1. Financial Data

2. TMA / WISDOM Excerpt 2 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 MEPRS Overview

3. TMA / WISDOM Excerpt 3 MEPRS Data Flow Workload (CHCS) Financial Data ( STANFINS, STARS/FL, BASF) Personnel Data (UCAPERS, SPMS, EAS) Local EAS IV Server MDR (Large MEPRS dataset) M2 (Smaller MEPRS dataset) (Monthly Processing) (Nightly/Monthly Processing) EAS IV Repository (Full MEPRS dataset)

4. TMA / WISDOM Excerpt 4 Using the Data!

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

6. TMA / WISDOM Excerpt 6 1st character – “MEPRS1 Code” –A - Inpatient –B - Ambulatory –C - Dental –D - Ancillary –E - Support –F - Special Programs –G - Readiness Terminology Use MEPRS Manual for detailed descriptions of all codes: www.meprs.info

7. TMA / WISDOM Excerpt 7 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 Parents and Children

8. TMA / WISDOM Excerpt 8 All data available by: Timeframe (months, years) MEPRS Code –All 4 char’s. Most questions only need 3. –Ex. MEPRS4 Code matches pattern DAA% MEPRS Summary Data

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

10. TMA / WISDOM Excerpt 10 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 Workload Data

11. TMA / WISDOM Excerpt 11

12. TMA / WISDOM Excerpt 12

13. TMA / WISDOM Excerpt 13

14. TMA / WISDOM Excerpt 14 San Diego’s Ambulatory Internal Medicine Clinic ordered 135K Lab RVUs from the lab at San Diego

15. TMA / WISDOM Excerpt 15 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! FTE Data

16. TMA / WISDOM Excerpt 16 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 Types of FTEs

17. TMA / WISDOM Excerpt 17

18. TMA / WISDOM Excerpt 18 Don’t add across months! 600 people each month, not 1200 people! Assigned < Available (OT, Resource Sharing, etc)

19. TMA / WISDOM Excerpt 19 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 Expense Assignment Allocated $ AAAA (Internal Medicine) Work Center Direct $ Total Expenses $ +=

20. TMA / WISDOM Excerpt 20 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 Expense Assignment

21. TMA / WISDOM Excerpt 21 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 Expense Assignment

22. TMA / WISDOM Excerpt 22 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 Expense Assignment

23. TMA / WISDOM Excerpt 23 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 Expense Variables

24. TMA / WISDOM Excerpt 24 Direct Expense Purified Expense Ancillary Expense +Support Expense Total Expense Final Accounts Inpatient (A), Ambulatory (B), Dental (C), Special Programs (F) and Readiness (G) are “FINAL ACCOUNTS”

25. TMA / WISDOM Excerpt 25

26. TMA / WISDOM Excerpt 26 A - Inpatient B- Ambulatory C- Dental D - Ancillary E - Support F - Special Progs G - Readiness Expense Assignment Note: Ancillary and Support Accounts should have total expense = 0 in the M2 (their expenses are already captured in the other work centers)!

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

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

29. TMA / WISDOM Excerpt 29

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

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