Assessing Readiness in Service Members Who Receive Private-Sector Behavioral Health Care

Jessica L. Sousa, Kimberly A. Hepner, Carol P. Roth, Lia Pak, Teague Ruder

ResearchPublished Oct 15, 2024

Ensuring that service members who receive behavioral health (BH) care receive routine readiness assessments is critical to maintaining a ready military force. Routine assessments of service members' medical readiness and deployability help identify any acute or chronic health conditions—physical or psychological—that could negatively affect a service member's ability to perform their military duties. Service members may receive BH care from a military treatment facility (MTF) provider (often referred to as direct care) or from a TRICARE-contracted civilian provider in the community (often referred to as private-sector care). While readiness assessments are routinely included in clinical encounters at MTFs, it has been unclear how readiness assessments are being conducted for service members seen in private-sector care. This report presents the findings and integration of two analyses—of administrative treatment data and of qualitative interviews with MTF administrators and clinical staff—that can inform policymaking and planning to improve readiness assessments and command communication for service members receiving private-sector BH care.

Key Findings

  • The Military Health System has increased its reliance on private-sector providers to deliver outpatient BH care to service members.
  • Readiness assessments are not adequately captured in the medical record, but one-third of service members initiating private-sector BH care received concurrent direct BH care.
  • Staff member approaches to readiness assessments for service members receiving private-sector BH care varied substantially.
  • Staff recommended improving access to documentation of private-sector BH care.

Recommendations

  • Ensure adequate staff to provide military BH care to service members and readiness assessments for those seen in private-sector care.
  • Clarify minimum requirements for tracking and monitoring the readiness of service members who receive private-sector BH care.
  • Identify mechanisms to improve private-sector BH providers' information-sharing to inform readiness assessment and command communication.

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Document Details

  • Availability: Available
  • Year: 2024
  • Print Format: Paperback
  • Paperback Pages: 130
  • Paperback Price: $40.00
  • Paperback ISBN/EAN: 1-9774-1340-4
  • DOI: https://doi.org/10.7249/RRA2255-1
  • Document Number: RR-A2255-1

Citation

RAND Style Manual

Sousa, Jessica L., Kimberly A. Hepner, Carol P. Roth, Lia Pak, and Teague Ruder, Assessing Readiness in Service Members Who Receive Private-Sector Behavioral Health Care, RAND Corporation, RR-A2255-1, 2024. As of April 8, 2025: https://www.rand.org/pubs/research_reports/RRA2255-1.html

Chicago Manual of Style

Sousa, Jessica L., Kimberly A. Hepner, Carol P. Roth, Lia Pak, and Teague Ruder, Assessing Readiness in Service Members Who Receive Private-Sector Behavioral Health Care. Santa Monica, CA: RAND Corporation, 2024. https://www.rand.org/pubs/research_reports/RRA2255-1.html. Also available in print form.
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This research was sponsored by the Office of the Assistant Secretary of Defense for Health Affairs and conducted within the Personnel, Readiness, and Health Program of the RAND National Security Research Division (NSRD).

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