U.S. Army Medical Department, Office of Medical History
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HISTORY OF THE OFFICE OF MEDICAL HISTORY

AMEDD BIOGRAPHIES

AMEDD CORPS HISTORY

BOOKS AND DOCUMENTS

HISTORICAL ART WORK & IMAGES

MEDICAL MEMOIRS

AMEDD MEDAL OF HONOR RECIPIENTS

ORGANIZATIONAL HISTORIES

THE SURGEONS GENERAL

ANNUAL REPORTS OF THE SURGEON GENERAL

AMEDD UNIT PATCHES AND LINEAGE

THE AMEDD HISTORIAN NEWSLETTER

Establishment of U.S. Army Medical Command

Organizational Histories

As the post-Cold War Army shrank, it was time for a new way of doing business and business was the way. HSC would operate like a corporation. In 1992, HSC launched Gateway To Care, a businesslike approach to health-care delivery. It was localized managed care, intended to give quality care with better access and less cost. In a design based more on catchment-area management than CHAMPUS Reform Initiative, Army hospital commanders got more responsibility and managerial authority. Eleven Gateway to Care sites opened in spring 1992. By fall, all HSC facilities had submitted business plans. Initial results were excellent. Starting in 1994, Gateway To Care was gradually absorbed into a new regional Defense Department triservice managed-care plan called TRICARE, which was modeled on the CHAMPUS Reform Initiative. Meanwhile, healing work continued. Hurricane Andrew slammed south Florida. Army troops moved to assist and Army Medicine was there. From early 1993 to early 1994, HSC people participated in Operation "Restore Hope" supporting American troops in Somalia. Now the AMEDD's effort to "heal itself" by becoming more efficient and forestalling the break-up of medical unity bore fruit. In August 1993, the Army chief of staff approved a plan to reorganize the AMEDD. Heart of the plan was to merge several medical elements into a new, expanded medical major command under the command of the surgeon general. In October 1993, the U.S. Army Medical Command (Provisional) began a one-year process of replacing HSC and absorbing other AMEDD elements. Surgeon General Lt. Gen. Alcide M. LaNoue commanded the provisional MEDCOM, while Maj. Gen. Richard D. Cameron continued as HSC commander. In November 1993, U.S. Army Dental Command (DENCOM) and U.S. Army Veterinary Command (VETCOM) were formed as provisional commands under the MEDCOM, to provide real command chains for more efficient control of dental and veterinary units-the first time those specialties had been commanded by the same authorities who provided their technical guidance. Next month, seven MEDCEN commanders assumed command and control over care in their regions. The new Health Service Support Areas, under the MEDCOM, had more responsibility and authority than the old HSC regions. In March 1994, a merger of Medical Research and Development Command, Medical Material Agency and Health Facilities Planning Agency created the Medical Research, Development, Acquisition and Logistics Command, subordinate to the provisional MEDCOM. The command shortly got a new and less formidable moniker: Medical Research and Materiel Command. Then in June 1994, an additional HSSA was formed to supervise medical care in Europe, replacing 7th Medical Command, which inactivated. That summer, the Army Environmental Hygiene Agency formed the basis of the provisional Center for Health Promotion and Preventive Medicine. Bit by bit, Army Medicine was coming together in a new home under the command of the same man who was the surgeon general-unifying the leadership and management of Army Medicine more than ever before. Except for the field medical units commanded by combat commanders, virtually all of Army Medicine as now part of the MEDCOM. The MEDCOM became fully operational, dropping the "provisional," in October 1994. In 1996, the HSSAs were renamed Regional Medical Commands.