does battlefield medicine look like in the
44:21
scenario where you are, you can't transport in or out.
44:27
And that's terrifying on one hand, and I know that the
44:32
country's best minds and smartest people are working on
44:35
that. And I've got 100% faith.
44:38
But that's the new world we're looking at.
44:40
And you can certainly see that happening in Ukraine and Russia
44:44
and Iran. I think we'll continue to see
44:46
that over the future. And that's that's the next
44:49
challenge to which we need to rise.
44:52
Closing this conversation down, we could talk for hours on time
44:57
flies on having such a great time.
44:59
But you're an entrepreneur at heart.
45:02
You started this business many years ago.
45:04
You've kept it going through the technological changes this
45:06
country's gone under, societal changes, so on and so forth.
45:10
A lot of my fellow veterans, including myself, want to get
45:13
into their own business, their own thing, and grow their own
45:17
company. And what's what advice or
45:22
strategy would you tell us to follow to make that happen?
45:26
How? Many one.
45:32
Raise your right hand to yourself and take the first step
45:34
because you got it. You got it.
45:37
It's scarier. I mean, it's scary.
45:39
Don't get me wrong. I have moments still.
45:41
I've been doing this a long time and I still have moments of oh
45:43
gosh, what have I done or what am I doing?
45:47
There's lots of support. There's lots of organizations
45:49
that help veterans start businesses.
45:52
There's something called the rule of two in the VA
45:56
acquisition system, which says if there are two qualified
46:01
veteran owned small businesses that can provide that service,
46:05
that contract is eligible only to veteran owned small
46:09
businesses. So do some research, figure out
46:13
where there's a gap in what the government buys and what people
46:18
are selling and start a company and look for people like us will
46:22
help you and go out there and make a difference.
46:26
So that's that's my advice. Go do it.
46:31
Fantastic. All right.
46:33
Last but not least, how can people like myself or the
46:37
veterans you're talking about connect with you and government
46:40
marketing strategies if if we need help?
46:43
Yeah, absolutely. So market strategiesonline.com
46:46
is our website and if you want to read about Patriot Health
46:49
back slash Patriot Health and then on LinkedIn and I can send
46:53
you the link Travis to the because that's a long mouthful
46:57
to say that LinkedIn, but you can find us on the web there.
47:01
You can send an e-mail, connect with us, etcetera.
47:03
And you know, we'd be more than happy to help in again in
47:07
service, and that's what we're here for.
47:10
Well, I will have those links in the Osmic Rio show post.
47:12
Ladies and gentlemen, I just want to thank Joanne for coming
47:15
on and talking with me. And you know, I, we, we condense
47:19
this, but I learned a whole lot in a short amount of time.
47:21
Would like to keep learning more and understand how this works
47:25
because to me, in closing, this is just you can't understand how
47:29
I get that that pair of glasses that I'm not wearing right now,
47:33
but should be wearing. But anyway, if I didn't
47:36
understand how they actually got there.
47:38
And it was a very interesting story.
47:39
So thank you for sharing with us.
47:41
All the best and I hope to talk to you again soon.
47:45
Absolutely, Travis. My pleasure.
47:46
Thank you. I'm Travis OM Radio.
47:49
There you go, Joanne Frederick with government marketing
47:51
strategies. We'll see you next time.
47:53
We are mission in flight. Every generation, every
47:58
sacrifice, our nation's service members have stood up for our
48:01
freedom, our families, and our future.
48:04
Now it's our turn to stand up for them.
48:06
This year, you can honor their service in a deeply personal way
48:09
by sponsoring a $17.00 Veteran's Wreath.
48:12
Each wreath is more than a symbol.
48:14
It's a heartfelt tribute to the heroes who served and to the
48:17
families who carry their legacy. Visit wreathsacrossamerica.org
48:21
to sponsor a wreath today. This isn't just a wreath, it's a
48:24
personal gift to an American hero.
48:28
Thank you for listening and watching OM Radio where our
48:32
active duty service members and veterans are in action and the
48:36
mission is in flight. OM Radio is an oversized load
48:44
coasts to one production. If you are a veteran or you're a
48:49
veteran who needs help, please dial 988 and press one for the
48:55
Veterans prices line.