Medical Executive Data Overview   Dr. Raymond “Tres” Crawford   Assistant Professor, Health Services   Administration   Un...
Objectives    •   Introduce common measures of workload used in the Military        Healthcare System (MHS)    •   To iden...
Workload Measures      Raw Workload Measures      Weighted Workload Measures
Simple Raw Workload Measures    •   Admission – acceptance of a patient by a facility as an inpatient        for treatment...
Calculated Raw Workload Measures    •   Occupied Bed Day – a day in which a patient occupies a bed at        the census-ta...
Case Mix Measures    •   Case Mix Complexity – with respect to workload measurement,        the resource intensity of trea...
Weighted Workload Measures    •   Relative Weighted Product (RWP)         • a measure of workload credit derived from biom...
Direct Care OutpatientWorkload Documentation SADR           Standard Ambulatory Data Record  Documentation of an encounter...
Direct Care InpatientWorkload Documentation SIDR             Standard Inpatient Data Record  Documentation of an inpatient...
Where Can You Get Data?               MDR              Raw Data         Difficult to Access                               ...
MDR  MHS Data Repository              What                         MDR                                        Why      Loc...
Data Flow to the M2       Source                      “MDR”   Big                              MDR                        ...
M2                  MHS MartA snapshot/subset of the MDR                 What                            M2               ...
M2     Direct Care            Purchased        Data         U        Care               =            M2       Eligibility ...
EAS  Expense Assignment System           What                    EAS                                Why                  M...
Other Tools              If you do not have an M2 analyst        TOC          Tri-Service Business        Population      ...
Sample Metrics    •   RVUs per provider FTE per day    •   Total number of RVUs    •   Total number of RWPs    •   Enrolle...
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Online Session - Medical Executive Data

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  • I have read through this presentation. I think its a good overview however, there are a lot of acronyms which have no definition and, in my case, if you have no idea what they mean you can be a little lost.
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  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • April 2007 Critical Decision Making for Medical Executives: Keys to Improving Healthcare Delivery
  • Online Session - Medical Executive Data

    1. 1. Medical Executive Data Overview Dr. Raymond “Tres” Crawford Assistant Professor, Health Services Administration Uniformed Services University of the Health Sciences rcrawford@usuhs.mil
    2. 2. Objectives • Introduce common measures of workload used in the Military Healthcare System (MHS) • To identify MHS systems where data is available to allow for data driven decisions • Introduce MHS productivity and production related terms and measures
    3. 3. Workload Measures Raw Workload Measures Weighted Workload Measures
    4. 4. Simple Raw Workload Measures • Admission – acceptance of a patient by a facility as an inpatient for treatment • Disposition – the removal of a patient from a hospitals census by reason of discharge, transfer, death, or other termination of inpatient care • Encounter – serves as a focal point linking clinical, administrative and financial information. Encounters occur in many different settings – ambulatory care, inpatient care, emergency-care, home health care, field and virtual (telemedicine)
    5. 5. Calculated Raw Workload Measures • Occupied Bed Day – a day in which a patient occupies a bed at the census-taking hour (usually midnight). Under certain circumstances, an OBD is also credited when a patient is admitted and discharged on the same day– e.g. same day surgery • Average Daily Patient Load – the average number of inpatients over a defined period of time • Length of Stay – refers to the number of days that comprise an inpatients hospital stay
    6. 6. Case Mix Measures • Case Mix Complexity – with respect to workload measurement, the resource intensity of treating a particular group of patients • Major Diagnostic Category (MDC) – a broad classification of diagnoses and procedures typically grouped by body system or etiology • Diagnosis Related Groups (DRG) – an inpatient classification system that relates demographic, diagnostic and therapeutic characteristics of patients to LOS and amount of resources consumed • Case Mix Index – the average relative weighted product (RWP) per disposition
    7. 7. Weighted Workload Measures • Relative Weighted Product (RWP) • a measure of workload credit derived from biometrics dispositions weighted by DRG weights • the number of RWPs is a measure of the relative resource consumption of a patient’s hospitalization as compared to that of other patients • RWP calculation example • Relative Value Units (RVU) • a weight assigned to an encounter based on CPT coding
    8. 8. Direct Care OutpatientWorkload Documentation SADR Standard Ambulatory Data Record Documentation of an encounter Detailed information on direct care outpatient workload Coding needing to show workload RVU Relative Value Unit Similar to CMS RVUs—some differences do exist though Based on CPT codes from SADR encounters Used in MHS performance metrics Used in Prospective Payments System
    9. 9. Direct Care InpatientWorkload Documentation SIDR Standard Inpatient Data Record Documentation of an inpatient episode of care Detailed information on direct care inpatient workload Coding needing to show workload RWP Relative Weighted Product Based on DRG rates from SIDR Used in MHS performance metrics (including PMPM calculations) Used in Prospective Payments System
    10. 10. Where Can You Get Data? MDR Raw Data Difficult to Access M2 EAS Processed Data Analyst Needed TOC PEPR Tri-Service Business Planning Tool Population Health Portal Web-based Balanced Scorecard DHP or Service Metrics Provided Data Driven Decisions
    11. 11. MDR MHS Data Repository What MDR Why Location of MHS Data Files Other data sets are often a reflection of the MDR Legal and financial mechanisms track to the MDR Extremely limited direct access
    12. 12. Data Flow to the M2 Source “MDR” Big MDR File M2 File
    13. 13. M2 MHS MartA snapshot/subset of the MDR What M2 Why One-stop shop for many used/needed data elements Allows MTFs to look beyond the “four walls” Learn about your MTF, other MTFs, and network M2 analyst required
    14. 14. M2 Direct Care Purchased Data U Care = M2 Eligibility Non-Institutional MHS Mart: A very powerful ad-hoc business Enrollment Institutional objects based query tool for trained analysts. Outpatient MCSC Pharmacy Inpatient TMOP Pharmacy Enrollee Network Care EAS MCFAS WWR ETC ETC
    15. 15. EAS Expense Assignment System What EAS Why MEPRS data FTE data (including skill types) EAS data is also in the M2
    16. 16. Other Tools If you do not have an M2 analyst TOC Tri-Service Business Population Planning Tool Health Web-based
    17. 17. Sample Metrics • RVUs per provider FTE per day • Total number of RVUs • Total number of RWPs • Enrollee medical cost per member per month

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