Military Health Policy Research Initiative

Leader: Sarah Meadows

More than 9 million active duty, Reserve, and retired military personnel along with their dependents are eligible to receive health care through the U.S. Department of Defense's (DoD's) Military Health System. In addition, nearly 6 million veterans receive health care benefits and services from the Veterans Health Administration, which is part of the U.S. Department of Veterans Affairs (VA).

DoD, the nation's largest health care provider, faces challenges both peculiar to the military environment and similar to those faced by civilian health systems. For example, DoD must maintain deployable medical assets to support military operations, facilitate medical readiness of the troops, and at the same time, offer integrated health care to beneficiaries—all while controlling rising health care costs. The VA health care system also faces challenges in serving its population within a fixed budget. Both systems provide primary and specialty health care services to diverse populations, including the war wounded, through a system of fixed federal facilities and by purchasing civilian-based health care services.

The overarching goal of the RAND Corporation's Center for Military Health Policy Research is to help DoD and VA meet the challenges of providing the best care possible while containing costs. The center's work aims to:

  • Help all branches of the military address emerging health care policy issues;
  • Assist DoD in assessing policy regarding health care services for nondeployed personnel, their families, retirees, and those eligible for VA services;
  • Help the VA with system management issues.

Research Approach

The Center for Military Health Policy Research is a joint endeavor of RAND Health, a division of the RAND Corporation, and two of the RAND Corporation's defense research units—the National Defense Research Institute and the RAND Arroyo Center. The National Defense Research Institute, a federally funded research and development center (FFRDC), conducts research for the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the defense agencies, the United States Marine Corps, and the United States Navy. The RAND Arroyo Center is the FFRDC for the U.S. Army.

This unique union of RAND divisions creates an interdisciplinary research environment that allows the center to tap corporate expertise in both defense and health policy. RAND experts include physicians, economists, psychologists, mathematicians, organizational analysts, political scientists, psycho-metricians, medical sociologists, policy analysts, operation researchers, and statisticians. The center is thus able to tackle often unique issues of importance to military health care, influencing policy on rapid timelines. The center's work also adds natural synergy to RAND Health's efforts to improve the U.S. health care system. Funding for much of the center's work comes from the Department of Defense, the VA, and the private sector.

Past Achievements

RAND has been conducting military health studies since the early 1970s, when its researchers examined physician supply and the use of physicians' assistants in order to answer questions critical to the introduction of the all-volunteer force. In the 1980s, RAND applied its expertise in health care finance to support the development of TRICARE, DoD's health care program that replaced the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) in 1995. In 1997, RAND created the Center for Military Health Policy Research to further broaden its capabilities in military health studies.

In addition to its research agenda, the center's expertise is also sought on national issues. For example, center codirector Susan Hosek has served on several task forces and commissions related to military health care. Most recently, she served as research director for the President's Commission on Care for America's Returning Wounded Warriors, and she provided analytic support to the Task Force on the Future of Military Health Care.

Since its creation, the Center for Military Health Policy Research has been addressing a wide range of topics in both medical readiness during wartime and peacetime care. The studies below were selected to show the depth and breadth of the center's achievements. Current studies are featured in the next section.