The National Disaster Medical System (NDMS) was established in 1984 to support large-scale movement of and medical care for U.S. combat casualties from an overseas military conflict. Fortunately, the NDMS has never had to respond at full-scale to such a conflict or other catastrophe in which 1000+ severely injured patients are transported to healthcare facilities across the U.S. for critical care every day for several months. However, recognizing the need to improve the nation’s preparedness for such extreme healthcare surge events, Congress has directed the Department of Defense to execute an NDMS Pilot Program (“Pilot”) over five years to strengthen interoperable partnerships across the NDMS and to increase the surge capabilities and capacities of the NDMS definitive care network. Since its launch in 2020, the Pilot has worked with its military and civilian partners at five regional NDMS sites – as well as with federal healthcare partners from the Departments of Defense, Health and Human Services, Homeland Security, Veterans Affairs, and Transportation – to identify priorities, develop improvement plans, and implement interventions for increasing healthcare surge capability and capacity and enhancing military-civilian interoperability at each site and across the NDMS. This Session highlights the Pilot’s activities currently underway in four areas: (1) field projects focused on the roles of NDMS Federal Coordinating Centers at the Pilot sites; (2) partner projects focused on medical surge at the Pilot sites; (3) strategic initiatives across the NDMS; and (4) federal-level programmatic strengthening within the NDMS. Panelists will discuss ongoing coordination and collaboration efforts between military and civilian partners at all levels of government and the non-governmental sector to enhance healthcare surge capability and capacity and military-civilian interoperability within the NDMS and the broader U.S. healthcare and public health systems. The Session also highlights near-term opportunities for improving the all-hazards surge readiness of healthcare and public health networks in the U.S., focusing particularly on military and civilian systems that would provide the health emergency management support needed during an overseas military conflict or domestic catastrophe response. The Session will conclude with a facilitated discussion among the federal healthcare leaders and industry partners in the audience to elicit comments and feedback regarding: (1) the current state of healthcare surge readiness in the military and federal civilian healthcare and public health systems; and (2) direction and recommendations for future Pilot activities that can inform military and federal civilian healthcare surge readiness efforts nationwide. Attendees will gain an understanding of the Pilot and insights into leveraging the Pilot’s activities to improve the healthcare surge readiness in their facilities, organizations, and communities.