Ranjit A et al. – This study compared the frequency of intrapartum obstetric procedures and outcomes such as severe acute maternal morbidity (SAMM) and common postpartum complications between direct and purchased care systems within TRICARE. A higher vaginal delivery rate along with a higher rate of common complications was reported with direct care compared with purchased care. This comparison can be useful while comparing obstetric care between salary–based and fee–for–service systems in the United States.