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Army Medical Department Funding
The many and varied activities of the Army Medical Command consume approximately $13 billion yearly.
However, that conveys only a superficial impression of a business whose complex financing can boggle the minds even of budget experts.
The funding complexity stems from the complexity of the MEDCOM's mission and the variety of its customers.
The money comes from different sources (appropriation categories and civilian sources). It flows through different channels (the Defense Department, various Army agencies, the other military services and billings).
The dollars involved are counted in different ways (categories and years).
And they are disbursed to many different kinds of recipients (Soldiers, Army civilian employees, contractors and suppliers).
All depends ultimately on which mission and customer is supported by a given dollar. Some missions receive funds from more than one source, if they serve multiple customers.
By far the biggest chunk of the MEDCOM budget is spent on delivery of health care to Soldiers and military Families.
Where it comes from is the Defense Health Program, or DHP. The DHP was created in 1992 to centralize funding and management of military health care (previously carried out independently by the separate services). The goal was to trim duplication and foster more interservice cooperation.
At a time of skyrocketing healthcare costs, the creation of the DHP was seen as essential to the goal of giving beneficiaries adequate access to high-quality care.
It was also tied to creation of the tri-service managed care program, Tricare®, which also depended on multiservice management and funding.
Tricare® money passes directly from DHP to the Tricare® Management Activity, which pays Tricare® contractors on behalf of the services. However, a share of Tricare® money is attributed to the MEDCOM budget, based on the amount of support allocated to Army hospitals.
A smaller but important source of funds is payments from civilian health insurance companies for military beneficiaries who have insurance (for example, Family members and retirees with civilian jobs). Also, other government agencies pay for care that the MEDCOM gives to their patients.
This money for purposes other than direct care comes mostly from Army appropriations, but some comes from other Defense Department funds (for example, funds for certain research programs) or other military services (such as reimbursed preventive medicine services).
Funds for military construction are paid to contractors by the Army Corps of Engineers, which supervises building projects. However, medical facilities are planned and explained to Congress by AMEDD officials and are for AMEDD use, so they count as MEDCOM budget items.
Substantial additional amounts of money are expended on the Army's non-MEDCOM medical force—the field or combat medical units and personnel.
However, those funds are channeled through the various combatant commands that "own" those units. Consequently, the amount is not included in the total managed by AMEDD leaders.