Navy Performance Based Budget (PBB) Indices January 2008 BUMED (M8) POCs: BUMED PA&E (M81) LCDR Matt Bouma, MSC, (202) , DSN 762 Mr. Robert Willis, (202)

4-Jan-08 PBB Definitions 2

4-Jan-08 3 PBB Adjustment Scales/Indices After these adjustments are done a mitigation is considered for each MTF to recognize staffing issues caused by deployments. Adjustment will be based upon 4 areas: 1) Evidenced Based Health Care 2) Bed Capacity Fill Rate 3) Individual Medical Readiness 4) Public Health Each will produce a weighted score that when summarized correspond to the adjustments recommended in the Adjustment Table below.

4-Jan-08 PBB Metric Data Collection Bed Capacity 1.Data is pulled from M2, SIDR files (Health Care Services, Direct Care, Inpatient Admissions Summary) for Bed Days, Raw. 2.A rolling 12 is calculated for Bed Days, Raw. A 4-month delay is built in (e.g. a 1 Dec pull would skip the previous 4 months and use Aug06-Jul07 as a rolling 12). 3.Bed Fill Rate is calculated as (Sum of Bed Days)/(Available Beds * 365). 4.Adjustment Rates are then based upon the percent fill rate – Unique scales are used based upon Bed Capacity size of the facility (Large, Medium, Small). EBHC 1.Data is from the MHS Population Health Portal (MHSPHP) via DoDPHP Aggregate Metric Tables. 2.A rolling 3 average for each EBHC measure is calculated based upon the most current 3 months of data. Typically there is about a 3-month lag in data. 3.The rolling 3 is compared to the 2006 HEDIS 90 th and 75 th percentile Goal as stated in the MHSPHP Methodology and Measurement documentation. IMR 1.Data is from the Medical Readiness Reporting System (MRRS) Navy/Marine Corp IMR Reports. 2.Data is pulled each month and current month is the basis for comparison to metric goal. 3.Indeterminate ratios are recorded for each MTF and scored according to IMR scale. Public Health 1.Data is from SMART, Public Health PE Data is pulled quarterly from SMART, for the most currently completed 4 quarters. 3.Certified Obligations+Commitments is compared to the Obligation Plan over the 4 quarters to produce the Execution to Plan % amount. 4.This Execution to Plan % produces a PBB adjustment based upon Public Health scale. PPS Recon 1.Data is from PPS Reconciliation provided from OSD(HA). 2.Data most recent report provided. Typically, there is a 2-month lag in reports. 3.Workload data and deltas are loaded into the PBB model for annotation purposes. 4.Any remaining FY07 values (75% * PPS Delta) are converted to FY08 values (100% * PPS Delta). Deployment Mitigation 1.See Deployment Mitigation Flowchart.

4-Jan-08 5 Deployment Mitigation Notes: 1.Sum of GDA FTEs (MEPRS Rolling 12) is taken for each Parent MTF. FTEs considered are Skill Type I and II Providers. Source: EAS-IV. 2.B RVUs per B Available Skill Type I and II providers for FY06 is calculated for each Parent MTF. Source: M2-RVUs, EAS-IV-Avail B FTEs. 3.GDA FTEs is multiplied by RVU rate per FTE to calculate a prospective lost RVU amount for each MTF. 4.MTF Lost RVUs are multiplied by the FY07 Avg RVU Rate given in PPS for each individual MTF to produce a GDA PPS Value: a)GDA PPS Value = MTF Lost RVUs x FY07 PPS RVU Rate x PPS FY08 Navy O&M Factor (45%). 5.PPS Recon Evaluation: a)If an MTF has a Negative PPS Recon, this is the maximum deployment credit they may be given. b)If an MTF has a Positive PPS Recon, they are not eligible for deployment credit. 6.GWOT Funding is FY07 GWOT Dollars provided to each MTF for Contract Backfill 7.GWOT funding is compared to calculated GDA PPS Value for final adjustment: a)If PPS Value < GWOT, No deployment credit/adjustment is given. b)If PPS Value > GWOT, Deployment credit/adjustment is given as follows: 1)GDA PPS Value – GWOT Contract Backfill $$$ Objective: To recognize lost workload at MTFs caused by provider deployment in support of GWOT. Sum GDA* FTEs FY06 RVUs per FTE MTF Lost RVUs FY07 PPS RVU Rate PPS Valu e > GW OT GDA PPS Value FY07 GWOT Contract Backfill $$$ X=X= Deployment Adjustment Yes No No Adjustment PPS Recon Status