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Enhanced Multi-Service Markets: An Evolution in Military Health System Governance.

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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.