preparing for an audit: dmhrsi time vs. workload reporting

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Preparing for an Audit: DMHRSi Time vs. Workload Reporting Herb Escobar Escobar Analytics and Services, Inc. [email protected] Navy Resources Symposium 4 June 2012

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Preparing for an Audit: DMHRSi Time vs. Workload Reporting. Navy Resources Symposium 4 June 2012. Herb Escobar Escobar Analytics and Services, Inc. [email protected]. Objectives. After completing this session the attendee can: - PowerPoint PPT Presentation

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Page 1: Preparing for an Audit:  DMHRSi Time vs. Workload Reporting

Preparing for an Audit: DMHRSi Time vs. Workload

Reporting

Herb EscobarEscobar Analytics and Services, Inc.

[email protected]

Navy Resources Symposium4 June 2012

Page 2: Preparing for an Audit:  DMHRSi Time vs. Workload Reporting

Objectives

After completing this session the attendee can:

• Describe the Defense Medical Human Resources Reporting System internet (DMHRSi).

• Characterize data that can be analyzed with DMHRSi not available in MEPRS.

• Characterize the extent to which workload and timesheet reporting differs at MTF and MEPRS Code level in Navy Medicine.

• Describe methods that can be used to test the extent to which timesheet and workload reporting differ.

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Outline

• DMHRSi Data and Application

• DMHRSi Data Quality Challenges

• Tri-Service Labor Reporting vs. Workload Study

• Questions

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DMHRSi Data and Application

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DMHRSi Overview

• Defense Medical Human Resources System - internet (DMHRSi)

• Repository for MHS human capital and labor cost assignment data

• Source for tri-Service medical human capital information• Source of FTE data and personnel expenses in MEPRS

and M2

• Self-reported labor hours across Functional Cost Codes (4th-level MEPRS Codes)

• Labor hours across MEPRS Codes lead to personnel costs

• Actual salary for Civilians• Uniform composite pay tables for Military• No personnel costs for Contractors

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DMHRSi Data Sources

• “DMHRSi Discoverer-Plus” is the integrated reporting tool

• Interactive Corporate Reports

• Ad-hoc queries• Performance and

documentation challenges

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• SMART receives regular DMHRSi extracts

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• Monthly DMHRSi HR extract available in MDR• Person-level assignment data from 1 Oct 2008

– Present• /mdr/pub/dmhrsi/hr/dmhrsi.sas7bdat

• EDIPN/NPI/SSN• Name/Rank/Grade• Person Category/Skill Type/Suffix• Occupation Code/Taxonomy/Job/Position• Assignment MTF/Organization/People Group• Labor Reporting MTF/Organization/People Group• Assignment Start/End Dates

7

DMHRSi Data Sources (Cont.)

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Analytic Applications of DMHRSi data

• Richness of DMHRSi data facilitates analyses not possible with MEPRS or M2 personnel data alone• Workload and cost metrics by Facility/Service of

assignment – Army or Air Force providers in Navy facilities

• Assigned/Available MEPRS codes by person – where are people actually working

• National Practitioner Identifier (NPI) and Electronic Data Interchange Person Number (EDIPN) facilitates linking workload from CAPER/SIDR to specific provider characteristics

• Labor reporting vs. workload across Functional Cost Codes

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DMHRSi Data Quality Challenges

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DMHRSi Data Quality

• Common of DQ issues observed – some easy to spot• Manual data entry errors:

UIC “KV!MFV9P" vs. "KV1MFV9P”• Inconsistent data entry:

“TMA” vs. “TRICARE MGT”, “PHS” vs. “Public Health”

• Caps vs. Lower Case:“Navy” vs. “NAVY”

• More serious DQ issues affect reconciliation of data transmitted to downstream systems

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DMHRSi = MEPRS

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

1 Clinician $1,682,291 $1,681,791 0.03% $233,293 $233,293 0.00% 191.9 191.2 0.35%

2 Direct Care Professional $617,409 $626,167 -1.40% $102,945 $103,383 -0.42% 80.8 81.7 -1.07%

3 Registered Nurse $1,450,958 $1,452,697 -0.12% $224,573 $224,573 0.00% 196.3 196.5 -0.11%

4 Direct Care Para-Professional $2,380,502 $2,380,502 0.00% $415,514 $417,184 -0.40% 499.7 500.2 -0.10%

5 Administrative/Clerical $1,627,095 $1,618,338 0.54% $292,494 $290,067 0.84% 479.5 478.4 0.23%

Total $7,758,256 $7,759,495 -0.02% $1,268,820 $1,268,501 0.03% 1,448.2 1,448.0 0.01%

