MEPRS for FMMTC

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  • <number>
    Uniform chart of accounting began in 1973. Uniform staffing methodologies developed in 1978
    STANDARD REPORTS ARE BY FUNCTIONAL COST CODES (FCCs) WHICH THEY MIGHT KNOW AS WORK CENTERS
    CAN LOOK AT PEDIATRICS CODE IN ONE FACILITY AND KNOW THAT THAT SAME CODE REPRESENTS PEDIATRICS IN ALL FACILITIES.
    DoD 6010.13: “EAS produces MEPRS by integrating financial, manpower and workload data, which results in total cost & average cost per output for each work center.
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    The MEPRS system aligns costs associated with production. At this time it does not provide a true cost per RVU. MEPRS has it’s own data processing flow as shown.
  • The Account Subset Definition Table contains all the Functional Cost Codes used at your facility
    The Medical Facility Identifier Table displays a listing of all facilities associated with your site
    The SEEC and SUEE Table identifies the Health Affairs SEECs, corresponding SUEE, and fixed cost percentages within a specified fiscal year
    You can also find descriptions and activation/deactivation dates for each record. All MTF/DTF can update the SUEE MTF/DTF fixed cost percentage
    During the initial load of the table back in 2000, all SUEE’s were assigned the fixed cost percentage of the SEEC in which it maps
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    F AND G ARE SOMEWHAT UNIQUE TO THE MILITARY.
    WE KEEP THEM SOMEWHAT SEPARATE TO ENSURE THAT WHEN WE USE THE OTHER DATA FOR COMPARISONS TO THE CIVILIAN SECTOR, WE ARE COMPARING APPLES TO APPLES.
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    Each work center has a four letter alpha numeric code that describes their function. Each character in a MEPRS codes provides detail on who you are and what you do. The first letter identifies a broad scope of medical category, such as inpatient, outpatient, dental, etc. The second letter is the summary account which now narrows the scope to a general specialty. The third level provides the greatest detail. Fourth level codes are specific to a location or scope of practice (such as APV with a number 5).
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  • Branch clinic example: Bethesda is the core facility… clinics examples are Navy Yard with fourth level of T, Dahlgren … fourth level S
    Unique funding or tracking: PDHRA will be using BHA2 in FY-07
  • Summarized Medical Analysis Resource tool (SMART)
    CHCS- Composite Health care system
    DENCAS: Dental Common access system
    SPMS: Standardized personnel management system
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    Labor hours are reported by all personnel. It identifies where you work and labor costs associated. 70% of total operation costs is labor.
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    Each individual is registered in the personnel system under a specific category. This chart shows the category types. For business purposes, the FTE/provider/day utilizes skill types 1 and 2. Each individual should validate the personnel category to ensure accuracy. If you have a provider registered as a skill type 3-5, their workload will not be recognized in the business models.
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    This exemplifies how MEPRS takes the labor costs and prorates costs to workcenters where manhours were reported. Again, note that the individual is not limited to 168 manhours a month. In this case they reported 174 hours.
  • SPMS… has one list of department codes: one for assigned labor, and one for charged labor.
    DMHRSi: 2 lists: Organizations (assigned people)
    Projects/tasks: assigned labor Project = group of tasks
  • Loaned labor issue is major difference between SPMS and DMHRSi. SPMS must be identified and documented in SPMS in the central system (by MEPRS coordinator). There is no automatic inclusion based on location of personnel. All linked to assigned organization (billet assigned workcenter)
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    EXAMPLE: COMMANDER’S COST IS DISTRIBUTED ACROSS ALL ACCOUNTS. THE BASIS FOR ALLOCATION IS FTEs; i.e., COSTS ARE DISTRIBUTED BASED ON HOW MANY FTEs YOU HAVE WITH THE THEORY BEING THAT THE MORE FTEs YOU HAVE, THE MORE ATTENTION THE COMMANDER HAS TO PAY TO YOUR AREA. YOU PAY FOR HIS OR HER TIME. COULD DO THIS BY SQUARE FOOTAGE OR SOME OTHER MEASURE AS WELL.
