The President of the United States of America, authorized by Act of Congress, July 9, 1918, takes pleasure in presenting the Air Force Distinguished Service Medal to Brigadier General Thomas S. Bailey, JR., United States Air Force, for exceptionally meritorious and distinguished service in a position of great responsibility to the Government of the United States. General Bailey distinguished himself as Commander, 74th Medical Group; Lead Agent, Department of Defense Health Services Region Five; Assistant Surgeon General for Dental Services and Command Surgeon, Headquarters Air Force Material Command, Wright-Patterson Air Force Base, Ohio, from 17 May 2002 to 31 December 2005. As the Lead Agent for the seven-state region, he ensured that a critical 1.3 billion dollar managed care support contract extension was brokered, ensuring uninterrupted beneficiary services for the Region until a new Department of Defense contract began in the summer of 2004. As Commander, 74th Medical Group, General Bailey strategically transformed the organizational culture to a more intensive expeditionary platform by inculcating a military-unique curriculum for all physician residents and launching “just-in-time” refresher training for all deploying providers. Based on his unequalled understanding of the expeditionary medical mission, he was chosen to chair the Air Force Surgeon General’s multi-major command meeting to develop a way to mitigate the impact of major deployments to beneficiaries while ensuring full capability to the warfighting commanders. General Bailey’s report to the Surgeon General outlined the solution perfectly and has effectively laid the foundation for the future of Air Force Medical Service expeditionary and in-garrison forces which is now being implemented. General Bailey’s commitment to high-quality care was formally recognized during a short-notice Air Force Inspection Agency “ODYSSEY” survey in which the 74th Medical Group scored 96 out of 100–the best rating of any Air Force medical center in four years. Recognizing the need for increased reliance on contract relationships to augment our military medical staff in our hospitals and clinics around the world, he built a strategy to achieve this end and received Air Force Surgeon General approval to establish the Air Force Medical Service Commodity Council. In less than eight months, a request for proposal to purchase the services of over 1,400 physicians, nurses, dentists and technicians over a 10-year period was released to private industry for their bid on this 2 billion dollar major acquisition. As Assistant Surgeon General for Dental Services, directly advising the Air Force Surgeon General, he oversaw the optimization of the Air Force’s dental deliver system which represents the most significant modernization and transformation in the dental corps’ history. General Bailey directed an ambitious five-year, 22 million dollar optimization of the Air Force dental program, tracked progress with a capabilities-based resourcing plan and performance improvement board, and reduced private sector care costs by over five million dollars, 50 percent in the first six months. The singularly distinctive accomplishments of General Bailey culminate a distinguished career in the service of his country and reflect great credit upon himself and the United States Air Force.