Need larger text?

Absolute and relative morbidity burdens attributable to various illnesses and injuries among non-service member beneficiaries of the Military Health System, 2025

Image of MSMR 202667 Photo9_ToC_9591642_Jul2026. The U.S. Military Health System fulfills a dual mandate: ensuring the operational medical readiness of the U.S. Armed Forces while providing comprehensive healthcare to eligible personnel and their dependents.

7/1/2026

Share this page

Social Media Links

Other Social Media

What are the new findings?

Analysis of 2025 data reveals that non-service member beneficiaries of the Military Health System remain overwhelmingly reliant upon outsourced care: Roughly 70% of TRICARE-eligible and more than 91% of Medicare-eligible individuals received their health care exclusively from civilian providers. The 2025 data also reveal distinct, age-related burdens of morbidity. While both mental health and developmental disorders dominate provision of care for beneficiaries under age 45 years, musculoskeletal system and cardiovascular conditions constitute the primary health care encounters for older adults.

What is the impact on readiness and force health protection?

The 2024-2029 Military Health System (MHS) Strategy aims to attract as well as re-attract beneficiaries to MHS medical facilities, not only to improve System efficiency but to purposely fulfill the nation’s promise to care for its military beneficiaries, as well as enriching the clinical experience for the ready military medical force. Continued evaluation of health care provision and diagnostic patterns may aid senior leaders’ resource allocation to realize current MHS strategy and goals.

Background

Operating as a globally integrated health delivery network, the Military Health System (MHS) executes a dual mandate: ensuring the operational medical readiness of the U.S. Armed Forces and providing comprehensive health care to eligible personnel and their dependents.1 This system relies on a hybrid model, balancing care delivered at military hospitals and clinics, known as the direct care system, with civilian care facilitated by the TRICARE network. Fulfilling its commitment to service members, retirees, and their families, the MHS provided TRICARE eligibility to approximately 9.4 million beneficiaries in fiscal year 2024.2

Due to the diversity of this beneficiary population, health care enrollment and provision patterns vary significantly among different demographic categories.2 To optimize this complex network, the current Department of War (DOW) strategy, guided by the MHS Strategy for Fiscal Years 2024-2029 and recent stabilization directives, heavily prioritizes rebuilding direct care capacity.3 A central objective of this strategy is to “attract and reattract beneficiaries to military treatment facilities,” a shift designed to maximize system efficiency, enrich clinical case diversity, and sustain the medical proficiency of the Ready Medical Force.4,5

When interpreting these usage patterns, the structural transition of health benefits at age 65 years is a critical factor. For beneficiaries younger than age 65 years, care is distributed between military hospitals and clinics and civilian providers. Upon reaching age 65 years and gaining Medicare eligibility, standard TRICARE coverage converts to TRICARE for Life (TFL), a Medicare supplement funded independently of the Defense Health Program. While Medicare-eligible individuals can still access military hospitals and clinics, depending on space availability, their care is predominantly outsourced via the civilian health care system. Consequently, morbidity burdens must be analyzed within specific age cohorts and care settings to accurately reflect their true impacts on MHS resources.

Building on prior annual analyses, this report quantifies the health care burdens of non-service member MHS beneficiaries during calendar year 2025. Morbidity was assessed using a modified Global Burden of Disease (GBD) classification framework6-9 in conjunction with standard International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnostic groupings for both hospitalizations, or inpatient visits, and ambulatory care, or outpatient visits. To account for the distinct health care provision differences driven by the TRICARE-to-Medicare transition, the resulting estimates are stratified by 4 age categories, with beneficiaries ages 65 years and older analyzed separately.

