In 1956 Congress enacted the Civilian Health and Medical Program of the Uniformed Services CHAMPUS in order to improve health care for military dependents and retirees. In 1988, a number of modifications to the CHAMPUS program were authorized on a demonstration basis. For selected MTFs located in Europe, Congress authorized the U.S. European Command After Hours Demonstration Project which allows outlying health clinics to negotiate agreements with host nation medical facilities for acute medical care during specified hours of the day. The success of this project has resulted in recommendations to make it a permanent program. Plans are being made at 7th MEDCOM to request that Congress extend the project to include routine health care in remote sites which have no outpatient health clinics. Other outpatient care options available in Europe include the Military-Civilian Health Services Partnership Program and the traditional CHAMPUS program. With the ongoing drawdown of troops in Europe, selecting the most appropriate source of outpatient care has become a priority. The present study consists of an evaluation of the various sources of outpatient care available at the Frankfurt Medical Department Activity, using the criteria of cost, acceptability and accessibility. Primary Care Alternatives, Outpatient Care in Europe, Contracting Out Military Health Care, Health Care Decision-Making in a Downsizing Environment.