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• [email protected]
– Ms. Nicole Brooks• 877.897.0691, ext. 601• [email protected]
– Ms. Kate Burchess• 410.620.3377• [email protected]
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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/