Abstract:The U.S. Coast Guard (USCG) Health, Safety and Work-Life Directorate provides health care to entitled service members to ensure that they are fit for full duty and worldwide deployment. The Coast Guard also provides access to care for dependents of active duty service members to promote family readiness. Furthermore, the Coast Guard provides access to care to retirees and their dependents as an earned entitlement. In fiscal year (FY) 2023, Coast Guard leadership had concerns about the access, cost, and staffing of health services for beneficiaries (i.e., active duty service members, reservists, retirees, and dependents). The Coast Guard asked the Homeland Security Operational Analysis Center (HSOAC) to conduct a strategic evaluation of health services delivery to these populations. We conducted this work in two parts. First, we conducted an evaluation focusing on the care provided to service members ashore by Coast Guard clinics and other providers. An unpublished FY 2023 report is available within the Coast Guard with additional detail about care in Coast Guard clinics and the state of the Coast Guard health care workforce. Second, we conducted additional data collection and analyses to further understand care for active duty Coast Guard service members, dependents, retirees, and reservists. The analyses focused on understanding access to health care. This included characterizing barriers to and facilitators of care and the Coast Guard health care system’s capabilities to provide health services to each population. This report documents findings from interviews with Coast Guard health care staff and representative stakeholders and analysis of access-to-care data. The findings should be of interest to Coast Guard leadership and other policymakers seeking information on how to direct resources efficiently to and within the Coast Guard to support readiness.