The DHA has a clear mission of improving health and building readiness across the Joint Force and to all those we are privileged to serve. The MHSER study (April 2023) has indicated the Defense Health Program (DHP) has a programmatic shortfall (FY26-30) of $12.7B, inclusive of the IM/IT programmatic shortfall, to meet the requirements established by the Services. While working closely with the Department to obtain that level of resourcing, in the interim, the DHA has prioritized services to rebalance MTF cost structure and is optimizing available resources to (a) ensure safe patient care, (b) stave off insolvency across the Military Healthcare System (MHS), while (c) continuing to support the medical readiness of the force, (d) ready medical forces (Knowledge Skill and Abilities (KSA)), and (e) force generation. MHS/DHA ASSESSMENTS: In early 2023, the new DHA Director conducted a 90-day assessment of the agency that identified DHA’s priorities for the coming years. This assessment highlighted the challenges faced by the MHS and the focus areas for DHA investments and attention for the next several years: “The MHS cannot sustain readiness of the medical force in the present operating model. The accelerating shift in healthcare to digitalization, patient-centeredness and hyper-specialization requires the MHS to adapt or face obsolescence….and I will partner with leaders in healthcare on virtual care, better using tools available now to improve both patient and provider experiences. In the medium term, I will look to incorporate artificial intelligence in clinical decision-making.” *This assessment was shared with military and civilian leaders throughout the Department. Also in later 2023, Deputy Secretary of Defense Hicks oversaw a broad review of the MHS that determined the complex approach to managing medical manpower “coupled with a challenging health care economy and ambitious private sector care capacity assumptions, led to chronically understaffed MTFs and DTFs that at times cannot deliver timely care to beneficiaries or ensure sufficient workload to maintain and sustain clinical skills.” The Deputy Secretary directed a number of steps to address this threat to readiness, to include both increasing MTF capacity, and reattracting at least 7% of care delivered in the private sector back to MTFs by the end of 2026.” MTF OPTIMIZATION EFFORTS: . Improved administrative oversight and resource management to include contracts management, data quality, coding and credit for workload, cost accounting, UBO activities for TPC, UBO, and MAC, and supply and equipment management. Improved hiring and contracting speed. Improved recruitment and retention of civilian employees (large scale application of SSRTs, etc.). Improved understanding and analytics regarding the availability and quality of Network (MCSC) care to MTF Prime enrolled beneficiaries. Improved analytics regarding necessity of Direct Care capabilities and capacities.