Methods

The surveillance population included all non-service member MHS beneficiaries who had at least 1 hospitalization or outpatient medical encounter from January 1 through December 31, 2025, with either a military hospital, clinic, or health care provider, or through a civilian facility or provider (if reimbursed through TRICARE or through Medicare with a co-payment by TFL). All inpatient and outpatient medical encounters for this analysis were summarized according to the primary (i.e., first-listed) ICD-10-CM codes that indicate the natures of illnesses or injuries (A00–T88). Nearly all records of encounters with first-listed diagnoses coded with ‘Z’ (“care other than for a current illness or injury,” e.g., general medical examinations, after care, vaccinations) or ‘V’, ‘W’, ‘X’, or ‘Y’ (“indicators of the external causes but not the natures of injuries”) were excluded from the analysis; encounters with a code of Z37 (“outcome of delivery”) in the primary position were retained.

For summary purposes, all illness- and injury-specific diagnoses (as defined by ICD-10) were grouped into 157 burden of disease-related conditions and 25 major morbidity categories, based upon a modified version of the classification system developed for the GBD Study. The methodology for summarizing absolute and relative morbidity has been used annually since 2014 and is described elsewhere.8 Results were stratified by source of health care (direct care [i.e., military hospitals and clinics] vs. civilian facilities) and by age group (0-17 years, 18-44 years, 45-64 years, 65 years and older). For analysis of morbidity burdens within the youngest age group, developmental disorders were included in the general category of mental health disorders.

Results

In 2025, the population of non-service member MHS care recipients included more female (57.3%) than male (42.7%) beneficiaries. Adults ages 65 years or older accounted for the highest number of individuals receiving health care (n=2.06 million, 33.5%), followed by pediatric beneficiaries ages 0-17 years (n=1.44 million, 23.3%), adults ages 18-44 years (n=1.37 million, 22.1%), and older adults ages 45-64 years (n=1.30 million, 21.1%) (Table 1).

Click on the table to access Section 508-compliant PDF version

In 2025, a total of 6,166,782 non-service member MHS beneficiaries had 93,079,550 recorded medical encounters. Over half (52.9%) of those medical encounters were among 2,063,683 MHS beneficiaries ages 65 years and older (Table 1). Provision of care for the oldest age group was almost exclusively from civilian providers, with 91.2% of individuals ages 65 years or older having medical encounters or hospital bed days documented only from reimbursements processed for care at civilian facilities (Table 2). Among TRICARE-eligible beneficiaries (younger than age 65 years), health care was also almost exclusively from civilian facilities. Adults ages 18-44 years received approximately one-third of their care exclusively from military hospitals and clinics (11.4%) or a combination of direct and outsourced care (19.4%) (Table 2).

Click on the table to access Section 508-compliant PDF version

The 3 most frequent morbidity-related categories accounting for the most medical encounters among TRICARE-eligible beneficiaries included mental health disorders, injuries, and symptoms, signs and ill-defined conditions (Figure 1a). Mental health disorders also represented the leading category for hospital bed days for beneficiaries younger than age 65 years, followed by maternal conditions (Figure 1b). 

FIGURE 1a. Numbers of Medical Encounters, Individuals Affected, and Hospital Bed Days, by Burden of Disease Major Category, Non-Service Member Military Health System Beneficiaries Younger than Age 65 Years, 2025 This combination chart displays three health metrics for non-service member MHS beneficiaries younger than age 65 in 2025: the number of medical encounters, individuals affected and hospital bed days, organized by major disease category. The chart uses vertical bars for encounters and affected individuals and square markers for bed days. Its purpose is to quantify the primary health burdens for this population group. Mental and substance abuse disorders are the leading category, with over 11 million medical encounters affecting over 2 million individuals and resulting in over 550,000 hospital bed days. The second most frequent category is symptoms and ill-defined conditions, followed by injuries. Maternal conditions, while lower in encounters and affected individuals, are the second-highest cause of hospital bed days, totaling over 280,000.

FIGURE 1b. Percentages of Medical Encounters and Hospital Bed Days, by Burden of Disease Major Category, Non-Service Member Military Health System Beneficiaries Younger than Age 65 Years, 2025 This stacked bar chart compares the percentage distribution of medical encounters and hospital bed days for non-service member MHS beneficiaries younger than age 65 in 2025. The chart’s purpose is to contrast health care provision with the severity of health conditions. Mental and substance abuse disorders represent the largest share of both medical encounters (26.4%) and hospital bed days (29.9%). Maternal conditions show a significant disparity, accounting for only 2.9% of medical encounters but 14.5% of hospital bed days. Conversely, symptoms and ill-defined conditions comprise 23.6% of encounters but only 4.3% of hospital bed days. Injuries account for 11.8% of encounters and 12.2% of hospital bed days, showing a more balanced impact.