    THE COMMANDER’S COSTS ARE FIRST DISTRIBUTED TO OTHER E ACCOUNTS, AND THEN TO OTHER SUPPORT ACCOUNTS – E.G., ANCILLARY SERVICE SUPPORT ACCOUNTS BENEFIT FROM THE COMMANDER’S TIME AS WELL.
    AT THE END OF THIS PROCESS, ALL E ACCOUNTS SHOULD BE AT $0.00.
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    1. What is the total expense to be distributed including expenses received from E accounts
    2. What portion of the expense should be distributed to what code
    3. Expense will be zero after redistribution of expenses.
    4. The account is closed and will no longer receive or distribute expenses
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    1. What is the total expense to be distributed including expense received from E accounts (In this case $921.05 was received from EBAA)
    2. What portion of the expense should be distributed to what code
    3. Expense will be zero after redistribution of expenses.
    4. The account is closed and will no longer receive or distribute expenses
  • <number>
    The MEPRS system aligns costs associated with production. At this time it does not provide a true cost per RVU. MEPRS has it’s own data processing flow as shown.
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  • MEPRS for FMMTC

    1. 1. 1 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Medical Expense and Performance Reporting System (MEPRS) Ms. Nancy Taylor August, 2006
    2. 2. 2 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Objectives Identify basic MEPRS business rules Understand MEPRS processing Comprehend MEPRS critical data elements Locate MEPRS guidance Define MEPRS analysis and basic MEPRS reports
    3. 3. 3 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM MEPRS Facts  Provides uniform reporting for DoD Medical and Dental Treatment Facilities  Data processed monthly: EOM + 30 (Navy)  Identifies production costs by standardized Functional Cost Centers (FCC) Basics MEPRS Labor/Personnel Expense Workload
    4. 4. 4 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM MEPRS Processing STARS - FL Patient seen Visit captured WAM Personnel Man hours MEPRS Coordinator Clinic MEPRS clerk Encounter generated SADR sent NMIMC SPMS EAS IV Ancillary workload Local EAS processing Financial Files DMHRSi Basics SMART Aligns costs with production
    5. 5. 5 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM MEPRS “Bibles”  Guidance – DoD 6010.13M – MEPRS Manual – Annual Financial Guidance  Critical Tables/documents – Account Subset Dictionary (ASD) – Medical Facility Identifier (MFI) Table – Standard Expense Element Code (SEEC) and Service Unique Expense Element Code (SUEE) Table Basics
    6. 6. 6 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Functional Cost Centers 4 digit alphanumeric code Represents work centers or reporting facilities Used to track costs, workload and FTEs First 3 letters are DoD-standard. Fourth character is MTF specific (Navy) Basics Microsoft Excel Worksheet
    7. 7. 7 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM MEPRS Code Format Outpatient Example B A C A Functional Category Summary Account Work Center Location, Special ID Outpatient CardiologyMedical Parent DMIS A = Inpatient B = Outpatient C = Dental D = Ancillary E = Support F = Special Prog G = Readiness A = Medical B = Surgical C = OB/GYN D = Pediatrics E = Ortho F = Mental Hlth G = Family Pract H = Primary Care I = ER J = Flight Med K = Undersea Med L = PT A = Parent J = Branch Clinic 5 = APV Specialty level Basics
    8. 8. 8 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM –BH = PRIMARY MEDICAL CARE –BHA = Primary Care Clinics –BHB = Medical Examination Clinic –BHC = Optometry Clinic –BHE = Speech Pathology Clinic –BHF = Community Health Clinic –BHG = Occupational Health Clinic Summary Account Examples Basics
    9. 9. 9 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Fourth Level  Service/MTF unique  Navy Identifiers: – Secondary location/branch clinic – Ambulatory Procedure = “5” – Unique funding/tracking • External Resource Sharing • Coumadin/Lipid Clinic  All fourth level usage MUST be approved through BUMED Basics
    10. 10. 10 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Tables/Systems Impacted by FCC  STARS/FL  SMART  CHCS  DENCAS  SPMS  MEPRS/EAS  UIC Table, if it is a new 4th level  Ensure square footage is assigned, JONs are established for supplies and labor, and workload is supported in CHCS.
