Herb Escobar SRA International, Inc. MEPRS Update: Active Feedback and Continuous Process Improvement TRICARE Conference 26 January 2005 Washington, DC Track 6, #068 Herb Escobar SRA International, Inc.

Typical applications include: The Medical Expense & Performance Reporting System (MEPRS) is the standard cost accounting system for the Military Health System (MHS), containing Tri-Service financial, personnel, and workload data from reporting medical and dental treatment facilities worldwide. Typical applications include: Health Affairs / Services Performance Contract “HA Instrument Panel” Prospective Payment System (PPS) metrics and reconciliation Accrual Fund and TRICARE for Life (TFL) rates, reconciliation and evaluation UBO billing rates (ASAs, APVs, Tent-Care, MAC, Inter-Agency, Anesthesia, etc) Six Sigma MTF performance metrics (S2M3) MILCON / Capital Project justification Patient-level SIDR and SADR costs on M2 MTF care Valuation and Efficiency metrics Optimization and Continuous Process Improvement implementation and evaluation Next-Generation TRICARE contracts benefit development and evaluation Service Business Case Analyses and MTF “make vs. buy” assessments PB&E budgeting and execution analyses DoD/VA and internal/external partnership program reporting and evaluation HPA&E evaluation and analyses initiatives MEPRS is the ONLY MHS cost accounting system containing uniform Tri-Service financial, workload, and personnel information. MEPRS data are routinely used by TMA, the Services and MTFs for critical policy and management decisions, as well as program evaluation

Active Feedback and Continuous Process Improvement MEPRS MEPRS Data Surveillance and Management Metrics Stepdown Expenses Ancillary • Support Data-Based MEPRS Education Improved MEPRS Data Quality 2 years ago a conceptual framework was instituted to address MEPRS data completion and data quality challenges head-on It’s premise was two-fold: If you educate MEPRS personnel on the importance of MEPRS, with emphasis on proper interpretation and application of MEPRS data and data quality, MEPRS personnel would be empowered and improvements in data quality and completeness would result To ensure the anticipated data improvements were realized, progress was to be monitored through centralized data quality surveillance, providing monthly feedback to MTFs, Service and TMA leadership. Those initiatives were called the MEPRS Application and Data Improvement (MADI) workshop and the MEPRS Early Warning and Control System (MEWACS). MEPRS Information Sharing MEPRS Policy and Business Rules Oversight

MEPRS Data Surveillance and Management Metrics MEPRS Early Warning and Control System (MEWACS) provides monthly MEPRS data quality feedback, systematically highlighting potential MTF data anomalies Human Systems Interface (HSI) provides expert assistance to the field, serving as the link between MEPRS education and data quality surveillance initiatives. Six Sigma- Key MEPRS- based performance metrics: Pharmacy Dispensing Costs FTEs per occupied bed day Ratio of support personnel to providers Pharmacy workload per pharmacy FTE Laboratory workload per lab FTE Inpatient costs per RWP Ambulatory costs per APG The Six Sigma MEPRS Management Metrics (S2M3) workbook is an interactive tool containing seven key MEPRS-based performance metrics S2M3 is a blend of Direct Care and civilian industry benchmark metrics Updated Semi-annually on the FY

MEPRS Training, Education and Information Sharing Tri-Service MEPRS Application and Data Improvement (MADI) worldwide workshops National MEPRS Conference attended by hundreds of Tri-Service MEPRS and RM personnel MEPRS.INFOrmer is the new MEPRS quarterly newsletter launched in 2003 Updates MEPRS stakeholders on policy issues, data quality activities, and best practices for MEPRS process improvement MEPRS Conference Exhibit provides thousands of MHS personnel the opportunity to interact with centrally available MEPRS tools and metrics, and learn about resources available through the MEPRS Information Portal MADI attendance detail: Air Force: 32 Army: 27 Navy: 16 TMA/DoD: 14 Total: 89

MEPRS Information Web Portal: http://www.MEPRS.info The MEPRS Information Portal is the gateway to MEPRS-related resources, including policy documents, learning materials, data quality surveillance tools, metrics, and much more The MEPRS.INFO web portal is hosted at the TRICARE web server – www.tricare.osd.mil The MEPRS Information Portal is the gateway to MEPRS-related resources, including policy documents, learning materials, data quality surveillance tools, and much more Based on site traffic statistics and comments received, all indications are that it is a success Plans are for its continued growth as the MEPRS Program matures. For example, distance learning capability, virtual communities through forums and discussion groups, and integration with other TMA CFO web resources. MEPRS Information Web Portal: http://www.MEPRS.info