Health Hazard Assessment
Medical Cost Avoidance Model (MCAM) 


Click here to access the MCAM


The MCAM was originally developed in 1998 and updated in 2005 using Headquarters, Department of the Army (HQDA) 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 became a publicly available web application in 2013 and was last updated to include occupational fields in 2016.


The MCAM is a web accessible application that provides the information needed to make informed decisions based on anticipated cost avoidance benefits, potentially reducing injuries and saving lives.  It predicts medical and lost time costs using Military Health System medical cost 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, fatality, and replacement training costs for active component Army personnel affected by injury or illness.  There are two tabs to the application:  Hazard Analysis and ICD-9 Analysis.


The Hazard Analysis Tab of the MCAM is based on the concept of risk assessment, considering the severity and probability of possible health hazards assessed by the Health Hazard Assessment Program in materiel systems.  The algorithms within the model incorporate severity categories and probability levels with medical treatment data, manpower information, and disability data to provide an estimated itemized and total cost avoidance expected for implementing mitigation strategies designed to reduce health hazard risks to Soldiers.


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 active component Army population and VA disability compensation costs based on the prevalence in the Army veteran population.


The MCAM provides the user a drop down menu to select specific grouping of occupations based on similar occupational settings that consider health and occupational exposure (e.g. health hazards and equipment use) based on job descriptions and assignments from Department of the Army Pamphlet 611-21.  The information button in the MCAM provides more detail.


  • Military Health System Management Analysis & Reporting Tool (M2) database.  The M2 database was used to extract medical treatment data (inpatient and outpatient) for active duty Army Soldiers for fiscal years 2011, 2012, and 2013 from the Military Health System.  The medical treatment data includes medical care provided by military treatment facilities and civilian providers.
  • Army Military-Civilian Cost System (AMCOS) Lite Database.  Salary and training cost information for active duty Army for fiscal year 2015 was extracted from the AMCOS Lite Database to determine the lost time costs and training replacement costs for the MCAM.
  • U.S. Department of Veterans Affairs.  Disability compensation data provided by the Veteran Benefits Administration for fiscal years 2011, 2012, and 2013 was used to determine the disability costs for the MCAM.  This data is not available publicly.


  • Average incidence by ICD-9 for disposition codes for clinic visit time, limited duty, quarters assignment, and convalescent leave were used in conjunction with average military grade to calculate predicted lost time costs.
  • Clinic visit time = 2 hours for direct care and 4 hours for purchase care.
  • Limited duty = 15 days of 30% reduced productivity.
  • Quarters = 3 days (8 hours/day).
  • Convalescent leave = 30 days (8 hours/day).
  • Fatality costs only includes death benefits (Service member’s Group Life Insurance and death gratuity), equaling to $500,000 for each fatality.
  • Training replacement costs are applied according to the paygrades and occupational fields of the fatalities observed.