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Briefing: MEPRS Fundamentals

Briefing: MEPRS Fundamentals. Speakers: Paulette Richards Sheri Weis Date: 29 July 2010 Time: 1300 – 1500. WELCOME. Medical Expense and Performance Reporting System (MEPRS) FUNDAMENTALS.

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Briefing: MEPRS Fundamentals

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  1. Briefing: MEPRS Fundamentals Speakers: Paulette Richards Sheri Weis Date: 29 July 2010 Time: 1300 – 1500

  2. WELCOME Medical Expense and Performance Reporting System (MEPRS) FUNDAMENTALS

  3. MEPRS Fundamentals: Background Standard Tables Financial Processing Paulette Richards

  4. MEPRS Fundamentals Objectives Understanding the basics of MEPRS Processing: Who… What… When… Where… Why… And HOW Financial, Workload and Personnel

  5. WHY MEPRS Uniform Chart of Accounts (UCA) aka MEPRS Joint study tasked to address four concerns: Anticipated physician shortages. The quality of systems for planning, management, and evaluation Increased overhead and support costs The social equality of military medical care and its compatibility with national health care objectives.

  6. WHY MEPRS Inconsistent & non-comparable data maintained Valid comparisons between MTF and the Services could not be made MTFs used separate & independent systems & data bases • Different interpretations of common data UNIFORM CHART OF ACCOUNTS (UCA) aka MEPRS Performance Measurements UNIFORM CHART OF ACCOUNTS Reporting

  7. STANDARD TABLES FCC Master – Standard to the third position of the Functional Cost Code (4th pos service unique) Service Element Expense Code (EEIC) TRICARE MANAGEMENT ACTIVITY Program Element Code (PEC) Standard Documentation Code Table

  8. Functional Categories A - Inpatient Care B - Ambulatory Care C - Dental Care D - Ancillary Services E - Support Services F - Special Programs G - Readiness A - Inpatient Care (functional category) AA - Medical Care (summary account) AAA - Internal Medicine (sub-account) AAB - Cardiology (sub-account) Intermediate Operating Final

  9. ASD & EAS IV PROCESSING MODEL DMHRSI Labor ERROR CORRECTION UNIT (ECU) MEPRS MANAGER VALIDATION CHECK EAS IV REPOSITORY ADJUSTMENTS CHCS/WAM Workload ALLOCATION CRIS Financial MHS Management Analysis and Reporting Tool- (M2) Communication ERROR CORRECTION UNIT (ECU)

  10. Account Subset Definition (ASD) Table Fundamentals • WHAT is an ASD? • 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. • HOW is the ASD Created? • AF MEPRS SG establishes approved FCC codes with the ASN in a standard table for the entire AF. • MEPRS Manager reviews and submits their local table. • HOW is the ASD Used • Determines if FCC are valid. • Contains the ASN which determines the order in which expenses from Intermediate accounts are allocated to Final accounts in the step-down process. • HOW is the ASD is STORED • The table is stored in the EASi application. • NOTE: At the beginning of each year the table is reviewed.

  11. ASD – CRITERIA FOR FCC CREATION Expenses – Attributed to work-center. Expenses include: direct, resource sharing, contract and personnel. Physical space – A location where the services are provided, must be capable of being measured in square. Personnel – Must have assigned/available personnel as identified in the DoD 6010.13M Unique Accounts: Service provided must be unique and not duplicated/provided by another work-center. ASD CRITERIA Workload Measure – Must have ability to measure meaningful workload identified in the DoD 6010.13M Work-center: Must meet definition as outlined in DoD 6010.13-M