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

C CIVILIAN $1,046,535 $1,046,535 0.00% $211,687 $211,687 0.00% 202.2 202.9 -0.37%

E ENLISTED $3,016,901 $3,016,901 0.00% $505,785 $505,466 0.06% 535.5 535.3 0.02%

O OFFICER $3,694,820 $3,687,141 0.21% $551,348 $551,348 0.00% 375.4 374.7 0.18%

V VOLUNTEER $0 $0 0.00% $0 $0 0.00% 7.8 7.8 0.29%

X CONTRACTOR $0 $8,918 -100.00% $0 $0 0.00% 327.4 327.2 0.04%

Total $7,758,256 $7,759,495 -0.02% $1,268,820 $1,268,501 0.03% 1,448.2 1,448.0 0.01%

DMHRSi Total Salary: $9,027,996 DMHRSi Available FTE: 1,448.0

EASIV Total Salary: $9,027,076 EASIV Available FTE: 1,448.2

EASIV - DMHRSi Difference: -$920 EASIV - DMHRSi Difference: 0.2

Available Salary Expense Non-Available Salary Expense Available FTE

Personnel Category

Skill Type

Available Salary Expense Non-Available Salary Expense Available FTE

Correct

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DMHRSi > MEPRS

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

1 Clinician $1,677,525 $1,737,054 -3.4% $161,694 $166,940 -3.1% 177.7 181.0 -1.8%

2 Direct Care Professional $470,248 $495,132 -5.0% $63,592 $63,154 0.7% 61.5 64.3 -4.4%

3 Registered Nurse $1,099,249 $1,121,840 -2.0% $164,489 $166,636 -1.3% 189.4 194.5 -2.6%

4 Direct Care Para-Professional $2,898,074 $2,953,737 -1.9% $410,359 $414,544 -1.0% 667.5 680.0 -1.8%

5 Administrative/Clerical $1,347,162 $1,350,580 -0.3% $170,763 $170,934 -0.1% 312.8 315.1 -0.7%

Total $7,492,258 $7,658,343 -2.2% $970,896 $982,207 -1.2% 1,408.9 1,434.7 -1.8%

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

C CIVILIAN $317,730 $327,166 -2.9% $49,876 $51,403 -3.0% 64.8 67.4 -3.9%

E ENLISTED $3,741,836 $3,786,096 -1.2% $506,828 $509,219 -0.5% 696.9 705.2 -1.2%

O OFFICER $3,432,691 $3,540,947 -3.1% $414,192 $421,585 -1.8% 328.0 338.3 -3.1%

V VOLUNTEER $0 $0 0.0% $0 $0 0.0% 13.1 13.1 0.0%

X CONTRACTOR $0 $4,134 -100.0% $0 $0 0.0% 306.1 310.6 -1.5%

Total $7,492,258 $7,658,343 -2.2% $970,896 $982,207 -1.2% 1,408.9 1,434.7 -1.8%

DMHRSi Total Salary: $8,640,550 DMHRSi Available FTE: 1,434.7

EASIV Total Salary: $8,463,154 EASIV Available FTE: 1,408.9

EASIV - DMHRSi Difference: -$177,395 EASIV - DMHRSi Difference: -25.9

Available Salary Expense Non-Available Salary Expense Available FTE

Personnel Category

Skill Type

Available Salary Expense Non-Available Salary Expense Available FTE

Incomplete Timecards Pulled?

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DMHRSi < MEPRS

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

1 Clinician $3,828,754 $3,820,226 0.2% $524,130 $519,585 0.9% 341.1 339.6 0.4%

2 Direct Care Professional $3,364,448 $3,345,389 0.6% $529,478 $521,743 1.5% 350.0 343.9 1.8%

3 Registered Nurse $4,253,795 $4,301,603 -1.1% $566,227 $576,611 -1.8% 500.3 506.4 -1.2%

4 Direct Care Para-Professional $5,265,663 $5,276,002 -0.2% $855,599 $859,234 -0.4% 1,113.4 1,112.7 0.1%

5 Administrative/Clerical $4,381,969 $4,293,801 2.1% $803,615 $806,897 -0.4% 1,121.6 925.1 21.2%

Total $21,094,629 $21,037,021 0.3% $3,279,050 $3,284,070 -0.2% 3,426.3 3,227.7 6.2%

