How experiences shape military and Veteran health care

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PA 

Ladies and gentlemen, welcome to Let's Talk Healthcare Perceptions: How experiences shape the healthcare of military families and veterans. 

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PA 

 This session explores how lived experiences shape the care that military families and veterans receive and how the healthcare system can evolve to meet those needs. We're joined today by three leaders from OptumServe, the federal facing business within UnitedHealth Group. Ms. Christine Erspamer, Senior Vice President and Chief of Growth for Product and Strategy at OptumServe. Over her 12 years with the company, she has held senior roles in health services, program integration and advisory services, and previously worked in health management consulting with Accenture. 

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PA 

 Ms. Christi Kruse, 

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PA 

 Senior Vice President of Product at OptumServe. With more than 25 years of healthcare experience, she leads the development and management of products and capabilities that serve a wide range of federal customers. 

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PA 

 Brigadier General Peder Swanson. United States Army, retired Vice President at OptumServe. A 28-year Army veteran, he has served in both active and reserve components, including assignments in the Office of the Secretary of Defense and the Department of the Army. Before joining OptumServe, he led strategic planning and integration efforts in support of the U.S. Intelligence Community and continues to champion the needs of service members and their families. 

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PA 

 Please join me in welcoming Ms. Christine Erspamer, Ms. Christi Kruse, and Brigadier General, retired Peder Swanson. 

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 ( Applause ) 

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Christi Kruse 

 Good morning, everyone, and thank you for joining us for this conversation about how a person's lived experience impacts their perceptions of health and healthcare, and therefore how they integrate and how they interact with the healthcare system. About eight years ago, OptumServe embarked on a journey of listening, 

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Christi Kruse 

 deeply listening to those people that we serve, whether they be veterans, military service members, or their families, so that we could truly understand how their experiences changed them and how those experience needed to change how we serve them. 

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Christi Kruse 

 So we did this through an approach to research called ethnography. And ethnography is a kind of qualitative research that is done in the environment, where instead of asking questions, surveys, where you say, "How much do you, you know, do you like this and give me a rate or scale?" Instead, you ask open-ended questions in your subject's environment and just listen to them and let them talk and let them keep talking. And by doing that, you get not only surface answers, but you then learn the underlying answers and the underlying causes and the causes of that as well. As I said, we started on this journey in 2018 with our first ethnography with veterans. And this involved interviewing 125 veterans in five cities, from all branches of service, all components, active, reserve, and guard, to give us a foundational understanding of veterans' experience. And then in 2020, we did another study, and this one was with military families. We wanted to understand how active duty military service not only impacted those service members, and we kind of got an insight into that experience during the veteran interviews, but we wanted to understand the unique perspectives of their families, understanding that military families are an extension of our service members. 

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Christi Kruse 

 And then in 2025, earlier this year, we went back out into the field to understand even more what had changed. Between 2018 and 2025, there were some significant changes for these two populations. There was the end of the engagements in Iraq and Afghanistan, which have significantly changed our military family and active duty military experiences. On the VA side, there was the community care program, the passage of the PACT Act, which extended access for a lot of veterans within the VA. So we wanted to understand what had changed and deepen our understanding so that we could more deeply serve veterans and military families. In 2025, we did an additional 208 interviews, and we also did 50, 60-minute interviews with employees of VA, whether they be providers or non-provider employees, because we wanted to make sure we understood not just the experience of veterans, but also the other side of that experience, those providers and employees who are dedicated to delivering service to those veterans. This time, we were in six markets across the country. You can see those on the screen. So all told, this entire body of research represents over 500 hours of interviews, of sitting in someone's living room, sitting in their kitchen across their table and listening to their experience. The way we do this research, we start by sending them a journal. And in that journal, they collect their thoughts. And for many of them, especially some of our more senior veterans, we're talking about documenting 50 to 60 years of their life and calling back to mind all of those experiences and memories. And then we sit with them, and they walk us through that journal, and they talk to us about their experiences. And by aggregating those experiences, we start to develop an understanding of a service member and veteran and their family's life. And so we look at these different, we kind of track insights across this continuum of experience, starting with the mindset of the military family and their lifestyle and how that impacts their individual health journey. 

