Briefing: MEPRS Fundamentals

MEPRS 2010From Source to Resource:

Data Quality Solutions for Today's MEPRS Challenges

26 – 29 July

Lansdowne, VA

Briefing: MEPRS Fundamentals

Speakers: Paulette RichardsSheri Weis

Date: 29 July 2010Time: 1300 – 1500

WELC

OM

E

Medical Expense and Performance Reporting System (MEPRS)

FUNDAMENTALS



26 – 29 July

Lansdowne, VA

MEPRS Fundamentals:

Background Standard Tables Financial Processing

Paulette Richards

MEPRS Fundamentals Objectives

Understanding the basics of MEPRS Processing:

Who…

What…

When…

Where…

Why…

And HOW

Financial, Workload and Personnel

4

WHY MEPRS

Increased overhead and support costs

The quality of systems for planning, management, and evaluation

Anticipated physician shortages.

The social equality of military medical care and its compatibility with national health care objectives.

Uniform Chart of Accounts (UCA) aka MEPRS

Joint study tasked to address four concerns:

WHY MEPRS

6

MTFs used separate & independent systems & data bases

Valid comparisons between MTF and the Services could not be made

Inconsistent & non-comparable data maintained

Different interpretations of common data

PerformanceMeasurements

UNIFORM CHART OF ACCOUNTS Reporting

STANDARD TABLES

TRICARE MANAGEMENT

ACTIVITY

FCC Master – Standard to the third position of the Functional Cost Code (4th pos service unique)

Standard Documentation Code Table

Service Element Expense Code (EEIC)

Program Element Code (PEC)

8

Intermediate Operating

Final

A - INPATIENT CAREB - AMBULATORY CAREC - DENTAL CARED - Ancillary ServicesE - Support ServicesF - SPECIAL PROGRAMSG - READINESS

A - Inpatient Care (functional category)AA - Medical Care (summary account)AAA - Internal Medicine (sub-account)

AAB - Cardiology (sub-account)

Functional Categories

ASD & EAS IV PROCESSING MODEL

MEPRS MANAGER

VALIDATION CHECK

CRISFinancial

CHCS/WAM Workload

DMHRSILabor

EAS IV REPOSITORY

ALLOCATION

ADJUSTMENTS

ERROR CORRECTION UNIT (ECU)


Communication

MHS Management Analysis and Reporting Tool- (M2)

HOW is the ASD is STORED

o The table is stored in the EASi application.

o NOTE: At the beginning of each year the table is reviewed.

WHAT is an ASD?

o ASD table is the dictionary listing of Functional Cost Codes (FCCs) which defines your MTF data reporting . This table defines what goes on in your MTF.

Account Subset Definition (ASD) Table Fundamentals

HOW is the ASD Created?

o AF MEPRS SG establishes approved FCC codes with the ASN in a standard table for the entire AF.

o MEPRS Manager reviews and submits their local table.

HOW is the ASD Used

o Determines if FCC are valid.o Contains the ASN which determines

the order in which expenses from Intermediate accounts are allocated to Final accounts in the step-down process.

ASD – CRITERIA FOR FCC CREATION

ASD CRITERIA

Unique Accounts: Service provided must be unique and not duplicated/provided by another work-center.

Expenses – Attributed to work-center. Expenses include: direct, resource sharing, contract and personnel.

Workload Measure – Must have ability to measure meaningful workload identified in the DoD 6010.13M

Physical space – A location where the services are provided, must be capable of being measured in square.

Work-center: Must meet definition as outlined in DoD 6010.13-M

Personnel – Must have assigned/available personnel as identified in the DoD 6010.13M

