meprs for fmmtc

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM

Medical Expense and Performance Reporting System (MEPRS)

Ms. Nancy Taylor

August, 2006

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Objectives

Identify basic MEPRS business rulesUnderstand MEPRS processingComprehend MEPRS critical data

elementsLocate MEPRS guidance Define MEPRS analysis and basic

MEPRS reports

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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

MEPRSLabor/Personnel

Expense

Workload

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM MEPRS Processing

STARS - FL

Patient seen Visit captured WAM

PersonnelMan hours

MEPRSCoordinator

Clinic MEPRSclerk

Encountergenerated

SADR sent

NMIMC

SPMS

EAS IV

Ancillary workload

Local EAS processing

Financial Files

DMHRSi

Basics

SMART

Aligns costs with production

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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

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Functional Cost Centers

4 digit alphanumeric codeRepresents work centers or reporting

facilitiesUsed to track costs, workload and FTEs First 3 letters are DoD-standard. Fourth

character is MTF specific (Navy)

Basics

Microsoft Excel Worksheet

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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 DMISA = InpatientB = OutpatientC = DentalD = AncillaryE = SupportF = Special ProgG = Readiness

A = MedicalB = SurgicalC = OB/GYND = PediatricsE = OrthoF = Mental HlthG = Family PractH = Primary CareI = ERJ = Flight MedK = Undersea MedL = PT

A = ParentJ = Branch Clinic5 = APV

Specialty level

Basics

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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 ExamplesBasics

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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

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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.

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Workload Data

Three main sources:– CHCS via Workload Assignment Module

(WAM)– Manual entry– ADM feed – CPT codes

Workload

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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

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Workload Examples - WAM

Category WorkloadInpatient 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

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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

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Support Services

Category Manual WorkloadAdministration 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

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM

Personnel/Labor

Labor

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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

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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

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM

Physician (suffix P)Dentist (suffix D)Medical ResidentMedical FellowMedical InternDental InternDental FellowDental ResidentVeterinarian

Physician AssistantNurse PractitionerNurse MidwifeNurse AnesthetistCommunity HealthOccupat. Health NurseClinical Nurse SpecialistOther DC Professionals

LPN or LVNNursing AssistantCorpsmanTechnicianOther

Registered NurseOther

LogisticsClericalAdministratorOther

Skill Type 1 Skill Type 2 Skill Type 3 Skill Type 4 Skill Type 5

Personnel Data Categories

IDC

Labor

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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.

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Basic Manhour Reporting

HOUR DISTRIBUTION ON Reported Time

Emergency RoomBIAA

PrimaryCare

BHAA

ReadinessGBAA

60 HRS = 35% OR $ 2,206

96 HRS =55% OR $ 3,466

18 HRS = 10% OR $ 630

O-2Monthly pay = $6,302Assigned work centerBHAA-Primary Care

Monthly pay is distributed based on the percent of time spent in each work center

Labor

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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

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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

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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

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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

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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

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM

Expense Allocation

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Financial Data

Types of Expenses– Pay Data

• Military• Civilian

– Contracts– Supplies– Equipment– Base Operations– Depreciation

Allocation

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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

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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

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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

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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

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM

Other E

Accnts

AInpatient

CareB

Amb.Care

CDental

Services

FSpecialProgsG

MedReadiness

DAncillary Services

ESupport Services

First, Support Services (“E” accounts) expensesare allocated

Each Support Services FCC is allocated until no expenses remain in “E” accounts

Expense AllocationAllocation

Support Allocation

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM

Other D

Accnts

AInpatient

CareB

Amb.Care

CDental

Services

FSpecialProgs

GMed

Readiness

DAncillary Services

Then, Ancillary Services (“D” accounts) expensesare allocated

Each Ancillary Services FCC is allocated until no expenses remain in “D” accounts

Expense AllocationAllocation

Ancillary Allocation

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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

AAXAAAAABAAABGAACAAA

Total: 175

DAAA Total

175175175175175

5010257515

Ratio

5010257515

28.57 %5.71 %

14.29 %42.86 %

8.57 %

Allocation

Introduction

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM

AAXAAAAABAAABGAACAAA

RatioDAAA Expenseto be Distributed

$100,921.05 X

Expense distributed

$100,921.05

DAAA Data Set - PharmacyDirect 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 %

$28,833.155,762.59

14,421.6243,254.76

8,648.93

Allocation

Allocation Example

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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 ExpensesA, B, C, F, G

Direct Expenses A, B, C, D, E, F, G=

Allocation

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM MEPRS Processing

STARS - FL

Patient seen Visit captured WAM

PersonnelMan hours

MEPRSCoordinator

Clinic MEPRSclerk

Encountergenerated

SADR sent

NMIMC

SPMS

EAS IV

Ancillary workload

Local EAS processing

Financial Files

DMHRSi

Basics

SMART

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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.htmlChapter 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

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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

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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

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MEPRSMEPRSMEDICAL EXPENSE & PERFORMANCE REPORTING SYSTEM Websites

TMA MEPRS website www.tricare.osd.mil/ebc/rm/rm_home.html

Navy MEPRS websitehttps://imcenter.med.navy.mil/eas/

Navy Data Quality Websitehttps://dq.med.navy.mil/reconcile

BUMED Portalhttps://199.26.34.9/servlet/portal/