Pediatric beneficiaries younger than age 18 years

Pediatric patients accounted for 14.4% of all medical encounters, 23.3% of all individuals affected, and 9.6% of all hospital bed days among non-service member MHS beneficiaries in 2025 (Table 1). On average, each pediatric beneficiary experienced 9.3 medical encounters during the year. Provision of care for pediatric patients was primarily through reimbursement for care in civilian facilities (70.4%), followed by a combination of direct and outsourced care (18.8%). Only 10.8% of pediatric patients received all medical encounters or hospital bed days directly from MHS providers (Table 2).

FIGURE 2a. Medical Encounters, Individuals Affected, and Hospital Bed Days, by Burden of Disease Major Category, Pediatric Non-Service Member Military Health System Beneficiaries, Ages 0–17 Years, 2025 This combination chart presents three health metrics for pediatric MHS beneficiaries (ages 0-17) in 2025: the number of medical encounters, individuals affected and hospital bed days, all organized by major disease category. The chart uses vertical bars for encounters and affected individuals and square markers for bed days. Its purpose is to quantify the main health burdens for this pediatric population. Mental and substance abuse disorders, which in this age group includes developmental disorders, is the leading category by a large margin, with over five million medical encounters, affecting over 300,000 individuals, and causing over 300,000 hospital bed days. The next leading categories for medical encounters are symptoms/ill-defined conditions and respiratory infections. Perinatal conditions are the second-highest cause of hospital bed days, despite far fewer health care encounters.

FIGURE 2b. Percentages of Medical Encounters and Hospital Bed Days, by Burden of Disease Category, Pediatric Non-Service Member Military Health System Beneficiaries, Ages 0–17 Years, 2025 This stacked bar chart compares the percentage distribution of medical encounters versus hospital bed days for pediatric MHS beneficiaries (ages 0-17) in 2025. The chart’s purpose is to contrast health care provision with condition severity. The data shows that mental health disorders (including developmental disorders) dominate both categories, accounting for 40.2% of all medical encounters and a substantial 58.3% of all hospital bed days. Symptoms and ill-defined conditions are the second-largest category for encounters, at 14.2%, but contribute only 2.2% to hospital bed days. Conversely, perinatal conditions account for a small fraction of encounters but are the second-largest contributor to hospital bed days, at 8.2%. Respiratory infections comprise 8.9% of encounters but only 2.7% of bed days.

FIGURE 2c. Percentages of Medical Encounters and Hospital Bed Days for Major Diagnostic Code Groupings Under Mental Health Disorder Burden of Disease Category, Pediatric Non-Service Member Military Health System Beneficiaries, Ages 0–17 Years, 2025 This stacked bar chart details the percentage distribution of medical encounters and hospital bed days for specific mental and developmental disorders among pediatric MHS beneficiaries (ages 0-17) in 2025. The purpose is to identify which specific conditions are the primary factors of the mental health burden in this population. The chart shows that autistic and pervasive developmental disorders are the leading cause of medical encounters, at 35.4% of the total within the mental health category. Specific developmental disorders of speech and language follow, at 23.6%, then attention-deficit hyperactivity disorders, at 11.4%. For hospital bed days, the pattern is different: Mood (affective) disorders are the overwhelming cause, accounting for 64.5% of all mental health-related hospital stays, despite representing only 6.9% of encounters.In 2025, mental health disorders represented the largest burden of disease among pediatric beneficiary medical encounters (40.2%, n=5,374,051) and contributed to the greatest number of hospital bed days (58.3%, n=334,980) (Figures 2a, 2b). On average, pediatric beneficiaries affected by a mental health disorder had 16.2 medical encounters during the year specifically related to this morbidity category (data not shown). More than two-thirds (70.3%) of all medical encounters for mental health disorders among pediatric beneficiaries were attributed to 3 groups of disorders: autistic disorders and pervasive developmental disorders (35.4%), developmental disorders of speech and language (23.6%), and attention-deficit hyperactivity disorders (11.4%) (Figure 2c). Pediatric patients affected by an autistic disorder had, on average, 41.4 autism-related encounters per individual (data not shown).