D&E FCCs require ASN

Clear Descriptions

Make sure all RC/CCs are current

ASD CREATION MODEL - OVERVIEW

MEPRS/EASLEADERSHIP

ASD STRUCTURE

ASD CHECKLIST

FCC CRITERIA

PEOPLE MANAGEMENT

CLEAN MEPRS/EAS

TABLES

PE-MAP

CHCS/WAM

DMHRSI

• AIR FORCE MEPRS PROGRAM OFFICE

• AFMOA MEPRS STAFF

• MTF STAFF

• EXPENSES• PHYSICAL

SPACE• MANPOWER• MEASURABLE

WORKLOAD

• MEPRS MGR• BUDGET POC• CHCS DBA• MANPOWER

POC

• VALIDATE ALL FCCs

• REVIEW ASN • ALIGN

EXTERNAL TABLES

• ADDRESS DUPLICATE FCCs

• FISCAL YEAR• DMIS ID• MEPRS/FCC

CODES• FCC

DESCRIPTIONS• ASN• ACTIVATION DATE• INACTIVATION

DATE• DEACTIVATION

DATE

• VALIDATE SITE DEFINABLE TABLE

• VALIDATE EACH PROJECT AND TASK

• VALIDATE AF SG FIINANCIAL GUIDANCE

• RCCC/MEPRS TABLE

MEPRS/EAS DATA QUALITY RELATIONSHIP LEARNING

ASD CREATION PROCESS DATY QUALITY VALIDATION RESULTS

ASD STAKEHOLDERS

PEOPLE MANAGEMENT

MEPRS MANAGER

Budget Office – Involved with correcting and identifying expenses associated with the work-center

Logistics Office – Ensure proper reporting of supplies, equipment, square footage and depreciation

RMO

CHCS DBA – Ensure the CHCS table is properly reporting workload for each MEPRS/FCCs

Manpower Office – Ensure the Activity Manning Document is up-to -date .

ASD CHECKLIST HELPFUL NOTES

INACTIVATE DATES will cause

a warning in the error

correction unit (ECU) during

the initial validation process.

ADD an FCC: Ensure MEPRS/FCCs are aligned with DoD 6010.13M

D and E FCC require ASN

INACTIVATE an FCC: This is a TEMPORARY date and can only occur in the current fiscal year.

* The date range must be within the current FY

DEACTIVATE an FCC: This is a PERMANENT date.

* Date cannot be before the beginning of the current year (30 Sep FY)

REACTIVATE an FCC: You will need to re-enter a current dat within the current fiscal year.* Change the inactivate Date Range.

FCCs can be added or reactivated in mid-year. Ensure the default date is changed.

TEAM EFFORT - All FCCs should be reviewed by RMO team and validated against the AF FCC Master Table.

PURPOSE & IMPACTSummary

The ASD is the roadmap which defines MTF unique data used by Expense Assignment System (EAS ) processing.

MEPRS utilizes Standardized business rules for collecting, calculating and reporting data used for clinical and management decisions.

Standard tables are published and maintained by TMA ensure MHS follow standardized business rules.

FINANCIAL PROCESSING

MEPRS MANAGER

VALIDATION CHECK

CRISFinancial

Resource Manager

EAS IV REPOSITORY

BUSINESS RESULTS

ALLOCATION

ADJUSTMENTS


ResultsERROR CORRECTION UNIT (ECU)

COMMANDERS RESOURCE INTERGRATION SYSTEM CRIS

18

Program Element Code

AF four-tier structure for handling funds:

CRIS

BAG

PEC

SUEE

RC/CC

Budget Activity Group

Responsibility Code

Cost Center

Service Unique Expense Element

COMMANDERS RESOURCE INTERGRATION SYSTEM (CRIS)

19

20

EASIV PURE FILE

21

Eff DateBQ SiteField Site (OPLOC)Operating Agency Code (OAC)OAC DescOperating Budget Account Number (OBAN)OBAN DescFY (4 Char)OBY (4 Char)Fund Type (FT)Fund Code (FC)Program Element Code (PEC)Element of Expense/Investment Code (EEIC)Resource Center/Cost Center (RCCC)BQ AmountBal ID (E & U)Bal ID DescRow Count

DMIS ID (OBAN)FCCRC/CCSEEC (EEIC)BSL (FC)PECSOFSchedule TypeOblig. Fiscal YearOblig. YTDExpense YTD (BQ Amount)

CRIS & EASIV PURE DATA ELEMENTS

CRIS EASIV Pure File

EASIV IMPORTS CRIS Data

22

CRIS

EASIV PURE

PEC6 Digit

PEC 5 Digit

$2,999,999 $2,999,999

23

FINANCIAL DATA OVERVIEW

24

What should I do to make sure

MEPRS Financial data is accurate?

Become familiar with data elements

(PECs/RC/CC) and how they relate to

FCCs.

Become intimately familiar with the Financial

Program Element (PE) Map table that is

provided each year by AF MEPRS Program Mgr

Know what data should be reported

in MEPRS.

Each work center must be mapped to

a cost center

Coordination between MEPRS Mgr,

Logistics, Budget and Resource Mgr.

ALLOCATION PROCESS IN THE EAS IV PROCESSING MODEL

MEPRS MANAGER

VALIDATION CHECK

CRISFinancial

DMHRSILabor

EAS IV REPOSITORY

BUSINESS RESULTS

ALLOCATION

ADJUSTMENTS


ResultsERROR CORRECTION UNIT (ECU)

ALLOCATION OVERVIEW

DEFINITION: Allocation is the reassignment (step down) of intermediate operating accounts (D & E ) expenses to final operating accounts (A, B, C, F and G) on the basis of the ASN from the ASD.