    11. 11. 11 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Workload Data Three main sources: – CHCS via Workload Assignment Module (WAM) – Manual entry – ADM feed – CPT codes Workload
    12. 12. 12 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Workload  CHCS- Source of medical workload data with some exceptions  Dental workload - Manually entered from DENCAS  Non-medical workload - Manually entered from work center reports  Workload Assignment Module (WAM) - Automates work load feed to EAS  ADM extract- Provides CPT data
    13. 13. 13 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Workload Examples - WAM Category Workload Inpatient Admissions, Dispositions, Bed Days Outpatient Visits, APVs Ancillary - Pharmacy Weighted/Raw Procedures Ancillary – Lab Raw, weighted procedures (CPT) Ancillary - Radiology Raw, weighted procedures (CPT) Nuclear Medicine Raw, weighted procedures Workload
    14. 14. 14 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Manual Workload Category Workload Dental DWV, DLWV (from DENCAS) Special Procedures Pulmonary Function, Cardiac Cath Ancillary Central Sterile Supply, Materiel Services Surgical Anesthesia, Surgical Suite, Post op Minutes of Service (wtd), Patients (raw) Ambulatory Surg Minutes of service, patients Other Ancillary Dialysis, Ambulatory Nursing, Inhalation Therapy, ICU Workload
    15. 15. 15 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Support Services Category Manual Workload Administration FTE Material Services Supply Expenses Linen/Laundry Pounds of Laundry Plant Management Hours of Service, Miles Driven, Square Footage Housekeeping Square Footage Transportation Miles Driven Workload
    16. 16. 16 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Personnel/Labor Labor
    17. 17. 17 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Labor Hours - What is Reported?  Hours you work in your Assigned work center loaned to another work center on duty  Education/training  Military training  Readiness training  Hours not worked Leave, Sick Day, etc. Labor Microsoft Word Document
    18. 18. 18 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Definitions  Full Time Equivalent (FTE) – Amount of labor available to the MTF work center if a person works 1 month – 168 Man-Hours = 1 FTE (Avg. 21 Days/Month x 8 Hours)  Assigned FTEs – Listed on facility manning documents for military, civilian and contractor (personal and non-personal services) personnel.  Available FTEs – Reported for assigned, attached, borrowed, contracted, and loaned personnel, and volunteers. – Includes but not limited to clinical, administrative, education, readiness activities.  Non-Available FTEs – Annual, sick, and holiday leave Labor
    19. 19. 19 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Physician (suffix P) Dentist (suffix D) Medical Resident Medical Fellow Medical Intern Dental Intern Dental Fellow Dental Resident Veterinarian Physician Assistant Nurse Practitioner Nurse Midwife Nurse Anesthetist Community Health Occupat. Health Nurse Clinical Nurse Specialist Other DC Professionals LPN or LVN Nursing Assistant Corpsman Technician Other Registered Nurse Other Logistics Clerical Administrator Other Skill Type 1 Skill Type 2 Skill Type 3 Skill Type 4 Skill Type 5 Personnel Data Categories IDC Labor
    20. 20. 20 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Labor allocation  An individual’s monthly pay is allocated to each cost or work center based on the % of time spent in each area.  For MEPRS processing, personnel assigned a pay grade – Example: • E-7 - $6975.67 • GS-11, Step 1 - $3581 • O-2 - $7291.42 • Contractor - $0*  Military Labor: Utilizes composite pay tables  Civilian labor: Actual pay source - DCPS Labor *Contractor expenses are included on the financial file imported from the service accounting systems. Note: Specific composite pay rates may vary between services. Composite pay rates include pay and benefits.