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

EASIV DMHRSiEAS/

DMHRSi Diff

C CIVILIAN $12,317,406 $12,292,309 0.2% $2,229,529 $2,240,679 -0.5% 2,031.3 2,025.7 0.3%

E ENLISTED $2,486,879 $2,468,992 0.7% $308,158 $306,089 0.7% 433.4 431.2 0.5%

O OFFICER $6,290,344 $6,275,719 0.2% $741,363 $737,302 0.6% 545.6 544.5 0.2%

V VOLUNTEER $0 $0 0.0% $0 $0 0.0% 0.7 0.0 0.0%

X CONTRACTOR $0 $0 0.0% $0 $0 0.0% 415.3 226.5 83.4%

Total $21,094,629 $21,037,021 0.3% $3,279,050 $3,284,070 -0.2% 3,426.3 3,227.7 6.2%

DMHRSi Total Salary: $24,321,091 DMHRSi Available FTE: 3,227.7

EASIV Total Salary: $24,373,678 EASIV Available FTE: 3,426.3

EASIV - DMHRSi Difference: $52,587 EASIV - DMHRSi Difference: 198.6

Available Salary Expense Non-Available Salary Expense Available FTE

Personnel Category

Skill Type

Available Salary Expense Non-Available Salary Expense Available FTE

Edits in MEPRS Only?

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Intercepted DMHRSi to EASIV Raw File

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Skill Type FTE Source FM01 FM02 FM03 FM04 FM05 FM06 FM07 FM08 FM09 FM10 FM11 FM12

1 EASIV 319.8 308.6 305.1 327.4 317.3 370.8 322.8 334.9 340.4 314.4 359.6 325.5

DMHRSi 319.6 308.7 304.9 327.2 317.3 370.7 322.8 334.6 340.7 314.3 359.5 321.2EAS - DMHRSi Diff 0.1 -0.1 0.2 0.2 0.0 0.1 0.0 0.2 -0.3 0.1 0.1 4.2

2 EASIV 227.2 123.8 123.9 132.3 124.2 150.0 131.5 131.4 134.1 118.0 132.6 122.8DMHRSi 128.1 123.8 123.8 132.2 124.2 149.9 131.0 132.5 134.0 117.9 132.5 123.8EAS - DMHRSi Diff 99.1 0.0 0.0 0.1 0.0 0.1 0.5 -1.0 0.1 0.1 0.1 -1.0

3 EASIV 325.5 321.0 327.4 337.8 319.7 368.1 338.1 349.5 350.9 324.7 346.7 319.2DMHRSi 325.5 321.0 327.4 337.8 319.7 368.0 338.5 349.5 350.8 324.7 346.7 309.3EAS - DMHRSi Diff 0.0 0.0 0.0 0.0 -0.1 0.1 -0.3 0.0 0.0 0.0 0.1 10.0

4 EASIV 821.3 798.8 772.9 815.1 757.7 886.1 797.6 808.7 845.2 788.2 878.7 825.8DMHRSi 819.4 796.8 772.8 817.2 757.7 885.9 797.6 808.8 845.2 788.2 878.5 808.5EAS - DMHRSi Diff 1.9 2.0 0.1 -2.1 0.0 0.2 0.0 -0.1 0.0 0.1 0.2 17.3

5 EASIV 565.7 547.4 530.7 569.9 536.8 640.1 566.0 550.7 574.8 536.5 601.4 551.1DMHRSi 567.5 549.4 531.5 568.6 536.9 639.8 565.8 550.7 574.0 536.3 600.9 544.6EAS - DMHRSi Diff -1.7 -2.0 -0.8 1.3 -0.1 0.3 0.2 0.0 0.8 0.2 0.4 6.5

N EASIVDMHRSi 0.7EAS - DMHRSi Diff 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 -0.7EASIV 2,259.6 2,099.6 2,060.0 2,182.5 2,055.7 2,415.2 2,156.0 2,175.2 2,245.3 2,081.8 2,319.0 2,144.4DMHRSi 2,160.2 2,099.6 2,060.5 2,183.1 2,055.8 2,414.4 2,155.6 2,176.0 2,244.8 2,081.4 2,318.0 2,108.1EAS - DMHRSi Diff 99.4 0.0 -0.5 -0.6 -0.1 0.8 0.4 -0.9 0.5 0.4 0.9 36.3