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Christi Kruse 

 And then we look at the actual military journey of that service member, 

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Christi Kruse 

 their transition out of the military, their process if they have a disability rating of how they went through that process, and then their current needs and their experience directly with the VA if they have one. Not every veteran we interviewed receives care from VA. And we did that on purpose because we wanted to understand those who did and those who didn't and understand why those who did not interact with the VA, why they didn't. Again, this broad picture of experience helps us understand how to best impact the system. A couple of caveats about this type of research, about ethnography. Although these studies were for their type very large. Most qualitative research like this is very, is limited. 

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Christi Kruse 

 But anytime you do qualitative research, you're really understanding one person's experience. And every one of us is different. And we know that veterans come from all walks of life. Military service members come from all walks of life. And so it's important that we don't generalize too far based on individual experiences. Which is why after the first research that we did in 2018, we did a follow-up qualitative, quantitative research to basically verify the findings. With that, that time we interviewed, we did a survey with 5,000 respondents who were, who aligned to the total makeup of the veteran community to make sure that we weren't extrapolating in ways that was not, that didn't truly reflect the experience of those we serve. 

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Christi Kruse 

 So as I said, the people that we talked to this time around in 2025 were from a variety of ages and military backgrounds. We made sure that we had a mix of genders, branch, rank, and discharge timing that reflected, truly reflected the veteran population and the military family population as it exists today. We also talked to people that served as far back as 1965 or separated, I should say, as far back as 1965 all the way through those who were serving today. And had experience serving across the globe in both peacetime and during times of conflict. 

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Christi Kruse 

 Those who, who served their entire time domestically and those who had experience overseas. Those in the active reserve and guard components. 

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Christi Kruse 

 In the first research, one of the things that we really wanted to understand is were there psychographic groupings? Psychographic segments of veterans where we could understand their thoughts and how they approached healthcare that went beyond simple demographics. It's pretty easy to lump people into categories. Are you a man? Are you a woman? Are you army? Are you navy? Are you an officer? Are you enlisted? Did you see combat? Did you not? But those easy segments aren't necessarily the kinds of segments that help you to understand what a person's needs are. So in that first research, we recognized that there were, there were two axes that helped us understand someone's attitudes and thinking when it came to healthcare. There was their connection to the military. This could be positive or negative connection. How much is that military history part of their life today? 

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Christi Kruse 

 Did they serve? Perhaps those who were in, who were drafted during Vietnam. Did they serve? They did their years. They separated and never looked back. That is someone with a distant connection to the mentality. Somebody who, who served and maintains close contact with their, with other veterans, very active and veteran service organizations. That's somebody who has a very close connection. And then high need to low need. How much do they need today? And, and, and understanding those needs. And so with those, we built these six psychographic profiles. And as we have endeavored to serve veterans in the eight year, in intervening years, we use these, these profiles to help us understand the journey of each of those veterans that would be within those profiles. To help us better understand them and make sure that the services that we deliver can serve veterans within these profiles. To make sure that we're not just focusing on those who already identify very closely with being a veteran, have those kind of close connections. Or those who only have high needs but not thinking about those who don't have as many needs but still need, we still need to understand their service and how it impacts their health. 

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Christi Kruse 

 So one of the things that, that we, as we looked at across all, both those who are active duty now and those who are, who are veterans, were these six needs that were universal. 

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Christi Kruse 

 I need continuity. I need to understand my care yesterday, today and tomorrow. And I need to feel like there is a connection to that. I need to understand that my experience in the military health system is going to extend into VA and any civilian providers I see as well. I need access. When I need care, I need to know the care is there. 

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Christi Kruse 

 I need to be heard. I have agency in my life and I need to make sure people hear what I'm saying when I'm saying it. 

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Christi Kruse 

 I need coordination. So although I need to be heard and although I need access, I also need help. I also need to, I need someone to help me, I need someone to help me navigate this system. 

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Christi Kruse 

 And then I need awareness. I need to know the things that I don't know. Healthcare is complicated and as a military family and as a veteran, there are other factors in my life that are even more complicated and don't exist for civilians. And I need to understand what's out there. I need to know where, when I'm not on my own. And we heard from a lot of veterans and a lot of military service members that they felt like they were on their own even when there were services and supports out there. And then lastly, they want and need a broader definition of care. It's not just about sick care. It's not just about going to the doctor. It's not just about taking a pill. It's about more than that. Recognize my needs are broader. 

