Aligning Military Readiness with Healthcare Equity: A Dual Path Forward

When we discuss healthcare equity, the conversation typically revolves around racial, ethnic, and socioeconomic disparities. However, military status—particularly for our 800,000+ reservists and National Guard members—represents another critical dimension of identity that shapes healthcare experiences and outcomes.

These service members, comprising nearly 38% of our total military force, receive fractured care as they move between military and civilian healthcare systems. During their civilian periods, approximately 70% rely on commercial healthcare providers who frequently lack an understanding of their unique health risks, exposures, and needs.

This is where The Joint Commission's healthcare equity framework provides a perfect template for improvement. The Joint Commission's accreditation standards now explicitly require healthcare organizations to identify and address disparities in care among the populations they serve. Military reserves and National Guard members represent precisely the type of distinct population whose care disparities must be addressed under these requirements.

How Military-Focused Improvements Satisfy The Joint Commission Requirements

The Joint Commission's healthcare equity accreditation process requires organizations to:

1. Identify vulnerable populations: Reserves and National Guard members clearly constitute a population with unique health needs and systemic barriers to appropriate care. A 2023 study found that 40% of these service members report care delays for service-connected conditions when navigating civilian healthcare systems.
2. Collect stratified data: By implementing military service screening questions in intake processes, healthcare systems can collect and analyze data on healthcare outcomes among military-affiliated patients—fulfilling a key requirement for demonstrating commitment to healthcare equity.
3. Develop targeted interventions: Creating specialized care pathways for reserves and National Guard members addresses The Joint Commission's requirement that organizations implement interventions to reduce identified disparities. These interventions might include military cultural competency training for staff, clinical competency training for staff on toxic exposure impacts, appointment scheduling flexibility for drill weekends, and care coordination with military health systems.
4. Engage the community: Forming partnerships with local military units and veteran service organizations satisfies The Joint Commission's community engagement requirements while creating valuable channels for improving care delivery.

The Quality and Safety Connection

Beyond equity considerations, military-focused improvements align perfectly with broader quality and safety requirements:

Military clinical and cultural competency training enhances clinicians' ability to recognize and appropriately treat health conditions like respiratory, cardiovascular, musculoskeletal, post-traumatic stress, and traumatic brain injury, etc.—conditions that are often missed or misdiagnosed in civilian settings. Studies indicate that approximately 28% of National Guard members report inadequate treatment of military-specific health concerns by civilian providers.

Improved screening and documentation of military service in electronic health records reduces medication errors and adverse events by ensuring providers have complete information about exposures and risk factors. This directly supports The Joint Commission's medication management and patient safety goals.

Coordinated care between civilian and military health systems reduces dangerous care fragmentation and promotes continuity—a core focus of accreditation requirements. Currently, health information exchange between these systems occurs effectively for only about 30% of the nation’s reserves and National Guard members.

The Business Case for Implementation

Healthcare leaders understandably focus on initiatives that provide maximum benefit across multiple strategic priorities. Improving care for military populations offers precisely this kind of high-leverage opportunity:

• Financial benefits: Military service members typically have stable insurance coverage, making them a reliable payer source. Additionally, recognized military competency can position healthcare systems to receive specialized grants and contracts.
• Workforce implications: With reserves and Guard members living in nearly every community in America, healthcare systems that meet their needs effectively gain access to a potential recruitment pool of skilled individuals with demonstrated commitment to service.
• Community reputation: Visible support for military families enhances community standing and builds positive relationships with influential local stakeholders.

Implementation Framework

Healthcare organizations looking to simultaneously improve military readiness and fulfill healthcare equity requirements should consider this phased approach:

1. Assessment: Add military service and affiliation questions to patient intake forms and analyze existing data to identify potential care disparities.
2. Training: Implement military clinical and cultural competency training for clinical and administrative staff, focusing on recognition of service-connected health concerns.
3. Partnerships: Establish formal relationships with local military units, VA facilities, and Veteran Service Organizations to facilitate information sharing and referral processes.
4. Process adaptation: Review and adjust appointment scheduling, medication management, and care transition protocols to accommodate military-specific needs.
5. Measurement: Develop dashboards that track care outcomes among military populations, aligning metrics with both The Joint Commission requirements and DoD readiness standards.
   
   

A Strategic Win-Win

As healthcare leaders seek efficient pathways to meeting regulatory and accreditation requirements while advancing their missions, the military readiness-healthcare equity connection offers a compelling opportunity. By recognizing reserves and National Guard members as a population requiring equity-focused interventions, healthcare organizations can simultaneously satisfy accreditation requirements, improve quality and safety, reduce cost, and contribute to national security and public safety.

The path forward is clear—it simply requires healthcare leaderships’ recognition of this strategic alignment and commitment to implementation.