On 1 October 2019, operational and administrative control of all military medical facilities transitioned to the Defense Health Agency.

[1][2] Historically, when Army field hospitals deployed, most clinical professional and support personnel came from MEDCOM's fixed facilities.

However, an official force requisition for ERST Teams was relayed to LTG Nadja West, former Army Surgeon General, in January 2016.

Often, clinicians must do complex procedures and care for patients in these training environments for prolonged periods of time, and with limited resources.

[5] The members of the team are selected by their respective military occupational specialty's (MOS) consultant to the surgeon general.

Selected members must be physically fit, subject matter experts in their fields, and ready to serve in a highly demanding position.

ERST's mission is to deploy far forward with SOF units, decreasing the time between point of injury (POI) to surgical care in austere environments while also being as light and mobile as possible.

In a design based more on catchment-area management than the previous "CHAMPUS Reform Initiative" (CRI), U.S. Army hospital commanders received more responsibility and managerial authority.

Starting in 1994, "Gateway To Care" was gradually absorbed into a new regional Defense Department tri-service managed-care plan called TRICARE, which was modeled on CRI.

In October 1993, the "U.S. Army Medical Command (Provisional)" began a one-year process of replacing HSC and absorbing other AMEDD elements.

The new "Health Service Support Areas" (HSSAs), under the MEDCOM, had more responsibility and authority than the old HSC regions.

That summer, the Army Environmental Hygiene Agency formed the basis of the provisional Center for Health Promotion and Preventive Medicine (CHPPM).

"The Defense Health Agency is assuming administration and management responsibilities from the Army, Navy and Air Force for all military hospitals and clinics [as of] 1 Oct.

DHA will initially oversee these facilities through a direct support relationship with the Military Medical Department intermediate management organizations.

The Walter Reed National Military Medical Center, Bethesda, MD, was transferred to the direct control of the Defense Health Agency.