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Military Health System Research Branch

Health care systems are complex, high-risk environments. Medical knowledge is expanding exponentially and producing data about health care delivery. Health systems research enhances our understanding of system-level improvements and innovations and seeks to identify factors influencing care delivery. 

R&E Military Health System Research supports the Military Health System, one of America's largest and most complex health care systems, which serves approximately 9.6 million beneficiaries. MHSR uses data to tease out patient-, system-, regional- and facility-level variables that can influence outcomes and improve beneficiary health. These efforts lead to military health care that is safe, effective, accessible and patient-centered.

Word cloud describing Military Health System Research. Describing words include Impact, Great Outcomes, Evidence, Quality, Analysis, MHS, DHA, Variables, Safety, Interventions, High Reliability, Translation, Health Policy, Health, Integral, Readiness, Social, HSR Strategic, Improve, Variation, Knowledge, Systems, Quadruple Aims, Costs, Data, Decision-making, Learning Organization, Enhance, MTF, Policy, Care, Clinics, Processes, Community, Programs, Health Economics, Supports, Multidisciplinary, Cost-effectiveness, Behaviors

Cycle between Research, Practice, Data, and Evidence. Systematically gather and create evidence. Apply the most promising evidence to improve care.

MHSR is key to ensuring the evolution of the Military Health System into a high-reliability organization skilled at acquiring and transferring knowledge and using new knowledge and insights to modify behaviors. As a strategic project in the DHA FY22-26 Campaign Plan, MHSR is a vital tool for generating critical evidence and actionable insights about health economics/costs, quality, variation, outcomes, health system reform, and health readiness.

Annual MHSR Grant Program

The MHSR program supports research projects with potential to innovate and improve military health care through annual grant awards. Funding for MHSR grants is made available through the Defense Health Program. For each funding round, MHSR publishes a Notice of Funding Opportunity on seeking rigorous intramural and extramural health systems research based on MHSR and clinical research priorities. The process for soliciting and reviewing proposals and awarding grants is updated each year.

The Fiscal Year 2025 Notice of Funding Opportunity for MHSR grants is expected to be released in February 2024.

MHSR Grant Process

Grant process: Release of NOFO (posted to, Deadline for receipt of LOI*, Begin releasing notifications and invitations to submit full proposals, Deadline for receipt of full proposals, Completion of scientific and programmatic reviews, Begin notifications of grant award winners.

*LOI: Letter of Intent

MHSR Priority Topic Areas and Clinical Priority Areas

Proposed research must address at least one MHSR priority topic area and one MHSR clinical priority area. Letters of Intent applicants that do not meet this requirement will not be asked to submit a full proposal.

MHSR Priority Topic Areas:

Economics and Cost – Research on the factors that shape the MHS cost, drive demand and utilization, and influence cost in either TRICARE direct or Click to closePurchased CareThe TRICARE Health Program is often referred to as purchased care. It is the services we “purchase” through the managed care support contracts.purchased care systems; issues related to efficiency, effectiveness, value and behavior in the production, and utilization of health care in terms of costs, charges, and expenditures; the impact of technologies on care delivery and cost; and the impact of workforce, recruitment, and retention of medical personnel. Research that delineates value-based care within the MHS in both purchased and Click to closeDirect CareDirect care refers to military hospitals and clinics, also known as “military treatment facilities” and “MTFs.”direct care; pre- and post- studies to evaluate the impact of the structure of the TRICARE contract on patient care.

Quality – Research which examines the degree to which health services for individuals and populations are safe, effective, patient-centered, timely, efficient, and equitable with the outcome of increasing the likelihood of improved health. The impact of standardizing clinical practice through clinical practice guidelines, evidence-based practices, and process improvements, on the health of the population/sub-population.

Outcomes – Health outcome research identifies and measures the factors which impact a population of patients at the enterprise, geographic market level, or sub-population levels; examines the system level factors which influence achievement of the Quadruple Aim “better health” in comparison to private sector efforts. Health outcomes research incorporates clinical outcomes, financial impact, patient health, quality of life, and measurement of indicators that predict results important to patients and patient experience.

