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Navy Performance Based Budget (PBB)

Navy Performance Based Budget (PBB). Business Planning Tool Training November 2007. BUMED (M8) . Agenda. Objectives of PBB Metrics Utilized Methodology of Adjustment Reports Distributed to Regions The Way Ahead. PBB Objectives. Create a linkage between Business Planning and Budgeting.

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Navy Performance Based Budget (PBB)

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  1. Navy Performance Based Budget(PBB) Business Planning Tool Training November 2007 BUMED (M8)

  2. Agenda • Objectives of PBB • Metrics Utilized • Methodology of Adjustment • Reports Distributed to Regions • The Way Ahead

  3. PBB Objectives • Create a linkage between Business Planning and Budgeting. • Controlled introduction of quality and effectiveness performance elements. • Align with QDR initiatives: “Transforming the Business” to use performance-based planning, financing and management. • Properly align authority, accountability and financial responsibility. • Provide the appropriate tools and information to enable leaders to achieve business plan performance goals.

  4. Metrics Utilized • Evidence Based Health Care (EBHC) • As Stated in Business Planning Guidance: Asthma, Diabetes A1c level, Diabetes A1c test, Diabetes LDL, Breast Screening. (Colorectal & Cervical Cancer shadowed only at this point). • Individual Medical Readiness (IMR) • BSO 18 Personnel Only. Focused on Percent “Indeterminate”. • Inpatient Bed Fill Rate • Based on “Active” Beds (excluding OR & ER beds) fill rate as compared to MTF bed capacity. • Public Health Execution Rate • Execution Rate to Plan based upon PE 0807705. PBB Applied to CONUS Facilities Only

  5. PBB Updates Public Health From PPS Reconciliation EBHC IMR BedCap Deployment Changes Under Development: • Public Health Metric: Reviewing Regional inputs for changing measure of public health or removing it in lieu of another metric. Submissions being reviewed include • Public Health Change: Immunizations, Smoking Cessation, Obesity • GME/Research • Pharmacy • Access to Care (No Show, LWOBS, Clinic Cancel) • Patient Satisfaction • Coding Compliance • Deployment Mitigation Review: • Basing calculation on GDA MEPRS code rather than comparing Available FTEs across FYs. Alternatives for calculating revenue credit per deployed provider & staff being reviewed. Next Update • Interim reports to be provided 3 Dec 07. • Formal Quarterly Report provided 4 Jan 08 Navy Performance Based Budget Staffing Mitigation = PPS + 10% + 5% + 5% + 5% + As of Sept PPS Recon NCA $2.6M NMW ($7.7M) NME ($9.8M) No Changes Changed from being based on % Not Medically Ready to % Indeterminate (See Scale Below) Changes Under Development No Changes Note: PBB calculates each individual quality metric at the Parent Level. Adjustments are based upon the “Planned” O&M budgetacross All BAGS and each metric may adjust up/down a maximum percentage based from the planned budget.

  6. Methodology • PPS Results are reported out in PBB as calculated via OSD(HA) PPS Reconciliation. They DO NOT effect PBB Methods or Calculations. • PBB calculates each individual quality metric at the Parent Level. Adjustments are based upon the “Planned” O&M budget and each metric may adjust up/down a maximum percentage based from the planned budget: MeasureMax Adjustment • EBHC (10%) • Inpatient Bed Fill (5%) • IMR (5%) • Public Health (5%) • Mitigation for deployments is then considered for each MTF based upon staffing levels. Revenue credit may be returned to the MTF if loss of workload is substantiated by understaffing issues. • After all plus-ups have been allocated, an Execution Adjustment is considered for each MTF based upon remaining monies in the adjustment pool. This execution adjustment MAY return portions of monies to MTFs previously decremented via the other adjustments.

  7. A Brief Example

  8. Navy PBB Example Public Health From PPS Reconciliation EBHC IMR BedCap Deployment Navy Performance Based Budget Staffing Adjustment = PPS + 10% + 5% + 5% + 5% + + + + + + Adjusted Total O&M $111.8M = ($3.3M) ($2M) $0M $0M $0.9M $0M Camp Pendleton $116.2M (Total = $4.4M or 3.8% reduction) + + + + + Camp Lejeune $80.6M = $1.98M $0M ($3.1M) $0M $0M $2.4M $81.9M (Total = $1.3M or 1.6% increase) Prospective Payment System (PPS): Effects 45% of the Bag 1 O&M Budget. Evidenced Based Health Care (EBHC): Effects 10% of the O&M Budget. Individual Medical Readiness (IMR): Effects 5% of the O&M Budget. BedCap: Bed Capacity Fill Rate of Active Beds (excludes ER&OR): Effects 5% of the O&M Budget. Public Health: Execution rate of Public Health budget (PE0807705): Effects 5% of the O&M Budget Deployment: Mitigates production losses based on observed staffing levels. All PBB Adjustments to be Approved by RQB

  9. Reports to Regions

  10. MTF Parent Level Reports

  11. Region Summaries

  12. How Will This Work? • Launched Aug/Sept 07: conduct socialization / refinements • Updates Quarterly beginning Jan 08 • Jan 08: execution review • Apr 08: mid-year adjustments based on performance • Jul 08: execution review • Aug 08: establish FY09 plan based on PBB Quarterly reviews will permit periodic adjustments; comptrollers will review monthly.

  13. Questions? POCs: BUMED PA&E (M81) LCDR Matt Bouma, MSC, (202)762-3533, DSN 762 matthew.bouma@med.navy.mil LCDR Randy Bills, MSC, (202)762-3236 randy.bills@med.navy.mil

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