Financial Data

MEPRS Overview

• MEPRS = Medical Expense and Performance Reporting System • Costs, workload and FTEs • Summary data only • MEPRS Business Rules estimate “work center” costs • Tri-Service Cost “Accounting” system TMA / WISDOM Excerpt 2

Workload (CHCS) Financial Data ( STANFINS, STARS/FL, BASF) Personnel Data (UCAPERS, SPMS, EAS) TMA / WISDOM Excerpt

MEPRS Data Flow

EAS IV Repository (Full MEPRS dataset) MDR (Large MEPRS dataset) Local EAS IV Server

(Monthly Processing) (Nightly/Monthly Processing)

M2 (Smaller MEPRS dataset) 3

TMA / WISDOM Excerpt

Using the Data!

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Terminology

• MEPRS Codes: Define the cost entities in an MTF • 4 character codes - imbedded hierarchical logic (each character means something!) • For example: AADA = Inpatient Dermatology TMA / WISDOM Excerpt 5

Terminology

• 1st character – “MEPRS1 Code” – A - Inpatient – B - Ambulatory – C - Dental – D - Ancillary – E - Support – F - Special Programs – G - Readiness Use MEPRS Manual for detailed descriptions of all codes: www.meprs.info

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Parents and Children

• MEPRS uses a unique parent/child structure • Smaller MTFs report through parents • Both parent and child (DMISID) levels of reporting are available in M2 • Parent DMISID of Record (MEPRS Parent) vs. Parent DMISID TMA / WISDOM Excerpt 7

MEPRS Summary Data

All data available by: • Timeframe (months, years) • MEPRS Code – All 4 char’s. Most questions only need 3.

– Ex. MEPRS4 Code matches pattern DAA% TMA / WISDOM Excerpt 8

Workload Data

Types of Workload: • Inpatient: Dispositions, Bed Days. As incurred in a month • Outpatient Visits • Inpatient Visits: (Ambulatory workload for inpatients) • Total Visits TMA / WISDOM Excerpt 9

Workload Data

• Weighted Rx workload: – Primarily contains prescriptions – Also bulk issue, unit doses, sterile products • Lab/Rad Weighted Workload (Relative Value Units) • Workload ordered by a particular work center and filled at the reporting MTF TMA / WISDOM Excerpt 10

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San Diego’s Ambulatory Internal Medicine Clinic ordered 135K Lab RVUs from the lab at San Diego

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FTE Data

• Assigned FTEs: From Service Personnel Systems –

Monthly

Assigned Staff – Won’t include borrowed labor or R/S • Available FTEs: From Timesheets –

Monthly

Available FTEs • Monthly Numbers: Don’t add people across months!

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Types of FTEs

• Clinician: MD, DO, DDS, Interns/Residents • “Other Clinician”: MD, DO, DDS • Professionals: PAs, NPs, Midwives, etc • Interns/Residents • RN: Registered Nurse • Para-Professionals: LPNs, X-Ray Techs, etc.

• Admin: Administrative Staff TMA / WISDOM Excerpt 16

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TMA / WISDOM Excerpt • Don’t add across months! 600 people each month, not 1200 people!

•Assigned < Available (OT, Resource Sharing, etc) 18

Expense Assignment

• Expenses are estimates.

• All work centers have direct expenses: The original work center that captures an expense – Often includes salaries, supplies and such • Work centers also have costs allocated to them AAAA (Internal Medicine) Work Center Direct $ TMA / WISDOM Excerpt + Allocated $ = Total Expenses $ 19

Expense Assignment

Allocated expenses: – Shared expenses • “Purified” as MEPRS calls them – Ancillary Services (MEPRS D codes) • Rx, lab, rad, ICU, etc.

– Support Services (MEPRS E codes) • Commanders salary, housekeeping, utilities • Allocation process is the same TMA / WISDOM Excerpt 20

Expense Assignment

• Expenses are allocated based on “performance factors” – Laundry: lbs of laundry – Commander’s salary: FTEs – Lab: weighted workload ordered – Pharmacy: weighted procedures – Housekeeping: square footage – Cost Pools: Minutes of service or OBD TMA / WISDOM Excerpt 21

Expense Assignment

Sample Allocation: – OB/GYN Supply Cabinet (MEPRS Code ACX): $10,000 – OB Workload (ACA): 500 OBDs, 83% of total workload – GYN Workload (ACB): 100 OBDs; 17% of total workload – Purified to OB: $10,000*83% or $8,300 – Purified to GYN: $10,000*17% or $1,700 TMA / WISDOM Excerpt 22

Expense Variables

Allocated Expense Measures from MEPRS: • Ancillary Expense: Sum of all allocated expenses to a given work center from ancillary accounts • Some components of ancillary expense (lab, rad and rx stepdown) • Purified Expense (shared) • Support Expense TMA / WISDOM Excerpt 23

Final Accounts

Direct Expense Purified Expense Ancillary Expense +Support Expense Total Expense

Inpatient (A), Ambulatory (B), Dental (C), Special Programs (F) and Readiness (G) are “FINAL ACCOUNTS”

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Expense Assignment

A - Inpatient B- Ambulatory C- Dental

D - Ancillary E - Support

F - Special Progs G - Readiness TMA / WISDOM Excerpt Note: Ancillary and Support Accounts should have total expense = 0 in the M2 (their expenses are already captured in the other work centers)!

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Support/Ancillary Accounts

Direct Expense + Allocated from others -Allocated out 0 Total Expense If total expense too much greater than 0, probably an error in MEPRS TMA / WISDOM Excerpt 27

Expense Assignment

To get a “total expense” for ancillary and support accounts: Use Cost Center Expense TMA / WISDOM Excerpt 28

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TMA / WISDOM Excerpt Very close to 0 in total expense. Probably rounding 30

Resources

• MEPRS Manual – Describes MEPRS Codes – FTE/workload reporting – Expense allocation process • MEWACS – Web based reports on MEPRS data quality. Site specific • TMA Website/MEPRS TMA / WISDOM Excerpt 31