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19 Association of the United States Navy One of the biggest issues in health care today is "bending the cost curve." What are we doing to slow down or reduce ever-increasing health costs in military medicine? We're looking for ways to use health IT [Information Tech- nology] to not only to create efficiencies, but design the health system around our patients. In the DHA, we've brought together 10 shared services that represent about 80 percent of the processes that occur across all the military medical services… like health IT, our budgeting process, pharmacy, the TRICARE health plan, medical logistics, education and training. We… identified those areas where we have redundancies as well as where we might have under-re- sourced our efforts. By bringing services together, we were able to optimize the performance of each of those while bending the cost curve. For example: in medical VADM Bono has been the director of the Defense Health Agency (DHA) since late 2015. The DHA is a joint Combat Support Agency (CSA) that enables the military to provide a medically-ready force and ready medical force. The DHA supports integrated, affordable, and high quality health services to MHS beneficiaries as well as greater integration of clinical and business processes. Ten shared health services—representing about 80 percent of the medical processes—have streamlined to save $1.4 billion between FY14 and FY16. Bono was previously the director of the National Capital Region Medical Directorate and the 11th Chief of the Navy Medical Corps. Commissioned in 1979, she completed her surgical internship and general Surgery residency at Naval Medical Center Portsmouth. Following a Trauma and Critical Care fellowship, she served in Operations Desert Shield and Desert Storm as head, Casualty Receiving, Fleet Hospital 5 in Saudi Arabia. She also served in a number of surgical positions and appointed duties until her assignment as the director of Restorative Care at the National Naval Medical Center in 1999. For the next 16 years, she held positions of increasing responsibility until she was appointed to this position. Bono completed her undergraduate work at the University of Texas at Austin and her medical degree at Texas Tech University, and earned an Executive MBA from the Carson School of Business at Washington State University. She is a diplomat of the American Board of Surgery and has been awarded three Defense Superior Service Medals, four Legion of Merit Medals, two Meritorious Service Medals, and two Navy and Marine Corps Commendation medals. Interview with Vice Admiral Raquel C. Bono Director Defense Health Agency Aug. 8, 2017 By Diana B. West Continued on next page U.S. NAVY PHOTO

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