Over two-thirds (64.5%) of hospital bed days related to mental health disorders among pediatric beneficiaries were attributable to mood disorders. Among all mood disorder-related hospital bed days, over 60% were attributed to 2 diagnostic categories: recurrent severe major depressive disorder without psychotic features (30.8%, ICD-10 F332) and disruptive mood dysregulation disorder (31.7%, ICD-10 F3481) (data not shown).

Perinatal conditions, or medical issues occurring within 1 year of birth, accounted for the second highest number of hospital bed days (n=47,254, 8.2%) in 2025 among pediatric beneficiaries, after mental health disorders (Figures 2a, 2b). Pediatric beneficiaries affected by malignant neoplasms had, on average, 13.5 neoplasm-related encounters per individual. The highest numbers of malignant neoplasm-related encounters and hospital bed days were attributable to leukemias (data not shown).

Respiratory infections (including upper and lower respiratory infections and otitis media) accounted for more medical encounters (8.9%) among pediatric beneficiaries compared to any older age group of beneficiaries (Figures 2b, 3b, 4b, 5b).

Beneficiaries ages 18–44 years

Individuals ages 18-44 years accounted for 14.4% of all medical encounters, 22.1% of all individuals affected, and 10.6% of hospital bed days among non-service member MHS beneficiaries in 2025 (Table 1). On average, each individual ages 18-44 years affected with an illness or injury (of any cause) had 9.8 medical encounters during the year. Provision of care for beneficiaries ages 18-44 years was primarily (69.2%) through reimbursement for care in civilian facilities, followed by a combination of direct and outsourced care (19.4%). Only 11.4% of beneficiaries ages 18-44 years received all medical encounters or hospital bed days directly from MHS providers (Table 2).

FIGURE 3a. Medical Encounters, Individuals Affected, and Hospital Bed Days, by Burden of Disease Major Category, Non-Service Member Military Health System Beneficiaries, Ages 18–44 Years, 2025 This combination chart displays three health metrics for non-service member MHS beneficiaries ages 18-44 in 2025: the number of medical encounters, individuals affected and hospital bed days, organized by major disease category. The chart uses vertical bars for encounters and individuals, and square markers for bed days. Its purpose is to quantify the main health burdens for young adult beneficiaries. Mental and substance abuse disorders are the leading category for medical encounters (over 3.5 million) and individuals affected (over 400,000). Maternal conditions, however, are the leading cause of hospital bed days (over 250,000), followed by mental health disorders (over 150,000) and injuries (over 100,000). Symptoms and ill-defined conditions also account for a high number of medical encounters.

Mental health disorders accounted for the most medical encounters (n=3,444,190, 25.6%) among adult MHS beneficiaries ages 18-44 years in 2025 (Figures 3a, 3b), also representing about one-fifth (19.9%) of total hospital bed days, and on average, 8.8 mental health-related encounters per individual. Anxiety disorders (37.1%), mood disorders (28.9%), and adjustment disorders (14.2%) accounted for over three-quarters (80.2%) of all medical mental health care encounters (data not shown). Mood and substance abuse disorders accounted for over three-quarters (48.6% and 26.7%, respectively) of hospital bed days required for mental health disorders.

