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The prime mission of the Air Force Medical Service (AFMS), like those of the medical departments of its sister services, is to provide medical care during wartime. AFMS currently runs three successful in-theater hospitals that treat severely injured or wounded U.S. personnel from all four services. But this wartime mission depends on capabilities built at home, as critical-care specialists maintain their technical proficiency, as much as peacetime opportunities allow, by meeting health-care needs of DoD beneficiaries at home. These patients have ranged from young, healthy active-duty personnel to aging retirees, historically presenting a broad range of injuries and illnesses for treatment. However, between the demands of deployments creating gaps in staff at home and changes in care plans, some beneficiaries now seek care in the civilian sector. In addition, several AFMS hospitals stateside have been closed, converted to clinics, or combined with those of other services for various reasons. All is problematic for two reasons: First, inpatient workloads in particular represent the best opportunities for critical care providers to prepare for their wartime missions. AFMS will need to increase these opportunities, perhaps working with other services, the Department of Veterans Affairs, or civilian hospitals. Second, AFMS's funding depends, in part, on the workload performed, but current measurement methods do not necessarily do a good job of accounting for the work AFMS practitioners accomplish outside their home stations. Some imminent changes may help resolve this situation, but AFMS should pursue opportunities to create additional workload for its medical personnel and to increase its budgets.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Overview of the Air Force Medical Service

  • Chapter Three

    Air Force Medical Service Funding

  • Chapter Four

    Measuring Military Medical Service Costs and Workloads

  • Chapter Five

    Why Has the Air Force Medical Service’s Workload Decreased?

  • Chapter Six

    Options Available for Recapturing and Expanding Workloads

  • Chapter Seven

    Conclusions

  • Appendix A

    Medical Workload by Service Military Treatment Facility

  • Appendix B

    Readiness Full-Time Equivalents by Service

  • Appendix C

    Prospective Payment System

  • Appendix D

    Medicare-Eligible Retiree Health Care Fund

  • Appendix E

    Consolidation of Wilford Hall Medical Center and Brooke Army Medical Center

  • Appendix F

    Efficiency-Wedge Reductions

  • Appendix G

    Support to Landstuhl Regional Medical Center

Research conducted by

The research described in this report was sponsored by the United States Air Force and conducted by RAND Project AIR FORCE.

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