WHY WE DO COST ALLOCATION: Provides the “Total Cost of Doing Business”

o Incorporates overhead expenses (Utilities, depreciation, housekeeping, etc.)o Determines total “unit cost”o Provides comparability with the civilian sector cost allocation methods

ALLOCATION OVERVIEW.......

DEFINITION:

The reassignment of intermediate operating (D & E) expenses is performed on the basis of assignment factors or ratios that measure the amount of services rendered by intermediate work centers to the other work centers.

WHY WE DO COST ALLOCATION:

Provides the “Cost of Doing Business”o Incorporates overhead expenses (Utilities, depreciation, housekeeping, etc.)o Determines real “unit cost” o Provides comparability with civilian sector cost allocation methods

Expense from FCC’s with an ‘X’ in the third position (COST POOLS) are distributed to final accounts based on the ratios calculated using the cost pool data set

Text ACA% ADA%ABA%AAA%

PURIFICATION PROCESS

A_X

STEPS in the ALLOCATION PROCESS

Create allocation ratio

Calculate personnel contribuited Create personnel allocation ratios

Purfy expense data

Stepdown E expense data

Stepdown D expense data

Calculate expenses contributed (X)

Update Service Unit Cost MappingsAccumulate DRG dataCalculate DRG cost data

Purify personnel dataAccumulate expense dataCopy Personnel allocated expense

Create Resp/Pulm data setsCreate ADM data setsPreallocation validation

Accum

ulate

data

sets

A

ccum

ulat e

perso

nnel

data

Initiate Allocation

Delete previous job

STEPDOWN aka ALLOCATION

E & D $2,559,987E%

D%

A%

B%

C%

F%

G%

Intermediate accounts are stepped down based on the order of the assignment sequence number (ASN) listed on the ASD

E & D $0

ALLOCATION SCENARIO

DSI Workload

AAAABAAABGAACAAADAAA

EBAA Total

EBAA Total: 380

380380380380380

10050

1504535

26.3157913.1578939.4736811.842119.21053

Ratio

10050

1504535

FCC: EBAA – Command & Admin DSI: FTEs

ALLOCATION SCENARIO

26.3157913.1578939.4736811.842119.21053

RatioEBAA Expenseto be Distributed

$10,000 X

Expense distributed

$2,631.581,315.793,947.371,184.21

921.05

AAAABAAABGAACAAADAAA

FCC: EBAA – Command & Admin DSI: FTEs %Total Expenses: $10,000

ALLOCATION OVERVIEW

DAAA - Pharmacy DSI: PHARMACY

Expense received from step-down:

Total expense to be distributed:

SAS 301 Workload

AAXAAAAABAAABGAACAAADAAA

Total: 200

DAAA Total

-25

175175175175175

28.571435.71429

14.2857142.857148.57143

5010257515

Ratio

501025751525

175

$921.05

$100,921.05

DAAA - Pharmacy Data Set ID: PharmacyDirect Expenses:

Expense received from step-down:

Total expense to be distributed:

AAAAAAAABAAABGAACAAA

% of Data Set Total

DAAA Expenseto be Distributed

$100,921.05 X

Expense distributed

$28,834.595,766.92

14,417.2943,251.888,650.38

28.571435.71429

14.2857142.857148.57143

$100,000.00$921.05

$100,921.05

ALLOCATION REPORTS

Allocation Summary Allocation Ratios ASN VerificationExpense Accepted/ Allocated DetailExpense AllocatedPersonnel Accepted/ Allocated Data Set Accepted/Allocated



26 – 29 July

Lansdowne, VA

MEPRS Fundamentals:

Workload and Personnel Processes

Sheri Weis

EAS Processes: Workload

37

System-Generated Dataand

Non-System Generated Data

EAS Processes: WorkloadSystem Generated Data

CHCS: Workload Assignment Module (WAM)Data Sets:

ADM

Dispositions

Occupied Bed Days

Outpatient Visits

Pharmacy (DAAA)

Total Visits

Radiology (DCAA)

Pathology (DBAA)

(only Lab and Rad provide CPT workload data)

38

EAS Processes: WorkloadSystem Generated Data: WAM

39

WAM is a Tri-Service component of CHCS that standardizes and streamlines workload reporting for MEPRS/EAS.

Workload templates are created at the beginning of each month using the Initialization action.