  12. D&E FCCs require ASN Clear Descriptions Make sure all RC/CCs are current

  13. ASD CREATION MODEL - OVERVIEW ASD CREATION PROCESS DATY QUALITY VALIDATION RESULTS PEOPLE MANAGEMENT DMHRSI • MEPRS MGR • BUDGET POC • CHCS DBA • MANPOWER POC • VALIDATE EACH PROJECT AND TASK ASD STRUCTURE CHCS/WAM FCC CRITERIA MEPRS/EAS LEADERSHIP CLEAN MEPRS/EAS TABLES • VALIDATE SITE DEFINABLE TABLE • FISCAL YEAR • DMIS ID • MEPRS/FCC CODES • FCC DESCRIPTIONS • ASN • ACTIVATION DATE • INACTIVATION DATE • DEACTIVATION DATE • EXPENSES • PHYSICAL SPACE • MANPOWER • MEASURABLE WORKLOAD • AIR FORCE MEPRS PROGRAM OFFICE • AFMOA MEPRS STAFF • MTF STAFF PE-MAP ASD CHECKLIST • VALIDATE ALL FCCs • REVIEW ASN • ALIGN EXTERNAL TABLES • ADDRESS DUPLICATE FCCs • VALIDATE AF SG FIINANCIAL GUIDANCE • RCCC/MEPRS TABLE MEPRS/EAS DATA QUALITY RELATIONSHIP LEARNING

  14. ASD STAKEHOLDERS CHCS DBA – Ensure the CHCS table is properly reporting workload for each MEPRS/FCCs Budget Office – Involved with correcting and identifying expenses associated with the work-center PEOPLE MANAGEMENT MEPRS MANAGER RMO Logistics Office – Ensure proper reporting of supplies, equipment, square footage and depreciation Manpower Office – Ensure the Activity Manning Document is up-to -date .

  15. ASD CHECKLIST HELPFUL NOTES 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) ADD an FCC: Ensure MEPRS/FCCs are aligned with DoD 6010.13M D and E FCC require ASN INACTIVATE DATES will cause a warning in the error correction unit (ECU) during the initial validation process. TEAM EFFORT - All FCCs should be reviewed by RMO team and validated against the AF FCC Master Table. FCCs can be added or reactivated in mid-year. Ensure the default date is changed. REACTIVATE an FCC: You will need to re-enter a current dat within the current fiscal year. * Change the inactivate Date Range.

  16. PURPOSE & IMPACT • Summary • 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.

  17. Resource Manager ERROR CORRECTION UNIT (ECU) MEPRS MANAGER VALIDATION CHECK EAS IV REPOSITORY BUSINESS RESULTS FINANCIAL PROCESSING ADJUSTMENTS ALLOCATION CRIS Financial Results ERROR CORRECTION UNIT (ECU)

  18. AF four-tier structure for handling funds: Budget Activity Group COMMANDERS RESOURCE INTERGRATION SYSTEM CRIS Program Element Code Responsibility Code Cost Center Service Unique Expense Element

  19. COMMANDERS RESOURCE INTERGRATION SYSTEM (CRIS)

  20. EASIV PURE FILE

  21. CRIS & EASIV PURE DATA ELEMENTS CRIS EASIV Pure File Eff Date BQ Site Field Site (OPLOC) Operating Agency Code (OAC) OAC Desc Operating Budget Account Number (OBAN) OBAN Desc FY (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 Amount Bal ID (E & U) Bal ID Desc Row Count DMIS ID (OBAN) FCC RC/CC SEEC (EEIC) BSL (FC) PEC SOF Schedule Type Oblig. Fiscal Year Oblig. YTD Expense YTD (BQ Amount)

  22. EASIV IMPORTS CRIS Data $2,999,999 $2,999,999

  23. FINANCIAL DATA OVERVIEW

  24. ALLOCATION PROCESS IN THE EAS IV PROCESSING MODEL ERROR CORRECTION UNIT (ECU) DMHRSI Labor VALIDATION CHECK EAS IV REPOSITORY BUSINESS RESULTS MEPRS MANAGER ADJUSTMENTS ALLOCATION CRIS Financial Results ERROR CORRECTION UNIT (ECU)

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

  26. 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” • Incorporates overhead expenses (Utilities, depreciation, housekeeping, etc.) • Determines real “unit cost” • Provides comparability with civilian sector cost allocation methods

