DOD Plans for “Stabilizing and Improving
the Military Health System”
August 29, 2024
The Department of Defense (DOD) administers a Military Health System (MHS) that provides health care
entitlements authorized in Title 10, Chapters 55 and 56, of the U.S. Code, and is organized, in part, under
the TRICARE program. The TRICARE program offers health care benefits to approximately 9.6 million
beneficiaries in DOD hospitals and clinics (i.e., military treatment facilities or MTFs) and through
networks of participating civilian health care providers (i.e., private sector care). The Defense Health
Agency (DHA) administers the TRICARE program, MTFs, and contracts with several managed care
organizations to deliver health entitlements and benefits.
Congress has expressed ongoing interest in MHS challenges with MTF staffing, access to care, and
curbing private sector care costs. In 2023, the Government Accountability Office found that “DHA faces
challenges mitigating shortfalls in military medical personnel in MTFs.” The DOD Inspector General
reported similar findings in 2023 and issued a management advisory to the DHA Director that described
“concerns related to access to care” in the MHS, including those resulting from MTF staffing shortages.
To address these challenges, DOD announced a series of actions to “get the right people into the right
military hospital or clinic at the right time–both medical staff and patients.”
This Insight provides an overview of DOD actions intended for “stabilizing and improving” the MHS and
identifies potential considerations for Congress.
Background
The MHS offers health care to eligible beneficiaries through two venues: MTFs and the private sector.
Generally, when an MTF is at capacity or lacks a certain clinical capability, beneficiaries are referred to
TRICARE providers in the private sector. Several factors may influence an MTF’s capacity or capability,
including health care staffing and demand, military requirements or training, deployments, and
geographic location. In the past, the MHS had varied strategies that emphasized either a shift in
beneficiary care to the MTF or to the private sector.
Figure 1 and Figure 2 show trends in beneficiary care location. Between FY2001 and FY2022, the
proportion of care delivered in MTFs has decreased. Figure 3 shows the number of MTFs in the MHS
between FY2004 and FY2022.
