1 Medical Expense and Performance Reporting System (MEPRS) Program Data Quality Tools Type Brief: Information April 30, 2014 DHA MEPRS Program Office “Medically.

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Medical Expense and Performance Reporting System (MEPRS) Program

Data Quality ToolsType Brief: Information

April 30, 2014

DHA MEPRS Program Office

““Medically Ready Force…Ready Medical Force”Medically Ready Force…Ready Medical Force”

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DHA Vision

“A joint, integrated, premier system of health, supporting those who serve in

the defense of our country.”


Agenda∎ MEPRS Policy and Business Rules

IntroductionAccount StructureData (Financial, Personnel, & Workload)Policy and Business Rules

∎ Data Quality Management Control Review ListEducationMEPRS Early Warning and Control System (MEWACS)

Data Load Status Summary Outliers Allocation Test

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Introduction to MEPRS

4““Medically Ready Force…Ready Medical Force”Medically Ready Force…Ready Medical Force”

14 December 2011 Pre-decisional FOUO 5

Introduction


Introduction

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∎ DoD 6010.13M (April 7, 2008; Change 2 April 15, 2014). Authority DoDD 6000.12E, “Health Services Operations

and Readiness” A uniform expense and labor reporting system shall be maintained in all fixed

MTFs and dental treatment facilities to provide standardized expense and

manpower data for management of health care resources.Standards for the Federal government Statement of

Federal Financial Accounting Standards (SFFAS) 4 MEPRS supports MTFs and all entities within the MHS in approximating and

reporting full cost of resources used to produce output by responsibility segments/functional cost centers. The full cost data derived from MEPRS may be used by the department in developing actuarial liability estimates for the Military Retirement Health Benefits Liability in the Other Defense Organization General Funds. This information is included in the department’s annual agency wide audited financial statements.”

∎ Purpose: Provide uniform reporting by Functional Cost Code (FCC) of expense, labor, & workload for DoD Military Treatment Facility (MTF) affording management a basic framework for cost and work center accounting.

∎ MEPRS refers to the expense, labor, and workload data.

∎ Expense Assignment System (EAS) is the Web-based hardware and software in which the data is created and the information resides.

Introduction

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• Business Planning• Medicare-Eligible Retiree HealthCare Fund (MERHCF)• Manpower Standards • Data Quality Statement

Multiple MEPRS Inputs

• Base Realignment and Closure (BRAC) Analysis Workload & Expenses

• Audit Agency • DHA Development of Per Member Per Month (PMPM)

Calculation• Billing Rates• MHS Balanced Scorecard Instrument Panel

Metrics Scorecard – Comparison of Service Productivity

Introduction

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RVUsb

“E” – Support

“D” – Ancillary

“A” – Inpatient

“B” – Outpatient

“C” – Dental

“F” – Special

Programs

“G” – Readiness

EAS IVExpenses

Labor

Workload

RECONCILE

Direct Care “Step Down”

Defense Health Program Managerial Cost Accounting

OUTPUT

TotalCost

RVUs RWPs

ICD/E&M/CPTDRGsSIDR

CAPERCHCS/AHLTA

Introduction

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MEPRS Data:DoD-Standardized,Aggregated by FCC

Service-specific FinancialdataArmy: STANFINS/GFEBS

(Standard Army Finance System/General Fund Enterprise System)

Navy: STARS-FL (Standard Accounting and Reporting System/Field level)Air Force: GAFS – R/ DEAMS

(General Accounting Finance System Rehost/Defense Enterprise Accounting and Management System)

Personnel DMHRSi

(Defense Medical Human Resource System - internet)

Workload

CHCS/WAM(Composite Health Care System / Workload Assignment Module)

Introduction

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Note: The DHA National Capital Region Medical Directorate (NCR-MD) currently uses GFEBS for Fort Belvoir and STARS/FL for Walter Reed National Military Medical Center

Functional Cost Codes (FCCs) are 4-character MTF-specific codes representing work centers or reporting facilities; used to track costs, workload and FTEs. The first 3 letters are DoD-standard.