All Data Set Identification (DSI) must be in Approved status for the ASCII file to be either created or re-created.

The ASCII file must be generated, before it’s transmitted to EAS via electronic interface.

EAS Processes: WorkloadSystem Generated Data: WAM

40

EAS Processes: Workload Non-System Generated Data

41

Dental Services Account Data Sets

Ancillary Services Accounts Data Sets Lab/Rad/Pharmacy are system-generated

Support Services Accounts Data Sets

Special Program Accounts Data Sets

Readiness Program Accounts Data Sets

Square Footage and Square Footage Cleaned

Ancillary Services Accounts Data Sets (D***)

42


Electrocardiogram/(EKG) – (DDAA) Ensure raw number of cases are reportedElectroencephalography/(EEG) – (DDBA) (The data can be entered by work center personnel)Electroneuromyography/(EMG) – (DDCA)Cardiac Catheterization (DDEA) Monthly report from Cardiac Catheterization work centerCentral Sterile Supply Division (DEAA) Monthly report from Central Sterile Anesthesiology (DFAA) Monthly report from Surgical DivisionSurgical Suite (DFBA) (Raw = # of cases Weighted = Minutes of Service)Post Anesthesia Care (DFCA)

Inhalation Respiratory (DHA*)/Pulmonary Functon (DDD*)

Verify statistical values have been entered by Pulmonary and Respiratory staff by Beneficiary Category and CPT code NLT the 10th workday of the month

Hemodialysis (DGB*)/Peritoneal Dialysis (DGD*) Ensure raw and weighted numbers are reported


43

Support Services Accounts Data Sets (E***) Third Party Collection (EBHA) Monthly report from Third PartyCollections (# of claims) Transportation (EDGA) Monthly report from Vehicle Control Officer

Medical Logistics: Supplies/Equipment (EEAA) Run the EAS Direct Expense Accepted Report for values to enter in the Data Set:Select “Standard Reports”Select “Direct Expense Accepted Report”Select “Refresh” to request the current monthFilter report on all 6XX SUEE except 64*; print report; enter NET Month values for each work center

Biomedical Equipment Repair (EGAA) Monthly DMLSS report from Biomed DivisionLaundry/Linen (EHAA) Monthly report from Housekeeping Nutrition Care (EIA*, EIB*, and EIC*) EIA* = Patient Food operations

EIB* = Combined Food OperationsEIC* = InPatient Clinical Nutrition Management


Special Program Accounts Data Sets (F***)

44

Immunizations (FBI*)Early Intervention Services (FBK*)Military Funded Emergency Leave Expenses (FDH*) These “F” accounts report raw procedures.Consecutive Overseas Tour Leave (FDI*)Ambulance Services (FEA*)Transient Patient Care (FEC*)Aeromedical Staging Facilities (FEF*)Area Dental Prosthetic Lab (FAB*) This “F” account reports weighted procedures


Readiness Program Accounts Data Sets (G***)

45

Captures only War Reserve Medical (WRM) readiness workload performed at your local facility- $ amounts. (GEAA)

Square Footage and Square Footage Cleaned

The Facility section should provide square footage information.

Be sure to make all corrections in the first month of the fiscal year.

Compare Square Footage with the Square Footage Cleaned to

ensure the correct values are being reported.

EAS Processes: WorkloadDatasets

46

Example

EAS Processes: Workload Steps

1. Import monthly CHCS/WAM file

2. Validation: select “ Available to Validate”

3. Address Errors and Warnings in the ECU: research, correct and re-validate

4. Enter Non-System Generated Reports under Adjustments-Workload-Data Sets

47

EAS Processes: WorkloadReconciliation

48

CHCS Reports:World Wide Workload Report (WWR): Validate monthly CHCS WAM workload prior to transmittal to EAS IV Follows the same business rules for calculating workload as WAM Can be used to validate Occupied Bed Days and Admissions

Monthly Statistical Report: Count and Non-Count for In-/Out-Patient areas by MEPRS Code;

in-depth look at discrepancies between the WWR and EASIV End of Day processing must be completed before the MSR can

be generated

TOPA

Logistics

Dental

Pulmonary/Respiratory

Biomed

Housekeeping

CHCS

Clinics/InPt Units/Surg

ery

EAS Processes: WorkloadStakeholders

49

MEPRS EAS

EAS Processes: Personnel

50


51

Personnel Included Personnel ExcludedInpatients (unless assigned to MTF)Medical Hold/Patient Squadron

Federal civilians Civilians paid from non-appropriated funds (Exception: Family Advocacy from Brooks)

TAD/TDY personnelBorrowed personnelDirect/indirect-hire foreign national employees paid from appropriated fundsForeign Armed Service personnelReservistsContract Personnel and Volunteers

US Military personnel on orders (includes students)

Good, basic stuff to know:1 FTE = 168 hours /month

Where are they?Available/Non-Available Time

5 Skill Types + Occupation Codes-what are they?


Good basic stuff to know:

1 FTE = 168 hours /month Are personnel assignments correct Report all Available/Non-Available Time 5 Skill Types + Occupation Codes-what are they?

