The Military Health System is continually evolving to become a more integrated system of readiness and health. On March 11, 2013, the Deputy Secretary of Defense issued a memorandum outlining the implementation of MHS governance reform as it was outlined in section 731 of the National Defense Authorization Act for Fiscal Year 2013. While the centerpiece for this reform as the establishment of the Defense Health Agency as a Combat Support Agency, this memorandum also established the multi-service market areas which served as a stepping stone to the DHA’s current health care market structure.

Multi-service market areas, or MSMs, were geographic areas where at least two military medical hospitals or clinics from different military Service branches – Army, Navy or Air Force – had overlapping service areas. There were 15 MSMs around the world; 11 in the U.S. and four overseas.

Enhanced Multi-Service Markets

Six of these markets were considered "enhanced" because of several factors, including overall size, medical mission and graduate medical education capacity. 

• Colorado Springs, Colorado
• National Capital Region
• Oahu, Hawaii
• Puget Sound, Washington
• San Antonio, Texas 
• Tidewater, Virginia

These eMSMs were also provided with “enhanced” authorities to:

• Manage the allocation of the budget for the market
• Direct the adoption of common clinical and business functions for the market
• Optimize readiness to deploy medically ready forces and ready medical forces
• Direct the movement of workload and workforce between or among the military medical hospitals and clinics within the market

DHA Health Care Market Structure

Today, the DHA has established a market-based structure to manage the military medical hospitals and clinics using lessons learned from the MSM and eMSM processes and procedures. >>Find out More about the DHA’s Health Care Market Structure