Department of Defense case study

Modernizing healthcare to address the invisible wounds of war

In 2007, Congress undertook an examination of how healthcare was provided to active-duty military service personnel and returning veterans. As a result of this study, the Department of Defense (DoD) pursued important actions to modernize the military healthcare system and create a more integrated model.

One of the special actions emanating from this transformation initiative included an expansion of capabilities regarding traumatic brain injury and the psychological health of warriors and their families.Psychological and cognitive injuries are sometimes overlooked and easily misunderstood. Brain trauma frequently results in psychological conditions that encompass a wide spectrum of post-injury issues and challenges. Proper diagnosis and treatment of these injuries and related conditions are critical elements in advancing the care of those affected.

The Congressional studies of military healthcare revealed an opportunity to enhance the quality of care in these areas, and soon afterward, the DoD developed and implemented a number of new healthcare programs. Funds were obligated for additional infrastructure and an effort to enhance world-class capabilities to assess, treat, and survey patients for follow-up care.

The DoD saw the need for an advisor with extensive capabilities and deep experience to help with extending the current capabilities of the military healthcare system. In February 2008, the Department asked PricewaterhouseCoopers (PwC) to help establish the Defense Centers of Excellence (DCoE), a new organization within the DoD.

In particular, PwC worked closely with the client on program development for the National Intrepid Center of Excellence (NICoE), a DCoE operational component scheduled for completion in late 2009. Its mission is to provide intensive outpatient evaluation and diagnosis, initial treatment plans, family-centered education, "telehealth", and long-term follow-up services for wounded military personnel, veterans, and their families or caregivers."PwC’s role", explained PwC director Aloha McBride, "includes helping shape the DCoE organization, providing strategic planning, communications, program design and operations, integration, and program evaluation. We will help our client strategically plan for and organizationally develop capabilities to meet its mission.

"To military personnel who have been affected by psychological or cognitive injuries and to their families, the newly integrated system of care will represent a significant change.Existing healthcare programs will be consolidated into a more integrated system of care. This integration will ensure the DCoE is better positioned to address the entire continuum of traumatic brain injury and psychological health challenges. Under the new system, military personnel will have a continuum of psychiatric care that monitors them before, during, and after their tours of duty. The new system will also revitalize efforts to re-integrate returning veterans back into their chosen communities.For PwC, the effort is more than an ordinary assignment. As Aloha explained, "There is tremendous motivation within PwC to contribute to such a worthy cause. This project has a uniquely human aspect because what we do is going to affect people who have selflessly served our country and who are trying to manage their injuries. PwC is fully dedicated to this effort."
The issues facing the client discussed herein, the advice given to it and the results achieved are unique to that client. The advice, solutions and results described in this document may not be applicable or appropriate for other entities or situations. This document should not be used as a substitute for consultation with professional accounting, tax, legal or other competent advisers.