Back to Top Skip to main content Skip to sub-navigation

Military hospital transformation – introducing the market construct

Barclay Butler, Ph.D., MBA, assistant director of management at DHA, explains the market concept to an audience of active-duty and civilian conference attendees at the 2019 AMSUS Annual Meeting in National Harbor, Maryland, Dec. 4. (Photo by MHS Communications) Barclay Butler, Ph.D., MBA, assistant director of management at DHA, explains the market concept to an audience of active-duty and civilian conference attendees at the 2019 AMSUS Annual Meeting in National Harbor, Maryland, Dec. 4. (Photo by MHS Communications)

Recommended Content:

Military Hospitals and Clinics | MHS Transformation

The Defense Health Agency launched the most significant change to the Military Health System in over three decades when in October it initiated the congressionally directed transfer of authority, direction, and control of military medical and dental facilities in the United States to DHA.

That set in motion plans to establish a market-based structure to manage the system’s 51 hospitals, 424 clinics and 248 dental clinics, with the first four markets coming on line in early 2020.

The DHA expects to create and certify a total of 21 large markets in major geographic areas in 2020 and stand up a management office to oversee stateside hospitals and clinics not aligned to a market such as those in rural areas or outside of major cities. In 2021, facilities in Europe and Indo-Pacific will transition into Defense Health Regions.

Dr. Barclay Butler, the DHA’s assistant director for management who heads up MTF transition planning, explained these upcoming changes at the 2019 annual meeting of the Society of Federal Health Professionals, known as AMSUS, in National Harbor, Maryland, on Dec. 4.

According to Butler, a market is a group of MTFs working together in one geographic area, operating as a system to support the sharing of patients, staff, budget, and other functions across facilities to improve readiness and the delivery and coordination of health services.

“It’s that geographic space encompassing all of the (health) care delivery organizations within that space,” Butler said.

For patients, a market gives them access to a larger network of providers and specialties, and centralized day-to-day management will increase standardization of patient facing services, business and clinical practices.

“It’s really driving standardization across the organization,” Butler said. “Wherever we drive standardization in health care, we always see an improved quality and lower cost.”

He explained the difference between DHA headquarters and the markets in terms of scope of responsibility. The DHA, as a combat support agency, coordinates strategy and operational requirements with the Military Departments and the combatant commands, collects and prioritizes those requirements against strategy, and communicates and assesses performance.

“The market offices are fundamentally execution offices,” Butler explained.  “They oversee the delivery of care, manage and administer the MTFs, and deliver readiness (within the market). That’s an important construct for us, because the market becomes DHA’s unit of engagement.”

DHA currently establishes requirements for health care delivery at hospitals and clinics. The market office, once established, tailors those requirements to their geographic region, both domestic and overseas, based on patient population and hospital performance, to ensure compliance. Markets would also fully integrate MTF and Purchased 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 through the TRICARE Health Plan, and work to create healthcare networks with other federal facilities such as Veterans Affairs hospitals.

“We have a very good need to expand our partnerships with civilian hospitals out there. That’s what I want market directors to be doing, looking at the entire care delivery system and how they can optimize care within that market,” Butler said.

Butler said he is excited about the potential success of these markets, bringing DHA closer to quality, patient-centered care.

“It’s about putting the patient at the center of everything we do,” Butler said. “Focusing on that patient-centered approach to care results in better understanding of our patients, leading to improved quality of life.”

For more information on the Military Health System Transformation, visit the MHS Transformation website on

You also may be interested in...

DHA, HA leaders discuss MHS Transformation at AHA panel

Military personnel talking at a podium

Army Lt. Gen. (Dr.) Ronald Place and Dr. Terry Adirim discussed MHS Transformation, MHS GENESIS, and highlighted the DHA’s response to COVID-19 in a virtual roundtable hosted April 12 by the American Hospital Association.

Recommended Content:

MHS GENESIS | MHS Transformation | Genesis of MHS GENESIS | Coronavirus

Wave CARSON+ deploys new EHR to 25 more MTF commands

Military health personnel wearing face mask looking at  a computer

MHS GENESIS, the DOD’s new electronic health record launched at Wave CARSON + over the weekend.

