Military Health System Research: Studying how the Health Care System Delivers Care

A grant program from the Defense Health Agency is now available to researchers studying how the Military Health System can identify and address major and minor changes that can lead to military health care that is safe, effective, accessible, and patient-centered.

The DHA Research and Engineering Directorate recently released the 2024 Notice of Funding Opportunities for future health system research studies on Grants.gov. Applicants will have the chance to contribute to advancing medical knowledge, enhancing health care outcomes, and improving the health and well-being of service members and their families.

All health systems researchers, from within and outside the military, are invited to review the eligibility criteria and submit a letter of intent. The deadline to submit is June 10, 2024, at 5 p.m. Eastern Standard Time.

“This grant program is focused on identifying the factors that influence the delivery of health care within the Military Health System,” said Dr. Richard Shoge, chief of the directorate’s MHS Research Branch. “In improving the delivery of care across the MHS, we impact cost, quality, and outcomes, which influence readiness of the force.”

Although still a relatively new program–with just four grant cycles completed—previous research studies funded by the MHSR program showcase variation in care and treatment across the MHS that can be addressed through information dissemination, standardization of clinical practices, and policies.

A study conducted by researchers from the University of Maryland showed that relative to male active duty service members with obstructive sleep apnea, female active duty service members with obstructive sleep apnea were 29% more likely to be diagnosed through the TRICARE network.

A research team from Penn State University identified variation across the MHS for breast and cervical cancer screening. Part of the findings indicated that in geographical areas where there is higher usage of TRICARE network care, there are also significantly lower screening rates. That suggests women are less likely to receive cervical or breast cancer screening in areas where overall care is predominantly delivered through the TRICARE network. Preventive care exams are covered under TRICARE and typically with no out-of-pocket costs.

As more studies near completion, results can help shape the way the MHS delivers care. Ensuring the quality of the research and relevance to the MHS is at the forefront for Dr. Sean Biggerstaff, the deputy director for the DHA Research and Engineering directorate, and attracting highly motivated researchers to submit letters of intent is critical to the success of the program and the patients. Awarded research grants go through a rigorous scientific and programmatic review process and findings are then shared with MHS leadership through targeted leadership seminars, annual conferences, and directly to the clinical communities.

“The MHS is the only universal health care system in the U.S., a large data-rich system that makes it ideal to study multiple issues related to the delivery of care,” Biggerstaff said. “Health system researchers will be able to collect a wide range of data on any number of priority areas and help directly impact the care and readiness of service members and their families.”

Application Process

Interested researchers will undergo a two-step application process, which starts with the submission of the letter of intent. The approving board will then reach out to selected applicants with an invitation to submit a full proposal, before eventually awarding final grants.
To qualify for the grant, proposed research must address at least one MHSR priority area and one MHSR clinical priority area. MHSR priority areas include:
• Economics and cost: research of the factors that shape the MHS costs, drive demand and utilization, and influence cost in either military hospitals and clinics or with civilian providers
• Health system: research that investigates the impact of significant changes in the policy or structure of the MHS on health care utilization, quality, cost, health outcomes, and other areas
• Variation: research that examines the market, facility, or service differences in health care
• Outcomes: research that identifies and measures the factors which impact a population of patients at the enterprise, network level, or for sub-populations
• Health Readiness: research examining the burden of disease, associated health, and risk factors within MHS populations, and the potential impact to force readiness

MHSR clinical priority areas include:
• Primary Care
• Specialty Care
• Sensory Health
• Nutritional Care
• Surgical Services
• Women’s Health
• Telehealth
• Cardiovascular Health
• Dental Health

More information on the application and grant process can be found at health.mil/HealthSystemResearch.