  27. PURIFICATION PROCESS ACA% ADA% Text ABA% 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 AAA% A_X

  28. STEPS in the ALLOCATION PROCESS Stepdown E expense data Stepdown D expense data Calculate expenses contributed (X) Calculate personnel contribuited Create personnel allocation ratios Purfy expense data Accumulate data sets Accumulat e personnel data Create allocation ratio Purify personnel data Accumulate expense data Copy Personnel allocated expense Delete previous job Create Resp/Pulm data sets Create ADM data sets Preallocation validation Update Service Unit Cost Mappings Accumulate DRG data Calculate DRG cost data Initiate Allocation

  29. STEPDOWN aka ALLOCATION E & D $2,559,987 E% D% A% B% C% F% G% E & D $0 Intermediate accounts are stepped down based on the order of the assignment sequence number (ASN) listed on the ASD

  30. ALLOCATION SCENARIO FCC: EBAA – Command & Admin DSI: FTEs EBAA Total Ratio DSI Workload 100 50 150 45 35 26.31579 13.15789 39.47368 11.84211 9.21053 AAAA BAAA BGAA CAAA DAAA 100 50 150 45 35 380 380 380 380 380 EBAA Total: 380

  31. ALLOCATION SCENARIO FCC: EBAA – Command & Admin DSI: FTEs % Total Expenses: $10,000 EBAA Expense to be Distributed Expense distributed Ratio AAAA BAAA BGAA CAAA DAAA $2,631.58 1,315.79 3,947.37 1,184.21 921.05 26.31579 13.15789 39.47368 11.84211 9.21053 X $10,000

  32. Expense received from step-down: Total expense to be distributed: ALLOCATION OVERVIEW DSI: PHARMACY DAAA - Pharmacy $921.05 $100,921.05 SAS 301 Workload DAAA Total Ratio 175 175 175 175 175 50 10 25 75 15 28.57143 5.71429 14.28571 42.85714 8.57143 AAXA AAAA BAAA BGAA CAAA DAAA 50 10 25 75 15 25 200 Total: -25 175

  33. $100,000.00 Direct Expenses: $921.05 Expense received from step-down: $100,921.05 Total expense to be distributed: Data Set ID: Pharmacy DAAA - Pharmacy % of Data Set Total Expense distributed DAAA Expense to be Distributed 28.57143 5.71429 14.28571 42.85714 8.57143 $28,834.59 5,766.92 14,417.29 43,251.88 8,650.38 AAAA AAAA BAAA BGAA CAAA X $100,921.05

  34. ALLOCATION REPORTS • Allocation Summary • Allocation Ratios ASN Verification • Expense Accepted/ Allocated Detail • Expense Allocated • Personnel Accepted/ Allocated • Data Set Accepted/Allocated

  35. MEPRS Fundamentals: Workload and Personnel Processes Sheri Weis

  36. EAS Processes: Workload System-Generated Data and Non-System Generated Data

  37. 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 • 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.

  39. EAS Processes: WorkloadSystem Generated Data: WAM

  40. EAS Processes: Workload Non-System Generated Data • 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

  41. EAS Processes: Workload Non-System Generated Data • Ancillary Services Accounts Data Sets (D***)

  42. EAS Processes: Workload Non-System Generated Data • Support Services Accounts Data Sets (E***)

  43. EAS Processes: Workload Non-System Generated Data • Special Program Accounts Data Sets (F***)

  44. EAS Processes: Workload Non-System Generated Data • Readiness Program Accounts Data Sets (G***) • 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.

  45. EAS Processes: WorkloadDatasets Example

  46. EAS Processes: Workload Steps • Import monthly CHCS/WAM file • Validation: select “ Available to Validate” • Address Errors and Warnings in the ECU: research, correct and re-validate • Enter Non-System Generated Reports under Adjustments-Workload-Data Sets

  47. EAS Processes: WorkloadReconciliation • 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

  48. EAS Processes: WorkloadStakeholders MEPRS EAS

  49. EAS Processes: Personnel

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