Recommended Content:

MHS GENESIS | MHS Transformation

DHA stands up new market in Tidewater region of Virginia

Military health personnel wearing masks holding up a flag

Tidewater Market is on the leading edge of the Military Health System’s historic change, following its certification by the Defense Health Agency on April 19, 2021.

Recommended Content:

MHS Transformation

Tidewater set to become fifth Military Health System market

Military health personnel reading a medical machine

The Tidewater Military Health System market in southeast Virginia is scheduled to officially stand up April 19.

Recommended Content:

COVID-19 Toolkit | Coronavirus | MHS Transformation

Tele-critical care will play increased COVID-19 response role in 2021

Infographic that says "202 tele-critical care successes will help 2021 COVID19 response"

Virtual health and particularly tele-critical care for critically ill patients assumed frontline roles in sustaining care while keeping beneficiaries and health care teams safe.

Recommended Content:

COVID-19 Toolkit | Coronavirus | MHS Transformation

DHA preparing to complete treatment facility transition by Fall 2021

Military medical personnel giving a vaccine shot to a soldier

The Military Health System’s military medical treatment facilities transition in “deep throes” of completion by Sept. 30, Defense Health Agency’s Dr. Brian Lein tells AMSUS.

Recommended Content:

MHS Transformation

Migration of MTF websites to complete

Three military personnel, wearing masks, sitting at a desk and typing on laptops

The goal is providing facility personnel and MTF recipients with a comprehensive source of information in an easily accessible, centralized location.

Recommended Content:

MHS Transformation

MHS Transformation results continue during COVID-19

Military personnel in a supply room, reaching for the top shelf

The MTF transition has enabled the DHA and the Services to increase standardization, eliminate duplicative contracts, and realize cost efficiencies by beginning the management of an enterprise-wide program.

Recommended Content:

Coronavirus | MHS Transformation

MTF facilities, markets set to resume transition heading into 2021

A military nurse, wearing a mask, prepares a needle for a vaccination

Butler says transition on track.

Recommended Content:

MHS Transformation | Coronavirus

Deputy defense secretary stresses team approach in battling COVID

Soldier wearing mask, standing at computer monitors in an office building

The Military Health System has played an important role implementing the National Defense Strategy, Norquist said.

Recommended Content:

MHS Transformation | Coronavirus | COVID-19 Vaccine Efforts | Health Readiness | COVID-19 Vaccine Toolkit

MHS leaders discuss future of military medicine during AMSUS panel

Military personnel, wearing masks, standing in a line in front of flags

For Dingle, readiness is the key issue during the transition.

Recommended Content:

Coronavirus | Convalescent Plasma Collection Program | MHS Transformation

Pandemic underscores MHS’ need for reform, McCaffery tells AMSUS

Army soldier gets nose swab

Before the COVID-19 pandemic, the MHS had embarked on reforms and initiatives to improve its medical support to the armed services.

Recommended Content:

MHS Transformation | Coronavirus | COVID-19 Vaccine Efforts | Vaccine Trials | Getting the COVID-19 Vaccine | COVID-19 Vaccine Toolkit

DHA Director outlines how MHS standardization bolsters reform

Two soldiers in masks, talking

How COVID-19 repositioned the best laid plans of the DoD.

Recommended Content:

Coronavirus | Joint Health Information Exchange | MHS GENESIS | MHS Transformation | MHS GENESIS

Defense Health Agency celebrates seven years of service

Lt. Gen. Ronald Place holding a wreath at Arlington National Cemetery

Seven ways DHA has improved military readiness over the years.

Recommended Content:

Defense Health Agency | Coronavirus | MHS Transformation | Technology | Global Health Engagement | TRICARE Health Program | Total Force Fitness

DHA Launches New Air Force Military Hospital and Clinic Websites

Two hands holding a tablet, which displays a new TRICARE MTF website, against a background of a wooden table.

The website enhancement is part of the transition of administrative oversight of MTFs to the DHA under the 2017 NDAA.

Recommended Content:

MHS Transformation
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 14

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.