FIGURE 3b. Percentages of Medical Encounters and Hospital Bed Days, by Burden of Disease Major Category, Non-Service Member Military Health System Beneficiaries, Ages 18–44 Years, 2025 This stacked bar chart compares the percentage distribution of medical encounters and hospital bed days for non-service member MHS beneficiaries ages 18-44 in 2025. The purpose is to contrast health care provision with condition severity in this age group. The chart shows that mental and substance abuse disorders account for the largest percentage of medical encounters, at 25.6%. Maternal conditions are the overwhelming cause of hospital bed days, however, comprising 44.5% of the total, despite accounting for only 8.3% of medical encounters. Mental health disorders are the second-largest contributor to hospital bed days, at 19.9%. Symptoms and ill-defined conditions represent a large portion of encounters (19.9%) but a small fraction of bed days (3.5%).

Maternal conditions accounted for more than two-fifths (n=282,691, 44.5%) of all hospital bed days among adults ages 18-44 years, as well as, on average, 6.7 medical encounters per affected individual (Figures 3a, 3b). Of the 282,691 hospital bed days for maternal conditions, 64.0% were attributed to pregnancy complications, with 18.9% due to infant deliveries (data not shown).

Malignant neoplasms, as a diagnostic group, resulted in 7.0 encounters, on average, per individual in 2025. Of the 106,604 medical encounters for malignant neoplasms among adults ages 18-44 years, 32.9% were attributed to malignant neoplasm of the breast (data not shown).

Beneficiaries ages 45–64 years

Non-service member beneficiaries ages 45-64 years constituted approximately one-fifth (18.3%) of all medical encounters, 21.1% of all individuals affected, and 12.6% of hospital bed days in 2025 (Table 1). Each affected individual ages 45-64 years had, on average, 13.1 medical encounters during the year. Provision of care for beneficiaries ages 45-64 years was primarily (73.5%) through reimbursement for care in civilian facilities, followed by a combination of direct and outsourced care (19.0%). Only 7.5% of beneficiaries ages 45-64 years received all medical encounters or hospital bed days directly from MHS providers (Table 2).

FIGURE 4a. Medical Encounters, Individuals Affected, and Hospital Bed Days, by Burden of Disease Major Category, Non-Service Member Military Health System Beneficiaries, Ages 45–64 Years, 2025 This combination chart displays three health metrics for non-service member MHS beneficiaries ages 45-64 in 2025: the number of medical encounters, individuals affected and hospital bed days, organized by major disease category. The chart uses vertical bars for encounters and individuals, and square markers for bed days. Its purpose is to quantify the primary health burdens for this middle-aged adult population. Musculoskeletal diseases are the leading cause of medical encounters (over 2.5 million) and affect the most individuals (over 700,000). Injuries are the leading cause of hospital bed days (over 120,000), followed closely by cardiovascular diseases (over 120,000). Symptoms and ill-defined conditions are the second-leading cause of medical encounters.

Of all morbidity-related categories, musculoskeletal diseases accounted for the most medical encounters (n=2,409,259, 14.2%) among older adult beneficiaries ages 45-64 years (Figures 4a, 4b); back problems accounted for 41.7% of those musculoskeletal disease-related encounters (data not shown). Injuries represented the highest proportion of hospital bed days (16.9%) among adults ages 45-64 years, followed by cardiovascular diseases (16.0%). Digestive diseases (9.4%) and malignant neoplasms (8.1%) accounted for larger percentages of total hospital bed days among beneficiaries of this age group compared to other age groups.

FIGURE 4b. Percentages of Medical Encounters and Hospital Bed Days, by Burden of Disease Major Category, Non-Service Member Military Health System Beneficiaries, Ages 45–64 Years, 2025 This stacked bar chart compares the percentage distribution of medical encounters and hospital bed days for non-service member MHS beneficiaries ages 45-64 in 2025. The purpose is to contrast health care provision with condition severity in this age group. The chart shows that musculoskeletal diseases account for the largest share of medical encounters, at 14.2%. For hospital bed days, the burden is led by injuries (16.9%) and cardiovascular diseases (16.0%). Symptoms and ill-defined conditions represent a significant portion of encounters (14.2%) but a much smaller percentage of bed days (3.2%). Conversely, malignant neoplasms account for only 3.2% of encounters but 8.1% of hospital bed days.

