Medical Management Guide, 2009, Version 3.0 - Tricare

Page 176Appendix C - DefinitionsVersion 3.0Medical Management GuideMilitary MedicineEvery Service’s delivery of health care within their departments, under the leadership of the Surgeon General,varies in its administration (i.e., different programs and services). Refer to each command/headquarters’references for more specific information. Military medicine within the DoD collaborates closely with the VA.Resources:Army Medicine—Army Medical Command (AMEDD): http://www.armymedicine.army.mil/index.html.Air Force Medicine—Air Force Medical Service (AFMS): http://www.airforcemedicine.afms.mil/.Navy Medicine—Bureau of Medicine and Surgery (BUMED): https://navymedicine.med.navy.mil/.Department of Veteran’s Affairs (VA): http://www.va.gov/.Milliman Care Guidelines ®Published by Milliman USA, these guidelines are a set of standardized criteria used in Medical Managementprograms, such as UM. The Guidelines are valuable management tools for treatment that span the continuumof patient care, describing best practices for treating common conditions in a variety of care settings. Used inconjunction with the healthcare professional’s clinical judgment, they define the assessment and treatmentmodalities that should occur at the primary care level prior to referral for specialty care.TMA maintains an enterprise-wide license annually for use by MTF personnel within the DCS and is user/password protected.Milliman Care Guidelines produces annually updated, evidence-based clinical guidelines that span thecontinuum of care, including chronic care management. The Milliman Care Guidelines ® provide much more thanjust authorization criteria, driving high-quality care through such tools as care pathway tables, flagged qualitymeasures, and integrated medical evidence.The current best evidence is optimal only when it allows healthcare professionals to make decisions about thecare of individual patients in an efficient and timely manner. To that end, the Care Guidelines are incorporatedinto easy-to-use software. From Web-based applications, to interactive software producing real-timemanagement reports, to handheld versions, Care Guidelines software makes the current best evidence readilyavailable for use where it matters: at the point of care.Resources:Milliman USA: http://www.milliman.com/.Milliman Care Guidelines: http://www.careguidelines.com/.CareWeb (Client Access): http://www.careguidelines.com/login-careweb.htm.National Defense Authorization Act (NDAA) 2008/NDAA 2007The National Defense Authorization Act (NDAA) 2008, Title XVI — Wounded Warrior Matters, acknowledgeschallenges associated with caring for wounded, ill, and injured (WII) ADSMs and their families. Under Title XVI,the law outlines specific screening, referral, and management requirements for PTSD, TBI, and behavioral healthconditions.