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Christi Kruse 

 One of the other things that we heard in the first research and was echoed each subsequent time we endeavored to listen to service members and their families was something that we heard yesterday morning in the opening plenary. And it was that change from the I to the we. And every service member and veteran and family member in this room knows what I mean by that. That shift of mindset, that shift of point of view that goes from thinking about yourself first to the we first. Who is my we? Who is my unit? Who shares my mission? And understanding that the individual actions of that service member or that veteran impacts those within their we. 

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Christi Kruse 

 And that never changes. 

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Christi Kruse 

 Once you make the transition from the I to the we, it stays with you for the rest of your life. And it impacts how you access healthcare. Because there is this, whether it is conscious or subconscious, there is a question of am I taking something that somebody else needs more? If I get access, if I get an appointment, does that mean my buddy doesn't? Or the VA is just for those who are really in bad shape, I'm getting by. 

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Christi Kruse 

 And so understanding that shift from the I to the we means as healthcare providers, we need to not only ask if somebody needs assistance, if somebody needs help, if they're getting their care needs, we probably shouldn't take the first no as the actual answer. 

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Christi Kruse 

 We need to follow up. And we need to say it's all right. This is for you. This care is for you. And by you getting the care you need, you are not taking anything away from somebody else. 

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Christi Kruse 

 This mindset shift is something that we have endeavored to include in our provider training to make sure that those civilian providers who are not always seeing veterans understand how to recognize veterans in their practice and how to understand that they may not come forward quickly to recognize their needs. 

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Christi Kruse 

 So as we wanted to have this conversation with you today, we wanted to lay the foundation about what we learned because we understand that this healthcare system that serves our veterans and our active duty military and their families is a national security asset. 

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Christi Kruse 

 During another session yesterday, I heard about how recognizing the readiness of the family is the readiness of the soldier, the sailor, the airman, the marina, the guardian. And that means that the healthcare system that supports them is a national security asset. And so we want now to open up the conversation beyond just my voice to my colleagues. And we're going to talk about three major areas of the study. And I'm telling you with between the two studies we have, I said over 600 hours of content. And with just a 45-minute session today, we absolutely cannot tell you everything. On your chairs and in those books is a little card. You can snap that QR code. It'll take you to a landing page where you can download two different reports, one that focuses on the military family experience and the other one that focuses on the veteran experience. So today we're going to just talk about three areas, but there is much more content within those stories, within those reports. 

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Christi Kruse 

 We're going to talk about reasons to stay. We're going to talk about quality and access. And we're going to talk about feeling heard. 

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Christi Kruse 

 So with that, I am going to hand the MC duties over to my colleague, Christine. I'm going to take a chair with her as we continue this conversation. 

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Christine Erspamer 

 Yeah, thanks, Christi. Excited to dig into it a little bit more and hear a little bit about, from this conversation, about how we take some of the things we heard and translate it into some of the different recommendations and things that we can all tackle as stakeholders. Because one thing that I think is important to realize is that we did this research, not just for the way that we think about the way we're going to deliver, but to really share with stakeholders across the space so that we can all collectively deliver for service members and veterans in the ways that they need us to. Absolutely. Let's dig into the first one, reasons to stay. Right? So we know that, and we heard from our research, right, that healthcare can be a big reason why people join or decide to stay in the military as well. And so what are things that stakeholders can do, kind of based on those things that they called out for us, to optimize care delivery and medical readiness? 

