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Research Question

  1. What are the key policy areas on which researchers should focus to find ways to reduce MHS costs?

The top three costs for the Military Health System (MHS) are health care delivery costs, military medical personnel costs, and Medicare Eligible Retiree Health Care Fund contributions. Determining how to curb burgeoning military health care costs without compromising (1) access to and quality of care or (2) the readiness of military medical personnel continues to be a priority for the Defense Health Agency.

The authors of this report conducted a literature review and solicited expert opinions to outline four key policy areas in which further research could be pursued to understand how to reduce MHS costs.

Key Findings

The authors found four key policy areas in which further research could be pursued

These areas were selected because of how they directly affect the three main MHS cost categories.

Reforms to the MHS, which are in progress, provide many possibilities for future research

Research would focus on how MHS reforms affect the utilization of direct and private-sector care, military health care delivery costs, and military medical personnel costs. Research would also examine whether the effects of MHS reforms vary across locations and how the coronavirus disease 2019 pandemic affects the MHS.

Implementing the military's universal health records system, MHS Genesis, could streamline service and provide cost savings

Research would examine how providers and beneficiaries use the platform, its impact on care and costs, and use cost-benefit analysis to determine whether and how the use of MHS Genesis should be expanded.

The military medical force, which needs to both be ready to deploy and provide regular medical care, should undergo a cost analysis

Research would determine what the most cost-effective personnel mix should be and examine the optimal mix of military- and privately provided care in a post–MHS reform era.

The TRICARE program, which covers existing and former military service members and their dependents, should undergo a cost analysis

Research would study the cost effects of changes to TRICARE that stemmed from the 2017 National Defense Authorization Act, cost effects of alternative plan designs for TRICARE and examine the merits of making changes to TRICARE for Life.

The research described in this report was prepared for the Office of the Secretary of Defense and conducted within the Forces and Resources Policy Center of the RAND National Security Research Division (NSRD).

This report is part of the RAND 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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