Military Health Systems Research
Overview
The Military Health System’s (MHS) TRICARE health plan services 9.4 million active duty and retired military personnel and their dependents, a cohort of universally insured individuals that reflects the socioeconomic and racial demographics seen in the U.S. The Military Health System Data Repository (MDR) offers an opportunity to understand variations and drivers in healthcare utilization within the MHS and beyond, identifying areas for value optimization and better health outcomes.
The Comparative Effectiveness and Provider Induced Demand Collaboration (EPIC) formed in 2011 as a partnership between CSPH and the Uniformed Services University (USU). Through this collaboration, the Military Health Systems research program is working to better the lives of military personnel and their families. The EPIC collaboration has brought the system to national attention comparing purchased and direct care, revealing the impact of provider-induced demand on healthcare costs. We have investigated opioid prescribing patterns in the MHS and demonstrated that under a universal healthcare scheme, racial disparities in outcomes disappear. Publishing articles across multiple research areas since 2016, the collaboration continues in new iterations to inform discussions on healthcare reform for the MHS and the nation.
Contact Information
Project Director: Alysa Pomer (apomer1@bwh.harvard.edu)
Projects
The collaboration focused on studying some of the most pressing healthcare challenges faced by military and civilian populations using the MDR. While initially established to identify drivers of increasing healthcare costs in the context of healthcare quality, utilization, and disparities, the collaboration has inspired a broader and deeper examination of contextual healthcare issues that impact military personnel and their dependents’ health outcomes. These include comparative effectiveness and outcomes, epidemiology, quality and practice improvement, healthcare disparities, provider-induced demand, and socioeconomic and geographic variation. This original version of EPIC ran from 2012 to 2021.
PI(s): Zara Cooper, Tracey Koehlmoos (USUHS)
Funding Source: Defense Health Agency (#HU0001-11-1-0023)
Since 2022, EPIC exists as two studies under the title “EPIC: A Clinical and Economic Analysis of Variation in Healthcare”. The first study of today’s EPIC focuses on Low-Value Care (LVC) in the Military Health System, which aims to produce high quality research around low and high value care in the Military Health System.
PI(s): Zara Cooper, Joel Weissman, Tracey Koehlmoos (USUHS)
Funding Source: Defense Health Agency (#HU00012320020)
Since 2022, EPIC exists as two studies under the title “EPIC: A Clinical and Economic Analysis of Variation in Healthcare”. The second study of today’s EPIC focuses on Service Women’s Health (SWH), with the goal of producing high quality research around service women’s health care in the Military Health System.
PI(s): Zara Cooper, Joel Weissman, Tracey Koehlmoos (USUHS)
Funding Source: Defense Health Agency (#HU00012320021)
The Military Health System Response to COVID-19 (MiHReC) project is a spin-off of the EPIC project which evaluates the impact of the COVID-19 pandemic on the MHS. The project investigates quality of care and health care effectiveness in the MHS, and the understand the long-term implications of the COVID-19 pandemic on military health/medical readiness, including the medical readiness of military service members and the professional readiness of the military health services.
PI(s): Andrew Schoenfeld, Joel Weissman, Tracey Koehlmoos (UHUHS)
Funding Source: Department of Defense
This project, entitled, “Increasing Access to Definitive Treatment for Prostate Cancer by Removing Transportation Barriers for Underserved Patients: A Multilevel Feasibility Study“ began in 2023. The project aims to produce evidence that can inform facility-level interventions to reduce travel burden for high-risk, historically marginalized populations seeking prostate cancer treatment.
PI: Quoc-Dien Trinh
Funding Source: Department of Defense office of the Congressionally Directed Medical Research Programs (#PC220551)