The fourth letter is MTF-unique and used to identify specific types of costs and workload:

B = AMBULATORY CARE (DoD standard)BH = PRIMARY MEDICAL CARE (DoD standard)

BHA = OUTPT PRIMARY CARE CLINICS (DoD standard)

BHAA = Outpt Primary Care Clinic – Parent Facility (MTF

specific) BHAM = Outpt Primary Care Clinic - TMC-

1 (MTF specific) BHAW = Outpt Primary Care Clinic - TMC-

5 (MTF specific)

Note: use of 4th Level MEPRS FCC for Patient Centered Medical Home

Chart of AccountsAccount Structure

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Account Structure


∎ Cost pools are identified with an “X” in the 3rd FCC position. They are used when time and expense cannot be specifically assigned because two or more work centers share space, personnel or supplies. For example, most inpatient wards.

∎ Expenses and FTEs in cost pools are reassigned (purified) on the basis of workload.

Expense Allocation

Account Structure

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$- $(10) $10 EFA

$- $(12) $2 $10 DBA

$- $(20) - $20 ABX

$33 - $8 $5 $15 $5 ABA

Total Expenses

Expenses Contributed

Ancillary Services

D

Support Services

E

Purified Cost Pools

Direct Expenses

3rd Level FCC

$3 $5 $5 ABI $4 $17 -

- -

- - N/A

Expense Allocation “ Step Down”

MEPRS Policy & Business Rules

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Financial

Service specific codes that categorize expenses into Pay Data (Military & Civilian),Contracts, Supplies, Equipment, Base Operations, etc. are mapped to DoD standard codes in EAS.

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DoD Air Force Army Navy

SEEC - Standard Expense Element Code

EEIC - Element of Expense Investment Code

EOR - Element of Resource EE - Expense

Element

PEC - Program Element Code

PEC - Program Element Code

AMSCO - Army Management Structure Code

SAG - Subactivity Group

CI – Commit. Item

Personnel

Full Time Equivalent (FTE)Amount of labor available to the MTF work center if a person works fulltime for 1 month.

Assigned FTEsTime reported by personnel assigned to specific positions/work centers on MTF manning documents.1 FTE = number of assigned days / the number of days in a month

Available FTEsTime reported by any personnel in a given clinic for a given month. Includes those who are Assigned, attached, borrowed, contracted, volunteers, etc.1 FTE = 168 man-hours in 1 month(1FTE is calculated as an average of 21 work days per month x 8 hours per day)

Non-Available FTEsTime reported by Assigned personnel in their Assigned work center that is unrelated to the healthcare mission such as sick leave, personal leave, etc.

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Personnel

PersonnelPersonnelCategoryCategory

Skill TypeSkill Type

Total FTEs (Assigned / Available)Total FTEs (Assigned / Available)

Skill TypeSkill TypeSuffixSuffix

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Personnel

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Workload

The main function of workload data in EAS is to provide a basis to allocate expenses among work centers; therefore, workload is collected in relationship to costing. Historically, MEPRS workload in EAS with its limited focus has been used for analysis, but today the MHS Data Mart (M2) is the official source of workload data because it serves an analysis mission.

Inpatient Services Admissions

DispositionsOccupied Bed DaysBassinet Days

Ambulatory ServicesVisits

Ancillary Services (D)Procedures (Raw and Weighted)

Minutes of Service (Surgical)

Hours of Service (ICU)

Special Programs (F)ImmunizationsVisits

Associated Workload

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Policy and Business Rules

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∎ DoD 6010. 13-M, dated 7 April 2008, Change 2, April 15, 2014: Provides Tri-Service MEPRS program policy and guidance to all MEPRS

reporting (fixed) MTFs/DTFs. Administrative Change published which alters only non-substantive

portions of the issuance due to the establishment of the Defense Health Agency (DHA).

Researching more timely method of update to link to annual update of EAS IV System Tables.

MEPRS Management Improvement Group (MMIG)The MMIG was established in 1999 to provide functional and

automated information system oversight for MEPRS, EAS, and the source systems. Current charter is dated 14 Dec 2009 and is currently under revision. It is an entity with a mission of uniformity, data integration, standardization, and compliance that operates under he auspices of the Resource Management Steering Committee. Meeting Minutes and Information on www.meprs.info .

HA / DHA Directorates

DH

A P

rogr

am

Offi

ces

(DH

IMS

/ DH

SS) Chartered W

orkgroups

(DQM

CP/UBU/UBO/CCAW

G)


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http://www.meprs.info/

EASi

DMHRSi

•Manpower data•MILPERS

EAS IV Repository Access via Business Objects

EAS IV Repository-- DoD- Standardized MEPRS Data

EAS IV

•O&M Expense•Civilian Salary•Obligation data•PEC data

Service FinancialSystem

Composite Health CareSystem (CHCS)

•Admissions/Discharges•Bed Days•Visits•Ancillary Workload

WAM

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∎ EASIV System Updates:EAS IV includes Service-unique and DoD/DHA tables that

contain multiple data elements which must be maintained and which must be in compliance with all current policy, regulations, etc.