Malignant neoplasm of the breast represented the leading cause of neoplasm-related encounters (26.3%) in adult beneficiaries ages 45-64 years (data not shown).

Medicare-eligible beneficiaries, ages 65 years and older

In 2025, non-service member beneficiaries ages 65 years or older accounted for the largest proportion (52.9%) of medical encounters, and their hospital bed days were more than double all other age groups combined. On average, each affected individual in Medicare-eligible age group had 23.9 medical encounters during the year (Table 1). Provision of care for Medicare-eligible beneficiaries was primarily through reimbursement of care from civilian facilities (91.2%); only 2% received all medical encounters or hospital bed days directly from MHS providers (Table 2).

FIGURE 5a. Medical Encounters, Individuals Affected, and Hospital Bed Days, by Burden of Disease Major Category, Non-Service Member Military Health System Beneficiaries, Age 65 Years or Older, 2025 This combination chart presents three health metrics for MHS beneficiaries aged 65 and older in 2025: the number of medical encounters, individuals affected and hospital bed days, organized by disease category. The chart uses vertical bars for encounters and individuals, and square markers for bed days. Its purpose is to quantify the main health burdens for the elderly beneficiary population. Musculoskeletal diseases are the leading cause of medical encounters (over 7 million) and affect the most individuals (over 1.2 million). Cardiovascular diseases follow closely in encounters and affected individuals, but are the leading cause of hospital bed days, with nearly one million bed days. Injuries are the second-leading cause of hospital bed days (over 800,000).

Musculoskeletal diseases (n=7,371,419, 15.0%) and cardiovascular diseases (n=6,846,617, 13.9%) together represented the leading causes for medical encounters among beneficiaries ages 65 years or older, while injury (n=875,871, 21.7%) and cardiovascular diseases (816,180 days, 20.2%) were the leading diagnostic categories for their hospital bed days (Figures 5a, 5b). Back problems accounted for a little more than one-third (35.0%) of all musculoskeletal disease-related medical encounters among individuals ages 65 years and older (data not shown).

FIGURE 5b. Percentages of Medical Encounters and Hospital Bed Days, by Burden of Disease Major Category, Non-Service Member Military Health System Beneficiaries, Age 65 Years or Older, 2025 This stacked bar chart compares the percentage distribution of medical encounters and hospital bed days for MHS beneficiaries ages 65 and older in 2025. The purpose is to contrast health care provision with condition severity in this older population. The chart shows that musculoskeletal diseases (15.0%) and cardiovascular diseases (13.9%) are the leading two categories for medical encounters. For hospital bed days, the order is reversed: Cardiovascular diseases are the leading cause, at 21.7%, followed by injuries, at 20.2%. Musculoskeletal diseases account for only 6.3% of hospital bed days. Symptoms and ill-defined conditions comprise 13.0% of encounters but only 2.3% of hospital bed days, while malignant neoplasms account for 4.5% of encounters but 8.1% of bed days.

Discussion

These findings from calendar year 2025 reveal a continued reliance on civilian care among all age groups of non-service member MHS beneficiaries. To improve access and sustain clinical readiness, DOW’s strategy for fiscal years 2024-2029 prioritizes “attracting and reattracting” beneficiaries to military hospitals and clinics. These data, however, demonstrate that most care is still nearly exclusively civilian for TRICARE-eligible beneficiaries (younger than age 65 years): 70.4% for those ages 0-17 years, 69.2% for those ages 18-44 years, and 73.5% for those ages 45-64 years.