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Peder Swanson 

 I'll jump in here. So first and foremost, I think it was fascinating for me as a former military service member and veteran to actually be invited into somebody's home and to actually have them open up the doors of their home for us to spend, in some cases, two to three hours with them. And I think that that was eye-opening in terms of actually them feeling encouraged and empowered to be heard. And at some point in time, it just kind of came spilling out of them. And I would say that in terms of reasons to join, I think that every family that I interacted with there was this underlying sense of assurance that there is an earned benefit that foundationally was present and matters. But I would also share that every single one of them at some point in time shared at least one if not multiple instances that were very poignant. And some of these kind of going back, you know, decades in some cases and actually recalling something that had happened in their healthcare experience that had impacted them or shaped them. And so I think one of the key takeaways of this study is that really every single interaction does matter between a veteran or a military service member. And so that weighs heavily or should weigh heavily on anybody that is entrusted with the care and support of military service members, their families, and veterans. And I would also offer that I think that we should be concerned that there's an increasing sense that engaging their health benefit could become, could be becoming more and more foreign. And what I mean by that is we have a next generation of digital natives and we use that term all the time. And yet if we don't actually modernize the experience and the engagement of that population with their health benefit, there's a gap, there's a divide. And so we actually need to think seriously about how we are thinking about user experience and the ability for that member or that veteran to actually engage their health benefit 

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Peder Swanson 

 through behaviors and experiences that are not foreign to them, that are kind of part of their digital native experience. 

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Christi Kruse 

 He got the answer right. That's why the alarm went off, just so you know. If there's no other alarms, it means we're not right. So I would agree with everything you said. And I would add a couple of thoughts, which are first of all that we need to make sure that we hold the value of the healthcare and the healthcare benefit for military families. They recognize that it's the benefit now, but we must make sure that it always has that ongoing value and that that value is recognized. That means that right now in comparison to a lot of employer-based benefits because TRICARE is for the family and for that active duty service member and employer benefit, that right now it's fairly, it's rich. It's probably rich beyond what most coverage for employees are. We must maintain that value because it isn't just an employer benefit, but it is also a national security asset. The next thing we need to do is we need to remove the friction from the system. Anytime you have to feel like that you are working for the system rather than the system working for you, if it is difficult to navigate referrals, if it's difficult to navigate networks, if it's difficult to understand benefits, 

[00:23:39:01 - 00:23:51:41] 

Christi Kruse 

 that even though it may be value in your mind that becomes less and less valuable because it feels like it's less and less about you and more about navigating something that's other. 

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Christi Kruse 

 And lastly, it's very important that throughout a service member's career and especially their family's career that we increase healthcare literacy. So as those families and service members move from service into civilian life, that they have a context for what it means to navigate the rest of the system because that healthcare literacy will help maintain their health and the health of their families after that military career. And one of the things that we heard over and over again in the research is that, especially from junior enlisted who maybe served four to eight years, that they said one of the hardest things about transition was navigating the healthcare system because for the last eight years somebody was telling them what to do. It was you're sick, go to sick call, you need care, go here, you've got a problem, go there. It's time to do your annual health risk assessment. It's time to fill out this form. It's time to do that. And if you have never been taught to, that's your responsibility now and that means you've got to find an in-network provider. You have to understand formulars. You have to understand coverage. That is a life skill we need to make sure that we are instilling at all levels but especially those in the junior enlisted ranks. 

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Christine Erspamer 

 So we are here TotalForce+ and so let's talk a little bit about what that means or continue that conversation around what that means for the 37% that are guard and reservists. What does some of those solutions look like in the total force, right, in some of those populations? 

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Peder Swanson 

 Yeah, Kristie mentioned something, you know, she mentioned transitions and I think that from a total force perspective even active duty service members, you know, if you PCS once every three years and you're taking, you know, 30 days of PCS leave and kind of the whole transition and really if you're empaneled at a DOD, MTF in one location and you're going to get empaneled in another location, that still represents being disconnected from your health benefit for 3% of your life. If you change that PCS cycle to once every 24 months, now you're disconnected from your health benefit for 5%. You know, and in some cases we have service members that are, you know, on a year PCS cycle especially if they're going to an OCONUS duty location and I would offer that our policy and programs need to keep the person at the center 

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Peder Swanson 

 and so how do we actually change some of the design of both policy and programs so there's not a disconnect of the individual where they actually are in between, you know, in a period that actually in some cases challenges both the service member and their family, you know, because there are many things going on in that PCS kind of move and so we have, we support a very transient population and they shouldn't need to be disconnected or feel disconnected from their health benefit and then you layer on top of that the fact that 37% of our force is in the guard and reserve and in some cases, you know, with the transition onto the kind of the full earned benefit, you know, if a guardsman or a reservist is on orders of greater than 30 days, now they're eligible and they have to go through a healthcare transition, why can't we design programs in a way where they make an election in advance and that transition becomes nearly seamless to them especially as they migrate from one Tricare plan to another. You know, it's one thing I think to migrate from an employer provided benefit to Tricare but if you're electing Tricare Reserve Select as a guardsman or a reservist, why is it that the burden of responsibility administratively is on the service member and their family as they go from periods where they're not activated to a period of not just mobilization but any period of duty of greater than 30 days. So again, as we approach the design of our programs, how can we remove burdens off of our service members so they still feel connected to the benefit that they've earned? 

