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Enhanced Multi-Service Markets: An Evolution in Military Health System Governance
Ronald P Hudak1, Rebecca Russell2, P Paul Toland3
1Defense Health Agency, 7700 Arlington Blvd, Falls Church, VA.
Military Medicine
|February 9, 2018
Summary
The Military Health System
Area of Science:
- Healthcare Management
- Military Health System Governance
- Health Services Research
Background:
- The Military Health System (MHS) has evolved its governance models for medical treatment facilities (MTFs).
- Enhanced Multi-Service Markets (eMSM) represent the latest effort, integrating multiple DoD Services within geographic markets.
- eMSMs aim to increase management authority over clinical operations, readiness, and workload.
Observation:
- A retrospective review analyzed MHS and civilian healthcare delivery models since the 1980s.
- The study examined the evolution of MTF governance, focusing on overlapping catchment areas.
- Data sources included comprehensive literature reviews and analysis of primary and secondary data.
Findings:
- MHS governance evolved from managed care to regional TRICARE models, culminating in eMSMs.
- The current eMSM model is a partial implementation, lacking full managerial authority.
- eMSM leaders have limited budgetary and resource allocation power, operating primarily through collaboration.
Implications:
- The full impact of eMSMs on patient-centric care and market efficiency remains unassessed due to incomplete implementation.
- Granting eMSM managers governance authority could optimize budgets, clinical functions, and force readiness.
- Further analysis is needed to determine if fully empowered eMSMs can achieve intended goals of improved healthcare and cost reduction.
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