52

EAS Processes: PersonnelDMHRSi

LCA Specialist: DMHRSi Output File DoD Create EASIV Extract File_XXXXXX (Text file for

importing into EAS) After creating the DMHRSi output file, run the EAS IV

Assigned Personnel and EAS IV Summary View reports- will help you to investigate errors

Note: Personnel errors cannot be adjusted in EAS. They must be corrected in the source system (DMHRSi), then re-imported.

53

EAS Processes: Personnel Steps

54

1. All personnel time has been processed for the month!

2. DMHRSi-DoD EASIV CREATE FILE : save as text file for import

3. Upload Personnel file

4. Import Personnel file

5. Validation: select “ Available to Validate”

6. Address Errors and Warnings in the ECU: research, make corrections in DMHRSi, re-import and re-validate

EAS Processes: PersonnelReconciliation

Compare the DMHRSi EAS IV Summary View Report with the EASIV Personnel Allocated Report to ensure that the total FTEs match

55

5656

FHI Implementation

13 Sites completed by end of 2009

Edwards & Ellsworth (2008)

Scott Misawa

Patrick FE Warren

Andrews Bolling

Hill Sheppard

Laughlin

Elmendorf

Lakenheath

20 “Homes” to be “built” in 2010

Barksdale McGuire

Charleston Offutt

Columbus Ramstein

Davis-Monthan Randolph

Goodfellow Shaw

Hickam Spangdahlem

Hurlburt Travis

Keesler Vance

Langley Wright Patterson

Luke Yokota

EAS Processes: WorkloadStakeholders

57

MTF Staff(Timecards!)

HRManagerManpower

MEPRSLCA Manager

EAS

EAS Processes: Workload and Personnel

58

Resources…

59

Air Force M E P R S

SUSER GUIDEDoD 6010.13-M Air Force

Instructions 41-102

DoD 6010.13-M - Medical Expense & Performance Reporting System for Fixed Military & Dental Treatment Facilities Manual

AF MEPRS Users Guide - MUG

Defense Health Services Systems - Expense Assignment System IV (EAS IV) Application Functional Users Guide (FUG) December 2009

Secretary of the Air Force – Air Force Instructions 41-102 31 March 2008 – Air Force Medical Expense & Performance Reporting System for Fixed Military & Dental Treatment Facilities

SGY & AFMOA – Air Force MEPRS Support Staff (Washington/San Antonio)

Vector Check - https://vc.afms.mil/AFMOA/SGA/SGAR/SGAR_MEPRS/default.aspx

Vector Check

Questions?

60

MEPRSPersonnel

Workload

Financial

UBOOther Health

Insurance

Eligibility

Demographics

CodingSIDR/SADR

MSDRG/RWP

RVU/CPT

Patient &

Provider

Data Quality

Data QualityData Q

uality

Data Quality

61

Name MAJCOM Phone DSN (969)

EMAIL

Keith Andre AFGS, ACC 210-395-9228 [email protected]

Dave Collins AFMC, AFSPC, USAFE, PACAF

210-395-9206 [email protected]

Paulette Richards

AFGS, ACC 210-395-9225 [email protected]

Dawn Simmons AETC, AFDW, AMC, AFSOC, USAFA


Sheri Weis AETC, AFDW, AMC, AFSOC, USAFA


TSgt Jeff Zukowski

AFMC, AFSPC, USAFE, PACAF


Contact Us

http://www.google.com/imgres?imgurl=http://www.maforix.ae/images/contactus.jpg&imgrefurl=http://www.maforix.ae/contactus.htm&usg=__X6zkEWctSa1iC7sNq_wFUbNsYO8=&h=600&w=800&sz=18&hl=en&start=11&um=1&itbs=1&tbnid=w4QfMZ2u9q-2tM:&tbnh=107&tbnw=143&prev=/images?q=contact+us&um=1&hl=en&safe=active&rlz=1G1GGLQ_ENUS370&tbs=isch:1

BACK-UP

62

Documents

Briefing: MEPRS Fundamentals