Notably, MHS beneficiaries receive higher health care provision compared to the general U.S. population. Compared to the National Ambulatory Medical Care Survey of 2019, which documented 3.2 ambulatory visits per person-year among the civilian population, non-service member MHS beneficiaries had 14.6 ambulatory health care visits per person-year.10 Since the National Ambulatory Medical Care survey includes uninsured individuals, financial barriers to care may explain a portion of the lower overall use rate among the general U.S. population. Conversely, MHS beneficiaries benefit from comprehensive coverage with minimal direct payment, or out-of-pocket costs, which drives higher general provision of care, while the unique stressors of military life may also generate significant demand for specific services, particularly mental health care.11,12

Consistent with prior years, this analysis reveals age-related contrasts in morbidity burdens. For pediatric (ages 0-17 years) and younger adult (ages 18-44 years) populations, mental health disorders remain the overwhelming cause of health care. In pediatric patients, outpatient mental health services are primarily influenced by developmental disorders, with nearly 70% of mental health encounters attributable to autistic disorders, developmental speech and language disorders, or attention-deficit hyperactivity disorders. Similarly, young adults seek extensive outpatient care for anxiety and mood disorders, while maternal conditions continue to account for the highest proportion of hospital bed days for the ages 18-44 years group.

In older MHS beneficiaries, the burden of health care shifts to chronic physical conditions and injuries, continuing trends consistent with 2024 data.14 Individuals ages 45 or older account for the highest volume of medical encounters, predominantly due to musculoskeletal conditions. Furthermore, injuries and cardiovascular diseases constitute the leading causes of hospital bed days for both the ages 45-64 years and Medicare-eligible (ages 65+ years) populations. Because the Medicare-eligible demographic generates the highest care provision rates but relies almost exclusively on non-MHS resources via Medicare and TFL, their direct impact on military hospital capacity remains mitigated.

While this report provides a comprehensive overview of morbidity-related diagnoses, it is inherently limited to care billed through TRICARE or Medicare (with TFL). Care paid for directly, or out-of-pocket, or through other unbilled primary health insurance, is not captured. This summary is based on primary (i.e., first-listed) diagnosis codes reported on ambulatory visit records and discharge diagnoses for hospitalizations; this summary discounts morbidity related to co-morbid and complicating conditions that may have been documented in secondary diagnostic positions. The accuracy of reported diagnoses likely varies according to medical condition, clinical setting, care provider, and health care facility, as the data were collected for non-surveillance purposes. The data presented in this report were extracted from DMSS on May 1, 2026.

Continued evaluation of health care provision and diagnostic patterns may aid senior leaders’ allocation of resources for realization of the current MHS strategy and goals. The gap between the reliance on civilian care and the strategic vision for the MHS is actively being addressed at the highest levels of the DOW. Ultimately, reversing the trend of outsourced care is not merely an administrative goal but strategic imperative: As noted by Defense Health leadership, providing accessible, high-quality care within the MHS directly sustains medical proficiency, ensuring that when military medical personnel take care of beneficiaries, they inherently increase the readiness of the total force.15

