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News | July 20, 2023

Tidewater Market Saves by Integrating and Optimizing Pathology Services

By Arif Patani

In a Defense Health Agency Market that serves more than 390,000 beneficiaries, U.S. Navy Capt. Stacie Milavec is the subject matter expert on all matters concerning clinical laboratory and anatomic pathology services.

So, when Naval Medical Center Portsmouth (NMCP) Commanding Officer U.S. Navy Capt. Shelley Perkins first asked her to look for ways to optimize services within the newly established Tidewater Market, Milavec, with more than 23 years of experience in military medicine, took on the challenge and immediately began to identify opportunities.

In 2022, Milavec established a Tidewater Market Laboratory/Pathology Integration Working Group with representatives from NMCP, the 633d Medical Group at Joint Base Langley-Eustis, McDonald Army Health Center, and members from DHA's Tidewater Market office. The working group began meeting monthly to discuss collaborative efforts and identify ways to cut costs by sharing resources.

"One of DHA's goals with setting up a market structure is to find efficiencies and optimize and standardize processes and services wherever possible," said Milavec. "We’ve been able to do exactly that by collaborating within our working group."

As an example of resource sharing, as a full-service medical center laboratory, NMCP had the capacity to take on pathology caseloads from the Market. The laboratory at NMCP began taking on head and neck pathology cases, Human Papilloma Virus (HPV) testing for all Market military treatment facilities (MTF), and supporting breast biopsy and PAP cases. All of these services were previously supported by other means and in some instances through commercially contracted laboratories for analysis at a price.

The working group’s efforts saved the Tidewater Market an estimated $80,000 during Fiscal Year 2022. The MTFs working geographically close to one another also equated to quicker turnaround times for test result availability.

Beginning this month, NMCP will take on additional clinical chemistry tests from the 633d Medical Group at Joint Base Langley-Eustis, which up until recently, were again sent to commercially contracted laboratories off base.

“[Through collaboration between the MTFs] We’ve been able to successfully transition civilian marketplace send-out testing back into the military market by utilizing market resources,” said U.S. Air Force Capt. Dianna Chormanski, a staff pathologist and laboratory medical director with the 633d Medical Group at Joint Base Langley-Eustis. “I’m a big fan of cooperation and working together, and that’s what a Market should be.”

Derived from the National Defense Authorization Act for Fiscal Year 2017, DHA established the market-based structure to consolidate the management of military hospitals and clinics into regions and to support the sharing of patients, staff, budget, and other functions across facilities to improve readiness and the delivery and coordination of health services.

The Tidewater Market, established in 2021, is the nation's fifth Military Health System market established to manage military medical treatment facilities that support the delivery of integrated, affordable, and high-quality health services for active-duty service members, retirees, Reservists and Guardsmen, and their families enrolled at Naval Medical Center Portsmouth, McDonald Army Health Center, the 633d Medical Group at Joint Base Langley-Eustis, U. S. Naval Hospital Guantanamo Bay, Cuba, as well as 14 health clinics in the Tidewater region.
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