A future conflict with a near peer in a contested, multi-domain battlefield will create a complex operational environment, exposing capability gaps for the U.S. Army. Our potential adversaries have capabilities tooperate in all domains and can be expected to exploit U.S. vulnerabilities resulting in an anti-access area denial battlefield A2AD. Our ability to evacuate casualties to a higher level of care and the capability needed to treat the casualties at the point of injury does not exist for an A2AD scenario. Given this prolonged care capability gap, the Army needs to assess, adapt, and reorganize medical assets to better support the force. Medical capabilities at the Role 1 must be increased to mitigate death in the future A2AD operational environment. The paper proposes leadership actions to influence doctrine, policies and laws,force structure reform of medical personnel authorizations to increase medical capability at the point of injury, and essential training in critical skills needed to save the most lives possible in prolonged care scenarios at Role 1.