    21. 21. 21 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Basic Manhour Reporting HOUR DISTRIBUTION ON Reported Time Emergency Room BIAA Primary Care BHAA Readiness GBAA 60 HRS = 35% OR $ 2,206 96 HRS = 55% OR $ 3,466 18 HRS = 10% OR $ 630 O-2 Monthly pay = $6,302 Assigned work center BHAA-Primary Care Monthly pay is distributed based on the percent of time spent in each work centerLabor
    22. 22. 22 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Labor Reporting Systems  Current - SPMS II (Standard Personnel Management System II) – Navy-only system – Decentralized client/server application • Each site has their own server and data is not visible outside the command at a detail level  Future – DMHRSi (Defense Medical Human Resources System-Internet) – Tri-service system – Centralized application with a single server accessed via the internet. • All data is visible centrally • HR data input is minimal due to central server Labor
    23. 23. 23 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Labor Reporting Systems  SPMS – Users report man-hours for calendar month by using department codes and/or time types. Data is entered as a monthly value. – Data is entered into SPMS centrally. – Borrowed/Loaned labor is reported by both commands manually (each site must enter the labor) – Exports: • Data (hours and expenses (if applicable) for all personnel is exported to EAS IV. • Data for military (active and reserve) is exported to SMART. Labor
    24. 24. 24 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM  DMHRSi – Users report their own labor using tasks and time types on a daily basis and submit it bi-weekly (matches civilian timecard periods). • This provides a greater level of detail available for data analysis. – Loaned labor is automatically determined based on the individual’s assignment and where they report their labor. – Exports: • Data (hours and expenses (if applicable) for all personnel is exported to EAS IV. • Data for military (active and reserve) and contractors is exported to SMART. Labor Reporting Systems Microsoft PowerPoint Presentation
    25. 25. 25 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Labor Reporting Systems  DMHRSi is currently in Limited Deployment to: – NH Jacksonville – Navy Medicine Support Command (NMSC) – Navy Environmental Health Center (NEHC) – Navy Medicine East (NME) – NH Beaufort – NH Charleston – NMCL Pax River – NMCL Annapolis – NMCL Quantico  Anticipate Full Deployment to begin in October 2006 and continue through 2008. – Next sites for deployment are NH Rota, NH Naples, NH Sigonella, & NMC Portsmouth
    26. 26. 26 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM DMHRSi – Functional Areas Manpower Where are they? Who are they? Personnel Who is trained? Education & Training How much do they cost? Labor Cost Assignment Who is deployable? Readiness Labor
    27. 27. 27 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Expense Allocation
    28. 28. 28 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Financial Data  Types of Expenses – Pay Data • Military • Civilian – Contracts – Supplies – Equipment – Base Operations – Depreciation Allocation
    29. 29. 29 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Allocation Process Cost Pools purified: Inpatient wards allocate shared expenses to services utilizing services, based on bed days Support Accounts: Uses assignment sequence numbers Ancillary Accounts: Uses assignment sequence numbers
    30. 30. 30 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Allocation Accounts  Final Operating Accounts – A - Inpatient Care – B - Ambulatory Care – C - Dental Care – F - Special Programs – G - Medical Readiness  Intermediate (Stepdown) Accounts – D - Ancillary Services – E - Support Services  Ancillary and Support expenses are allocated (stepped-down) across final accounts Allocation
    31. 31. 31 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Cost Pools –Identified with an “X” in the 3rd Level FCC code –Used when time and expense cannot be specifically assigned because two or more work centers share space, personnel or supplies. For example, mixed wards. –Expenses and FTEs in cost pools are reassigned (purified) on the basis of workload. –Cost pools are purified in alphabetical order before allocation of support and ancillary expenses. Allocation