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Christine Erspamer 

 Yeah, absolutely. And so there are a lot of different MHS plan options that are out there, right, and that exist and we heard a lot about them, right? We heard about people that have used all of these different plan designs, each come with their own, you know, kind of unique considerations and, you know, components that have been factored in. And so as we think about some of the things that we heard there and some of the things that you're tapping into, you know, how can some of the delivery of those plans, how can the design really help to address some of the key concerns around quality of care and access? 

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Christi Kruse 

 Yeah, one of the things that we heard over and over again was that when things are normal, when things are the way that they should be, families are very, very grateful and thankful for their Tricare benefit and for the care that they receive at MTFs if they're on Tricare Prime and the access to community providers if they're on Select. 

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Christi Kruse 

 The caveat to that is, is things are almost never normal. So it's great when it's normal, too bad it's pretty much never normal. And so I think that one of the things that Peder mentioned about those times of transition that are so important, those times of transition are almost always happening. Either you are getting ready to transition or you have just transitioned. And what's important to understand about those transitions is that especially for service members in Tricare Prime, it's not just their own transitions that matter, it's their provider's transitions as well. Because just as they're moving around from duty station to duty station, their providers are as well. 

[00:30:29:04 - 00:32:06:05] 

Christi Kruse 

 So understanding the need to address that, whether it is recognizing that a care team is not just a single person, recognizing that the connections between the family and the care team have to happen at multiple levels. And then also recognizing that there are understandable inflection points that you can know in advance are going to impact, are going to be impacted by either the service members move or the providers move, things like pregnancy. I was shocked the number of times I think that in both, in the first and the second studies that I probably personally interviewed about 25 women and I think 18 of them, of the 25 had a PCS within two weeks of delivering a child. I was floored, really, I couldn't believe it kept happening. And I suppose if you think about the number of children born, the number of service members, number of families, the number of moves, that probably makes sense. That's something that can be anticipated. You may not be able to change that PCS date, but you can plan for it and support the family throughout both the mother and whether, if the mother is the active duty service member, that kind of support. And if the mother is the spouse, the family support around that. So recognizing that we can't change the not normal part of this life, but we can try to mitigate the impact of that not normal. 

[00:32:07:08 - 00:32:07:50] 

Christi Kruse 

 Other thoughts, Peder? 

[00:32:07:50 - 00:34:28:24] 

Peder Swanson 

 You know, I think that there are some kind of, there are definitely opportunities to take existing programs, so I don't think that this is sort of, you know, represents necessarily an overhaul of the system, you know, but I think it does beg kind of a hard look at some of our practices. And so in, for the direct care system, the impanlement of beneficiaries at an MTF, why is it necessary to break that impanlement in their out processing of that particular duty station rather than actually maintaining, especially now with tools and technology available to us, why don't you maintain the impanlement of that beneficiary and utilize the relationship between the primary care provider and that family through that period of transition. Whether they need the care or not, it's ensuring that they feel as though their support kind of during those periods of transition. There are other programs such as the Military Health Systems Global Nurse Advice Line that actually is a centralized program that supports, you know, 9.5 and the 9.6 million beneficiaries. And so how could you actually take an existing program like that? Connect it with virtual health, ensuring that you actually have kind of a continuum where the beneficiary is able to engage with the nurse advice line. And if the care need is appropriate for some type of virtual health engagement, you can get to a provider, you know, through telephonic or really any modality at this point in time. And so how do you bridge those transitions? And Christi really raised an important point. A lot of our providers and care teams are, they themselves are in transition during the periods when the rest of the service member population is in transition. And so how do we actually need to think about partnering differently between government and industry to actually support the military health system in those periods of transition? So all of those, I think that there are solutions available to us with, you know, minor tweaks rather than like system overhauls. 