FY11 Fiscal Months

• EASIV output file is sometimes intercepted and edited due to DMHRSi system performance challenges

• Easy to make mistakes & makes traceability of data impossible

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Tri-Service Labor Reporting vs. Workload Study

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Background

• Labor costs account for about 70% of MHS facility expenses.• Accurate reporting of labor hours across facility work centers

is critical for valid healthcare cost and productivity analysis.• DoD 6010.13M provides detailed labor reporting policy and

instructions.• First-of-its-kind study sponsored by the Methods, Measures

and Analyses Directorate at TMA/DHCAPE through Axiom – Resource Management examined reported labor and associated workload across clinics.

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Context

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Method

• Darnall AMC - Ft. Hood, NH Pensacola, and the 60th Medical Group –Travis AFB Fiscal Year 2011 data were analyzed

• Person-specific Available hours by facility, fiscal month, and cost center were obtained from DMHRSi Labor Cost Assignment (LCA) module via Discoverer

• CAPER and SIDR workload records by facility, fiscal month, and cost center were extracted from the MHS Data Repository (MDR)

• EDIPN and NPI data were added to the LCA extract to facilitate provider-level matching to CAPER/SIDR workload datasets

• LCA data matched to CAPER/SIDR by facility, fiscal month, and 4th-level Functional Cost Code

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Method (Cont.)

• All skill types were included in the LCA analysis dataset (i.e., providers, nurses, techs, etc.)

• Only MEPRS-B CAPERs were included• Provider 1 – 5 Work RVUs and individual providers

in CAPERs were included (only 1 – 3 were populated)

• CAPER/LCA match on EDIPN then NPI• SIDR analyses included Attending, Admitting, and

procedure-specific providers; Total RWPs retained• SIDR/LCA match on NPI

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• Aggregate Provider Work RVUs used

• Match by Fiscal Year, Fiscal Month, Parent DMISID, Child DMISID, and 4th-Level Cost Center per MEPRS labor reporting policy

• Variance noted across aggregated by Child MTFs

• Color coding criteria is not per policy; no prior quantitative assessments have been performed

Matching CAPER/LCA by Child DMISIDMTF

ParentDMISID ChildName Yes No Pct

0014 0014 60th MED GRP-TRAVIS 284,206 41,659 87%

0014 Total 284,206 41,659 87%

0038 0038 NH PENSACOLA 169,243 24,891 87%

0107 NBHC NSA MID-SOUTH 19,714 2,572 88%

0260 NBHC NAS PENSACOLA 28,040 7,274 79%

0261 NBHC MILTON WHITING FIELD 18,353 2,641 87%

0262 NBHC NATTC PENSACOLA 22,291 11,580 66%

0265 NBHC NAVCOASTSYSC PANAMA CITY 3,400 362 90%

0316 NBHC GULFPORT 7,184 19,372 27%

0317 NBHC MERIDIAN 8,629 704 92%

0357 NBHC WPNSCEN CRANE 3,195 4 100%

0436 NBHC NAS BELLE CHASE 15,360 6,493 70%

0513 NBHC NTTC PENSACOLA 19,059 3,489 85%

0038 Total 314,468 79,382 80%

0110 0110 DARNALL AMC-FT. HOOD 446,325 91,109 83%

0362 RED RIVER ARMY DEPOT OHC 3,166 0 100%

1592 MONROE CONSOLIDATED-FT. HOOD 12,958 1,579 89%

1599 TMC-12- FT. HOOD 5,816 714 89%

1601 TMC-14- FT. HOOD 33 0 99%

6014 CHARLES MOORE HLTH CLN-FT HOOD 80,357 17,603 82%

6076 WEST FORT HOOD CLINIC 33,790 9,464 78%

6077 TBI 1 CLINIC-FT. HOOD 13,733 733 95%

6078 INTENSIVE OUTPNT DAY TMNT CLNC 1,742 707 71%

6111 HARKER HEIGHTS MED HOME-HOOD 7,128 0 100%

6112 KILLEEN MEDICAL HOME-HOOD 845 0 100%

6113 COPPERAS COVE MED HOME-HOOD 4,922 90 98%

7236 BENNETT FAM CARE CLINIC - HOOD 52,701 9,803 84%

0110 Total 663,516 131,803 83%

CAPER/LCA Match

Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent20

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• Aggregate Provider Work RVUs used