    32. 32. 32 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Cost Pool Allocation Ward 3E has a supply closet shared by three specialties -- Cost Pool ABX ($100) –ABA - General Surgery (25 OBDs) –ABI - Plastic Surgery (25 OBDs) –ABK - Urology (50 OBDs) Supply costs accumulated in ABX ($100) are purified based on each specialty’s proportional Ward 3E occupied bed days (OBDs) ABX $100 ABI $25 ABK $50 ABA $25 ABX $0 Allocation
    33. 33. 33 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Other E Accnts A Inpatient Care B Amb. Care C Dental Services F Special ProgsG Med Readiness D Ancillary Services E Support Services First, Support Services (“E” accounts) expenses are allocated Each Support Services FCC is allocated until no expenses remain in “E” accounts Expense Allocation Allocation Support Allocation
    34. 34. 34 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Other D Accnts A Inpatient Care B Amb. Care C Dental Services F Special Progs G Med Readiness D Ancillary Services Then, Ancillary Services (“D” accounts) expenses are allocated Each Ancillary Services FCC is allocated until no expenses remain in “D” accounts Expense AllocationAllocation Ancillary Allocation
    35. 35. 35 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM DAAA Data Set - Pharmacy Direct Expenses: $100,000.00 Expense received from allocation: $921.05 Total expense to be distributed: $100,921.05 Total Workload: 175 Weighted Prescriptions Allocation DAAA Data Set AAXA AAAA BAAA BGAA CAAA Total: 175 DAAA Total 175 175 175 175 175 50 10 25 75 15 Ratio 50 10 25 75 15 28.57 % 5.71 % 14.29 % 42.86 % 8.57 % Allocation Introduction
    36. 36. 36 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM AAXA AAAA BAAA BGAA CAAA RatioDAAA Expense to be Distributed $100,921.05 X Expense distributed $100,921.05 DAAA Data Set - Pharmacy Direct Expenses: $100,000.00 Expense received from allocation: $921.05 Total expense to be distributed: $100,921.05 Total Workload: 175 Weighted Prescriptions 28.57 % 5.71 % 14.29 % 42.86 % 8.57 % $28,833.15 5,762.59 14,421.62 43,254.76 8,648.93 Allocation Allocation Example
    37. 37. 37 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Total Expenses – Direct Expenses • Supplies • Labor • Etc. – Expenses from Cost Pools – Expenses Contributed – Expenses from Ancillary (D) accounts – Expenses from Support (E) accounts Total Expenses A, B, C, F, G Direct Expenses A, B, C, D, E, F, G= Allocation
    38. 38. 38 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM MEPRS Processing STARS - FL Patient seen Visit captured WAM Personnel Man hours MEPRS Coordinator Clinic MEPRS clerk Encounter generated SADR sent NMIMC SPMS EAS IV Ancillary workload Local EAS processing Financial Files DMHRSi Basics SMART
    39. 39. 39 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Guidance  DoD 6010.13M – Provides Tri-Service guidance to all MEPRS reporting MTFs / DTFs – Contains policy and guidance for implementation of MEPRS program – Download from: www.tricare.osd.mil/ebc/rm/rm_home.html Chapter 1: Background Chapter 2: Chart of Functional Cost Codes Chapter 3: Manpower & Expense Assignment Chapter 4: Reporting Requirements Chapter 5: MEPRS Issue Process Appendices Acronyms, Definitions, Guidelines for reporting FTE
    40. 40. 40 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Points of Contact - BUMED  BUMED Data Quality Staff – Ms. Jane Cunningham • 202.762.0551 • jmcunningham@us.med.navy.mil – Ms. Nicole Brooks • 877.897.0691, ext. 601 • nmbrooks@us.med.navy.mil – Ms. Kate Burchess • 410.620.3377 • kkburchess@comcast.net
    41. 41. 41 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Other Points of Contact  NME – Ms. Lisa Adams  NMW – Mr. Fred Aguon – Ms. Maureen Brown  NCR – Ms. Kat Gettings  NMSC – Ms. Meg Reesey
    42. 42. 42 MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Websites  TMA MEPRS website www.tricare.osd.mil/ebc/rm/rm_home.html  Navy MEPRS website https://imcenter.med.navy.mil/eas/  Navy Data Quality Website https://dq.med.navy.mil/reconcile  BUMED Portal https://199.26.34.9/servlet/portal/

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