[00:34:28:24 - 00:35:45:25] 

Christine Erspamer 

 Yeah, absolutely. Building upon what's there, right? And I will say that's something too, just to kind of tie it back. I mean, we heard so much that it's really looking at what does the outcome of the care actually take us to? Something that I know that we're spending a lot of time at, right, with an OptumService thinking about how do we think about the entire care journey, right, and being able to help to support providers, being able to come up with ideas that can help to point to more outcome-based, right, care design and something that I know we're excited to be able to continue conversations on within that space. The other thing that I would pull the thread on a little bit is, you mentioned earlier how important every interaction is. I heard someone this week talk about how, you know, you can, it's so many, it takes a lot less time to break trust than it is to be able to build it, right? One interaction can change a person's perception or change how they think about interacting with the system. And so how do we as a system better listen to the things that we're hearing from our service members and veterans when they're receiving their care and addressing some of their individual needs, realizing that care may come from within the system, right, within the community, et cetera. So how can we better listen, right, to some of the things that they're telling us? 

[00:35:45:25 - 00:36:54:46] 

Christi Kruse 

 One of the things that we heard in almost every conversation with the military families, the military spouse, that the spouse is the center, is the hub of that family. And because the service member needed to be able to be, have the ultimate flexibility because they never knew when duty was calling, that the military spouse needed to be the one that was the center of the equation, that they had the information, they had to be the expert. And so it's really important that that spouse feels heard and recognizing that although the provider may be the expert in their area, medical specialty and care delivery, but that military spouse is the expert on that family, the expert on the children, the experts on themselves, and in many cases, the expert on the health needs of their service member, and so because we're talking about so many transitions and because there can be limited time within that healthcare interaction, 

[00:36:56:12 - 00:38:07:47] 

Christi Kruse 

 recognizing that with the military, within this community, it's even more important to recognize the expertise of the spouse and saying that let them be heard because most likely they've been through this, they've been through this transition, they've explained this background in this situation to multiple providers in the past. They've navigated it many times and if we want to get through it faster and deliver quality care faster, it comes from listening and empowering that military spouse with the tools they need to provide continuity. So Peder talked about digital tools, different ways that you can use extenders like Nurse Advice Line or other support services, military one source, and other things that empower the family who already is the expert to be part of that continuity and helping them be heard. I think that those are the types of kind of recognitions and supports that can help those families do what they're already doing, which is keeping the service member family together. 

[00:38:07:47 - 00:39:19:36] 

Peder Swanson 

 Well, and Christi, so if the spouse is really the center of gravity for the engagement from the family with their health benefit, you know, recognizing, you know, that point and then thinking about the impact on that spouse in terms of engaging their health benefit. So I really think that as healthcare modernizes, we actually have to change the user experience. There has to be the ability to engage your health benefit and whether it's like having things at your fingertips like what is the copay? And the copay, you know, differs whether you're prime or select and depending on which plan and whether it's physical therapy versus a primary care appointment. And so like how do we actually put resources at the fingertips of really any of the beneficiaries? And one of the things that we keep hearing is that any people facing program that the federal health sector is developing really needs to think hard about user experience. 

[00:39:20:49 - 00:39:30:29] 

Peder Swanson 

 And I'll kind of just point out one example, you know, so tri-care beneficiary, tri-care families like when your child is approaching age 21, 

[00:39:31:42 - 00:40:45:30] 

Peder Swanson 

 you know, you need, and that beneficiary, that son or daughter is a student, you actually have to provide proof that they're in some type of full-time education. Well, right now, generally speaking, that involves travel to a DEERS/RAPIDS office for somebody to put that form that you've obtained from the educational institution on a flatbed scanner, scan it in. Again, like most of us have converted to scanning off of a phone, but how does the approach to providing that documentation need to change rather than somebody having to travel one hour or for a guardsman or a reservist multiple hours to a DEERS/RAPIDS office for somebody to put that piece of paper on a scanner when you could actually scan it and transmit it securely to ensure that that change in benefit is provided as opposed to it being so hard that actually the health benefit of that 21-year-old is actually dropped because it's just so hard and you're kind of assuming some risk along the way. So the user experience has to change. 