The Table Update process in EAS IV also includes mapping the Service-unique data elements to a corresponding DoD/DHA data elements for consistent MHS MEPRS reporting.

Some of the EAS IV tables can be updated monthly, but all Service and DHA tables must be updated at least once a year. This monthly and annual process is referred to as the EAS IV Table Update Process.

MEPRS Data Quality Management Control Review List


MEPRS DQMC Review List Questions

∎Education 5M2U (MADI)

∎MEWACSData Load StatusOutliersAllocation

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MEPRS Education

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Question A.7.c) “Have the members of the DQ Assurance Team been

trained in their area of responsibility?”Note: A.7.c is to be used locally to ensure that team members have training in their functions and responsibilities. (E.g., Analysis: WISDOM; Medical Expense and Performance Reporting System (MEPRS): MADI, QUEST; Uniform Business Office (UBO): webinars; Patient Administration (PAD): Service PAD Course.)

WWW.MEPRS.INFO/5M2U

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5 Minute MEPRS University (5M2U)

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A web-based distance learning vehicle that offers animated tutorials that illustrate MEPRS concepts and processes.

Each tutorial contains targeted learning content and is approximately five minutes in length.

Consists of the five core modules that make up the MEPRS Application and Data Improvement (MADI) course as well as modules to guide the repository user through common data extraction scenarios.

Data Load Status

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Question C.1.c) “Were the data load status, outlier and allocation

tabs in the MEWACS document reviewed and explanations provided in the comments section for flagged data anomalies?”

Data Load StatusWW.MEPRS.INFO/MEWACS

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Data Load Status

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Review Item 1. “EAS IV Repository MEPRS data load

status and compliance with the 45-day reporting suspense or Service Guidance whichever is earlier. If the facility has a pattern (2 or more) of flagged cells on this tab, has it corrected it or developed a plan to correct it? Provide an explanation in the Comments Section.”

Data Load Status

14 December 2011 Pre-decisional FOUO33

Data Load Status

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Data Load Status

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DQMC Review List

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Review Item 2. “MTF-specific summary data outliers.

If the facility has any Prior Fiscal Year or Current Fiscal Year flagged cells on this tab, provide an explanation in the Comments Section.”

Summary Outliers


Clicking on the outlier month will take you to MTF

Data Profiles

Summary Outliers


Summary Outliers

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Summary Outliers

14 December 2011 Pre-decisional FOUO

Multiple selection is available on many of

the fields

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Allocation

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Review Item 3. “Ancillary and Support expense

allocation tests. If the facility is flagged in the Prior Fiscal Year or Current Fiscal Year due to incomplete allocation of ancillary or support expenses, provide an explanation in the Comments Section, including projected date for submitting corrected data.”

Allocation

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Allocation

Fourth level FCC drilldown

available.

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Allocation

Fourth level FCC drilldown

available.

THANK YOU FOR YOUR INTEREST IN MEPRS !QUESTIONS?

MEPRS PROGRAM OVERVIEW


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MHS Objectives

∎ Promote more effective and efficient health operations through enhanced enterprise-wide shared services

∎ Deliver more comprehensive primary care and integrated health services using advanced patient-centered medical homes

∎ Coordinate care over time and across treatment settings to improve outcomes in the management of chronic illness, particularly for patients with complex medical and social problems

∎ Match personnel, infrastructure, and funding to current missions, future missions, and population demand

∎ Establish more inter-service standards/metrics, and standard process to promote learning and continuous improvement

∎ Create enhanced value in military medical markets using an integrated approach in 5-year business plans

∎ Align incentives with health and readiness outcomes to reward value creation∎ Improve the health of the population by addressing determinants of health


1 Medical Expense and Performance Reporting System (MEPRS) Program Data Quality Tools Type Brief: Information April 30, 2014 DHA MEPRS Program Office “Medically.

Documents

predecisional fouopurpose

predecisional fouomeprs

cost data

decisional fouo14

decisional fouointroduction14

medical expense

workload data

manpower data