Variation – Studies that examine the factors that influence unwarranted variation or differences in quality, utilization, cost, or outcomes within the MHS and the implications to the enterprise as a system of system of care.

Health Readiness – Burden of disease and associated health and risk factors within the MHS populations that affect active-duty service members’ ability to deploy. Implications of disease burden as an indicator of medical readiness, potential impact to staffing, network utilization, and cost for direct care and/or purchased care.

Health System – Research related to the impact of the significant changes in policy or structure of the MHS on health care cost, quality, utilization, health outcomes, manpower/staffing, or health care readiness. Comparisons between direct and purchased care, or care within the private sector, and includes measurement of the impact of policy changes to the TRICARE benefit structure on utilization and cost.

FY2025 MHSR Clinical Priority Areas (new areas are determined each grant cycle):

  • Behavioral Health
  • Neuro-musculoskeletal
  • Primary Care
  • Specialty Care
  • Surgical Services
  • Women and Infant
  • Telehealth
  • Dental

Helpful Resources

For Health Services Research Funding and Resources

For the Military Health System

For Researchers Concerning Data and Data Sharing

Fiscal Year 2023 MHSR Research Awardees

Institution Project Title
USU/HJF Impacts of TRICARE's Expansions of Behavioral Health Benefits and Provider Availability on Access to and Utilization and Expenditure of Behavioral Health Care, Health Outcomes, and Medical Readiness 
Complex Ped/Geneva  Health Care Transitions for Military-Connected Children and Spouses with Complex Medical Conditions 
USU/HJF  Improving healthcare value and access for mother-infant dyads in the Military Health System: complex care co-location, transfer patterns, and service quality 
USU/HJF  Assessing the Effect of the Military Health System Consolidation under a Single Management Structure on Health Care Utilization, Cost, Quality and Military Readiness 
USU/HJF  Impact of the COVID-19 Pandemic on Rehabilitation Care Utilization and Delivery for Active-Duty Service Members with Neuromusculoskeletal Injuries 
Defense Health Management Systems/HJF  Contraceptive Care among Active-Duty Service Women 
UARIEM  Service-member Post-Operative Rehabilitation and Training to Improve Outcomes, Optimize Military Return-To-Duty, and Mitigate Re-Injury and Lower Extremity after Lower Extremity Surgery 
Penn State Direct vs. Purchased Care as Drivers of Geographic Variation in Cancer Outcomes in the Military Health System 

Fiscal Year 2022 MHSR Research Awardees

Institution  Project Title 
Cornell University  Efficiency of Direct vs Purchased Care Primary Care Managers 
USC  The Cost Effectiveness and Value of Treating Combat Ocular Trauma 
Dartmouth Hitchcock Medical Center  Quality of Care for Children With Medical Complexity in the Military Health System and Association With Maternal Behavioral Health 
VA Boston Healthcare System  Enhancing Measurement-Based Behavioral Health Care in the Military Health System 
Trustees of Dartmouth College  Understanding Market Determinants of Variation: Using compulsory Migration to Study Variation in Spending and Utilization 
UMD School of Medicine, Baltimore  Value-based Military Sleep Medicine: Health Economic Aspects of Sleep Disorders Treatments in the US MHS  
USUHS  Medical READiness PROject (MED READ PRO) 
Naval Health Research Center  Navy Medicine's Temporary Limited Duty Patient Population: Evidence about Care Source and Case Management Services to Inform the MHS 
NICoE/ WRNMMC  Recovery Expectations in TBI Related Outpatient Settings: Identifying key trajectories of recovery in service members and veterans 
USA Medical CoE/ BAMC  The Effects of Nursing Staff Mix and Turnover on Productivity and Outcomes 
Naval Health Research Center  Patterns of Tele-Behavioral Health Care Utilization Among Active Duty Service Members Across 
USA Research Institute of
Environmental Medicine 
Examining the Role of Social Networks on Health-Related Behaviors and Musculoskeletal-Related Medical Discharges in the Army 

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Last Updated: January 30, 2024
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