References

  1. Mendez BHP, Congressional Research Service. Defense Primer: Military Health System. In Focus (10530). Library of Congress. Updated Oct. 2024. Accessed Aug. 5, 2025. https://www.congress.gov/crs-product/if10530
  2. Chief Data and Analytics Office, Defense Health Agency. Fiscal Year 2024 TRICARE Program Evaluation Report. U.S. Dept. of War. Sep. 23, 2025. Accessed May 15, 2026. https://www.health.mil/reference-center/reports/2025/09/23/annual-evaluation-of-the-tricare-program-fy24
  3. Military Health System. Military Health System Strategy: Fiscal Years 2024-2029. Defense Health Agency, U.S. Dept. of War. Accessed Aug. 5, 2025. https://health.mil/reference-center/publications/2023/12/15/mhs_strategic_plan_fy24_29
  4. Office of the Deputy Secretary of Defense. Memorandum: Stabilizing and Improving the Military Health System. U.S. Dept. of War. Dec. 6, 2023.
  5. Office of the Under Secretary of Defense. Memorandum for Senior Pentagon Leadership, Defense Health Agency and DoD Field Activity Directors: Directive-Type Memorandum 24-003–“Military Health System Manpower Requirements Determination, Resourcing, and Assignment”. U.S. Department of War. Jun. 2024. Accessed Jun. 26, 2026. www.esd.whs.mil/portals/54/documents/dd/issuances/dtm/dtm-24-003.pdf?ver=nzqjvmhrb8dohutj8wgqa%3d%3d
  6. Murray CJ, Lopez AD, Jamison DT. The global burden of disease in 1990: summary results, sensitivity analysis and future directions. Bull World Health Organ. 1994;72(3):495-509. Accessed Aug. 26, 2025. https://iris.who.int/bitstream/handle/10665/41177/9241561750_en_part2.pdf;jsessionid=3145C7676FA5B9E812A71046BA6326A2?sequence=2
  7. World Health Organization. The Global Burden of Disease: 2004 Update. World Health Organization;2008. Accessed Aug. 26, 2025. https://www.who.int/publications/i/item/9789241563710
  8. Murray CJL. The Global Burden of Disease Study at 30 years. Nat Med. 2022;28(10):2019-2026. doi:10.1038/s41591-022-01990-1
  9. Roser M, Ritchie H, Spooner F. Burden of disease. Our World in Data. Updated Feb. 2024. Accessed May 2, 2024. https://ourworldindata.org/burden-of-disease
  10. Murray CJL, Lopez AD, eds. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. Harvard University Press;1996:120-122.
  11. Santo L, Kang K., National Center for Health Statistics. National Ambulatory Health Care Survey: 2019 National Summary. Centers for Disease Control and Prevention, U.S. Dept. of Health and Human Services. 2019. Accessed May 24, 2024. https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2019-namcs-web-tables-508.pdf
  12. Frakes MD, Gruber J, Justicz T. Public and private options in practice: the Military Health System. Am Econ J Econ Policy. 2023;15(4):37-74. doi:10.1257/pol.20210625 
  13. Wooten NR, Brittingham JA, Pitner RO, et al. Purchased behavioral health care received by Military Health System beneficiaries in civilian medical facilities, 2000–2014. Mil Med. 2018;183(7-8):e278-e290. doi:10.1093/milmed/usx101
  14. Armed Forces Health Surveillance Division. Absolute and relative morbidity burdens attributable to various illnesses and injuries among non-service member beneficiaries of the Military Health System, 2024. MSMR. 2024; 32(9):45-54. Accessed Jun. 12, 2026. https://www.health.mil/news/articles/2024/07/01/msmr-mhs-beneficiaries-2023 
  15. Mincher R, Military Health Systems Communications. Military Health System Stabilization: Rebuilding Health Care Access Is Critical to Patient’s Well-Being. U.S. Dept. of War. 2024. Accessed Jun. 10, 2026. https://www.defense.gov/news/news-stories/article/article/3652092/military-health-system-stabilization-rebuilding-health-care-access-is-critical

You also may be interested in...

Article
May 1, 2025

Trends of Sepsis Hospitalizations Among Female Active Component U.S. Service Members, 2011–2022

This report on sepsis hospitalizations among service women is in response to studies of sepsis among active component U.S. military members that have shown markedly increased rates of sepsis hospitalizations, especially among women, among whom rates are higher than male service members as well as the general U.S. population.

Recommended Content Medical Surveillance Monthly Report
Article
April 25, 2025

Medical Surveillance Monthly Report "30th Anniversary" Issue Celebrates a Milestone

MSMR 30th anniversary issue celebrates a milestone

This year marks a significant milestone for the Medical Surveillance Monthly Report as we celebrate its 30th anniversary. Throughout its three decades, MSMR has continuously improved its content with the goal of providing readers with unbiased, scientifically rigorous, evidence-based medical surveillance information on the current status, trends, ...

Recommended Content Medical Surveillance Monthly Report
Article
April 1, 2025

Guest Editorial: The Department of Defense Global Respiratory Pathogen Surveillance Program: Its Impact on Public Health, from the U.S. Armed Forces to Global Health

This editorial discusses the U.S. Department of Defense Global Respiratory Pathogen Surveillance Program, a cornerstone of U.S. Department of Defense respiratory disease surveillance, and its surveillance network of 115 active sentinel sites in addition to other participating sites, deployed locations, and partner laboratories across the globe.

Recommended Content Medical Surveillance Monthly Report
Refine your search