Health Hazard Assessment
Medical Cost Avoidance Model (MCAM) 




The MCAM was originally developed in 1998 and updated in 2005 using Headquarters, Department of the Army Study funding.  It was published in the Defense Safety Oversight Council Injury Prevention Report No. 12-HF-04MT-08 in December 2008 and published in the January 2010 edition of the American Journal of Preventive Medicine.  The MCAM was updated in 2013 with data extracted from the Military Health System Management Analysis Reporting Tool (M2) database for fiscal years (FY) 2010, 2011, and 2012 along with Army Manpower Cost System (AMCOS) and Veteran Administration data for disability compensation.

This web accessible MCAM application predicts medical and lost time costs using M2 direct care and purchased care medical costs data, Military Personnel Cost data, and Veterans Affairs (VA) Disability Compensation data.  These data sources are used to calculate cost factors such as, average clinic costs, average daily hospital costs, and expected lost time, and fatality costs for active duty Army personnel.  The Hazard Analysis tab of the MCAM application is based on the concept of hazard severity and hazard probability and uses the cost factors and materiel system information in algorithms developed to calculate costs and present the likely monetary impact of unabated medical and lost time injuries.  The International Classification of Diseases (ICD)-9 Analysis Tab of this application is designed to present medical and lost time costs based on actual Army medical records.  In addition, an estimate is provided for potential fatality based on incidence rates in the Army active duty population and VA disability compensation costs based on the prevalence in the Army veteran population.


The purpose of this application is to provide a method to optimize investment decisions to maximize the Return on Investment in other areas.  The MCAM provides the information needed to make informed decisions based on anticipated cost avoidance benefits, potentially reducing injuries and saving lives.


  • Inputs include data from the M2, AMCOS, and VA from FY 2010 to 2012
  • Hazard categories in the Hazard Analysis Tab are linked to Army medical records by mapping to potential ICD-9 outcomes
  • Average incidences by ICD-9 for disposition codes for limited duty, quarters assignment, and convalescent leave were used in conjunction with average military grade to calculate predicted lost time costs
  • Fatality costs include death benefit payments only