Health care systems are complex, high-risk environments. Medical knowledge is expanding significantly and producing data about health care delivery. Health systems research enhances our understanding of system-level improvements 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 the delivery of care, beneficiary health, and readiness of the Force. These efforts lead to military health care that is safe, effective, accessible and patient-centered.
MHSR is key to ensuring the evolution of the Military Health System into a high-reliability organization that acquires and uses 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 actionable insights about health delivery in terms of economics/costs, quality, variation, outcomes, health system reform, and the impact to health readiness.
Annual MHSR Grant Program
The MHSR program supports research projects 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 grants.gov 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 was released on April 24, 2024. Researchers interested in applying can find eligibility criteria and submission requirements by visiting grants.gov and searching by keyword MHSRP or Opportunity Number HT9425-25-MHSRP.
MHSR Grant Process
*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 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. Research should measure the impact of standardizing clinical practice through clinical practice guidelines, evidence-based practices, and process interventions on the health of the population/sub-population.
Outcomes – Health outcome research identifies and measures the factors which impact a population of patients and examines the system level factors which influence achievement of the Quadruple Aim “better health.” Comparison to private sector efforts or between direct and purchased care should be considered. Health outcomes research incorporates more than clinical outcomes, it must include consideration of the financial impact, health, quality of life, and measurement of indicators that predict factors important to patients and patient experience at the enterprise, geographic market level, or sub-population levels.
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 private care.
Health System – Research related to the impact of the significant changes in policy, structure, or funding of healthcare system; impact of policy and system change to healthcare cost, quality, utilization, health outcomes, manpower/staffing, or health care readiness; comparisons between direct and private care, or care within the private sector should be considered; measurement of the impact of policy changes to the TRICARE benefit structure on utilization and cost to the system.
FY2025 MHSR Clinical Priority Areas (new areas are determined each grant cycle):
- Cardiovascular Health
- Women Health
- Primary Care
- Specialty Care
- Surgical Services
- Telehealth
- Sensory Health
- Nutritional Care
- Dental Care
All research should consider including in their analysis an examination the system variables listed below:
- Disparities in care in terms of age, race, gender, rank, service
- Manpower and staffing models should include physicians, nurses, allied health professionals and administrative support
- Impact of major transformational change resulting from Genesis
- Difference between care delivered in the direct versus private care system
Fiscal Year 2024 MHSR Research Awardees
| Institution | Project Title |
|---|---|
| Weil Cornell Medical College | The Impact of Staffing Levels on Access, Quality, and Utilization: Evidence from Primary Care |
| University of Massachusetts, Amherst | Cumulative Psychosocial Stress and Health Readiness among Military Personnel in the Millennium Cohort Study: Examining the role of Racial/Ethnic, Gender, and Socioeconomic Disparities |
| Naval Health Research Center | The Impact of Multimorbidity on Military Readiness |
| NMRTC San Diego | Assessment of Outcomes for Children with Infections in the Military Health System and of the Appropriate Use of Antimicrobials |
| Naval Postgraduate School | Monetary and Non-monetary Factors Influencing the Geographic and Temporal Variation in Military Physician Retention |
| Naval Postgraduate School | Relocation-Related Changes in Mental Health and Self-reported Behavioral Outcomes of Active-Duty Personnel and their Families |
| University of Nebraska Medical Center | Mapping Global Disease Burden |
| Naval Health Research Center | Impact of Occupational Stress and Burnout on Health Care Readiness in Independent Duty Corpsmen |
| University of Nevada, Las Vegas | Models of Medical Readiness/Healthcare Delivery: Cost and Efficiency Analysis |
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 |
| USU/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 |
| University of Southern California | 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 |
| Boston VA Research Institute | 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 |
Helpful Resources
For Health Services Research Funding and Resources
For the Military Health System
For Researchers Concerning Data and Data Sharing