The Military Health System (MHS) is the most comprehensive military medical enterprise in the world. Its goal is to ensure a medically ready force to execute the National Defense Strategy, and a ready medical force to support our armed forces throughout the world.

This report summarizes the Department’s decisions to align Military Treatment Facilities (MTFs) to increase the readiness of our operational and medical forces. (See section 703(d)(1) of the National Defense Authorization Act (NDAA) for Fiscal Year (FY) 2017 (Public Law 114–328)). These decisions have been reviewed and accepted by the Secretary of Defense, and reflect the Department’s underlying principle to improve the readiness of our force, while ensuring all beneficiaries have access to high-quality medical care.

The decisions in this report were based on an initial screening of 343 MTFs identified as providing healthcare services in the United States. The report contains analysis that is independent of other initiatives that will have an impact on manpower. From the 343 MTFs initially assessed, 77 were identified for further assessment. The assessment was completed using agreed upon methods by Department senior leadership including:

• Use of comprehensive data on MTF performance.
• Government and independent commercial assessments of local market capabilities and capacities.
• Data call identifying MTF readiness and mission requirements.
• Input from Service and local medical facility leadership and staff.
• On-site assessments when required.

The assessment identified: 50 MTFs for right-sizing, 21 with no change, and six deferred for further review. 

This report provides a strategic framework for MTF realignment and restructuring that will be supplemented by more detailed implementation plans that include a timeline for achieving the planned end state along with estimates of implementation costs and any savings that may result. The Department will continue to evaluate MTFs for additional changes in delivery patterns using the methods described in this report.

The increased demand from the beneficiary population transitioning to local networks is the key driver of MTF implementation timelines. Most MTFs will need to follow a measured approach by transitioning beneficiary populations gradually to care from commercial providers.

During the transition, some local markets may be challenged to absorb the additional MTF beneficiary demand. As demand grows, the expectation is that new entrants to the market will increase network capacity. However, this expectation will be carefully managed during the transition and, if during implementation, local networks are challenged to absorb demand, the Department will revise its implementation plan. Markets are expected to transition MTF eligibles to the network at different rates and, in certain markets, the transition could take several years.

The below table outlines a complete list of the 50 MTFs designated for restructure. Some PDF files may not be 508 compliant, but will be made so soon. 

Read the Report to Congress

NOTE: The COVID-19 pandemic impacted civilian providers and health care networks and Congress directed a hold on any actions to restructure military hospitals and clinics in the Fiscal Year 2023 National Defense Authorization Act. Therefore, information contained in this report should not be considered final and more information will be forthcoming from Congress and Department leaders.