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MEPRS for FMMTC

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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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