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Research Questions

  1. What special and incentive (S&I) pays are available for military physicians and other health care professionals?
  2. What are the relative earnings of military and civilian health care professionals?
  3. How can policymakers assessing how alternative S&I pay adjustments affect the retention of mental health care officers?

After more than a decade of war, the military services have many returning personnel with mental health needs, and thus the United States needs to ensure that it has the capacity to address their needs. Officer special and incentive (S&I) pays are used to create incentives for officer retention to meet manning requirements. However, no capability exists to assess how alternative S&I pay adjustments affect the retention of mental health care officers, and, as a result, policymakers lack an analytical and empirical basis for determining the effect of such adjustments on retention.

The authors of this report adapt RAND's dynamic retention model (DRM) to handle multiyear special pay and develop estimates of expected military and civilian pay over a career, which are needed inputs to the model. Using longitudinal data on officer retention for entry cohorts from 1990 to 2000 followed to 2010, the authors obtain DRM parameter estimates for psychiatrists, psychologists, nurses, occupational therapists, physician assistants, and social workers. Nearly all estimates are statistically significant, and the estimated models fit the data well. To demonstrate the needed capability, the authors use the estimated models to simulate the retention effects of alternative S&I pays.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Military Financial Aid Programs for Physicians

  • Chapter Three

    Conceptualizing and Modeling the Military Financial Aid Choice and Retention Decision

  • Chapter Four

    Active Component Earnings of Mental Health Professionals

  • Chapter Five

    Civilian Earnings of Mental Health Professionals

  • Chapter Six

    Dynamic Retention Model Parameter Estimation

  • Chapter Seven

    Policy Simulations and Analyses

  • Chapter Eight

    Conclusion

  • Appendix A

    Cost to the Individual of a Two-Period Commitment

  • Appendix B

    Possible Selectivity by Military Financial Aid Pathway

  • Appendix C

    Reserve Duty Earnings

  • Appendix D

    Comparisons of Military Pay Using the Pay Table Approach Versus Observed Pay from the Pay Files

  • Appendix E

    Civilian Earnings of Mental Health Care Providers

  • Appendix F

    Civilian Earnings of Female Physicians

This research was conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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