Conspiring to succeed: the process of a joint military health care merger

Congress has mandated that the military services improve their health care systems to improve access, assure high-quality care, provide more choices, and contain costs. In response, the Department of Defense established the TRICARE system, organizing it geographically into 12 health services regions. This paper tracks the efforts of one of those 12--region IV--to plan for this change using strategic planning. Region IV's board of governors represents military facilities in Mississippi, Florida, Alabama, Tennessee, and Louisiana, including one clinic managed by the U.S. Coast Guard, Department of Transportation. Strategic planning usually involves people who know each other and work together. Because of the joint nature of this effort, the members were unfamiliar with one another and with the others' systems. There were also physical distances to overcome. This paper documents that unique experience, likened to a "corporate merger," and the lessons learned from it.