[00:40:47:27 - 00:41:24:25] 

Christine Erspamer 

 Yeah, absolutely. And some of that goes both ways as well as far as you're, we're talking about, you know, some of the ways that the spouse, the service nurse engages well. But it's also about like helping providers to be able to recognize who their patients are. And I'm talking more when they might be seeing providers right outside of the direct care system. You know, one thing we've been looking at a lot is how do we help to engage providers to be able to just even ask the question, right? Like what is some of your background? What are some of your experiences and how might those impact your care as well? So just another kind of flip to the coin as well about how we think about educating our providers and informing them in new ways. 

[00:41:24:25 - 00:42:16:05] 

Peder Swanson 

 Christine, can I actually seize on that? So you're raising a really good point. We've touched on the fact that, you know, we focused on kind of the service member or family member's experience, but what about our provider's experience? And again, there's tools in technology to relieve burdens on those providers. And so we need to do a better job of actually equipping them and removing burdens from them that can easily be removed so that they can actually engage with the beneficiary in a more focused manner. And so whether it's bringing forward dynamically, bringing forward information, health risk indicators, leveraging technology to augment their clinical decision making. And again, those are resources. And so I think that we do need to be aware of the impact on the providers who are also beneficiaries. 

[00:42:16:05 - 00:42:44:01] 

Christine Erspamer 

 Yeah, absolutely. And we do touch on some of that, right? Some of the research papers or something maybe to take a look at as we walk away from here. So we've got only a couple minutes left. So leave me with what are some of your key takeaways? What are some of the key insights that you want to share with this stakeholder group? Because really it takes all of us to be able to address some of the things we heard. It takes all of us to come up with those solutions, right? And this is just the start of the conversation and the start of the solutions that we're spending a lot of time focusing on. So what are your key takeaways? 

[00:42:44:01 - 00:44:25:37] 

Christi Kruse 

 So I think the biggest takeaway for me, and this is across everything we do, and it was kind of the genesis of this research at the beginning, is recognizing that it's all connected. It's one healthcare system. And that we need to be thinking about how the military health system connects to the VA system, connects to the civilian system. And that if there are 15.8 million veterans in the country, and 9 million of them are enrolled for care at VA, and about 6 to 7 million are getting care each year, that means that the balance of that, that means that 9 million veterans are getting care in the civilian sector, and that for all of those who select, tricare select, those military families are also getting care in the civilian system. We can't think about this as it's the military health system's problem, or it's the VA's problem. It is a challenge and a pleasure for the entire US healthcare system to support military families and veterans, because veterans are already, and military families are already in those systems. So as one of the largest healthcare providers, the largest healthcare provider in the country, it's our responsibility to listen, and to participate, and to lead in how we care for our military families and our veterans. And that's why we do this, and that's why we want to collaborate with you to advance the solutions to care for those who care for us. 

[00:44:26:38 - 00:44:41:43] 

Peder Swanson 

 I'll go back to kind of the first comment that I made is the assurance that exists among military service members, families, and veterans that they have, you know, a health benefit that has been, 

[00:44:42:51 - 00:45:25:16] 

Peder Swanson 

 has served them well, and will continue to serve them well, but how do we actually modernize that to kind of keep pace with digital transformation and user experience that everybody is accustomed to now? And how do we remove some of the barriers, you know, so if the financial services industry can do this, why can't healthcare do this? So how do we actually, and how do we collaborate between government and industry in ways where we're sharing, you know, how we actually move through a period of transformation where there is a markedly different user experience still resting on the assurance? Of that really sound health benefit. 

[00:45:26:36 - 00:46:12:23] 

Christine Erspamer 

 Awesome. Well, thank you guys so much for answering some questions. If you in the audience have any questions for us, we'll definitely be sticking around, happy to dig into it. We really do see this as an opportunity to have more conversations, to solution together, right, and to be able to extend this research into anywhere that it can be helpful. You know, we learned so much from just taking the time to stop and listen and to hear from the actual stories that they have, and I think that continues within all stakeholders as well, right? We all have stories to tell. We all have things that can help us to be able to bring that forward into the way that we support the healthcare across all aspects of the system. So thank you for the time. Check out the research, more information about both veterans and service members through the QR code there. Thank you.