• Match by Fiscal Year, Fiscal Month, Parent DMISID, Child DMISID, and 4th-Level Cost Center per MEPRS labor reporting policy

• Variance noted across clinical services

Matching CAPER/LCA by Summary

Cost CenterMTF Parent MEPR2 Description Yes No Pct

0014 BA MEDICAL CARE 58,666 9,154 87%

Travis BB SURGICAL CARE 32,539 5,866 85%

BC OBSTETRICAL AND GYNECOLOGICAL CARE 8,658 850 91%

BD PEDIATRIC CARE 14,384 276 98%

BE ORTHOPEDIC CARE 17,922 3,661 83%

BF PSYCHIATRIC/MENTAL HEALTH CARE 10,566 454 96%

BG FAMILY PRACTICE CARE 61,553 16,119 79%

BH PRIMARY MEDICAL CARE 11,822 402 97%

BI EMERGENCY MEDICAL CARE 44,119 1,106 98%

BJ FLIGHT MEDICINE CARE 4,734 2,015 70%

BL REHAB AMBULATORY SERVICES 19,241 1,757 92%

0014 Total 284,206 41,659 87%

0038 BA MEDICAL CARE 44,030 1,484 97%

Pensacola BB SURGICAL CARE 17,914 5,724 76%

BC OBSTETRICAL AND GYNECOLOGICAL CARE 11,945 574 95%

BD PEDIATRIC CARE 15,541 471 97%

BE ORTHOPEDIC CARE 17,762 1,148 94%

BF PSYCHIATRIC/MENTAL HEALTH CARE 26,514 2,166 92%

BG FAMILY PRACTICE CARE 101,791 38,290 73%

BH PRIMARY MEDICAL CARE 25,724 6,240 80%

BI EMERGENCY MEDICAL CARE 20,207 4,517 82%

BJ FLIGHT MEDICINE CARE 10,141 10,801 48%

BL REHAB AMBULATORY SERVICES 22,898 7,967 74%

0038 Total 314,468 79,382 80%

0110 BA MEDICAL CARE 58,571 8,215 88%

Ft. Hood BB SURGICAL CARE 50,212 7,528 87%

BC OBSTETRICAL AND GYNECOLOGICAL CARE 53,742 13,514 80%

BD PEDIATRIC CARE 49,738 13,800 78%

BE ORTHOPEDIC CARE 32,100 12,048 73%

BF PSYCHIATRIC/MENTAL HEALTH CARE 99,320 19,663 83%

BG FAMILY PRACTICE CARE 143,357 25,310 85%

BH PRIMARY MEDICAL CARE 50,550 5,766 90%

BI EMERGENCY MEDICAL CARE 79,147 16,876 82%

BJ FLIGHT MEDICINE CARE 12,629 1,387 90%

BL REHAB AMBULATORY SERVICES 34,149 7,696 82%

0110 Total 663,516 131,803 83%

CAPER/LCA Match

Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent21

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Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent

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• Attending Provider Total RWPs shown (Admitting Provider also analyzed with poorer results)

• Match by Fiscal Year, Fiscal Month, Parent DMISID, Child DMISID, and 4th-Level Cost Center per MEPRS labor reporting policy

• Variance noted across clinical services, poor match overall

Matching SIDR/LCA by Summary

Cost Center

Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent

MTF Parent MEPR2 Description Yes No Pct

0014 AA MEDICAL CARE 567.9 1,624.6 26%

Travis AB SURGICAL CARE 584.1 1,373.6 30%

AC OBSTETRICAL AND GYNECOLOGICAL CARE 236.3 41.2 85%

AD PEDIATRIC CARE 43.9 53.3 45%

AE ORTHOPEDIC CARE 35.9 109.7 25%

AF PSYCHIATRIC CARE 113.7 67.4 63%

AG FAMILY PRACTICE CARE 650.6 466.2 58%

0014 Total 2,232 3,736 37%

0038 AA MEDICAL CARE 274.5 164.3 63%

Pensacola AB SURGICAL CARE 188.3 183.7 51%

AC OBSTETRICAL AND GYNECOLOGICAL CARE 306.4 56.9 84%

AD PEDIATRIC CARE 21.3 86.5 20%

AE ORTHOPEDIC CARE 170.4 33.1 84%

AG FAMILY PRACTICE CARE 179.7 91.8 66%

0038 Total 1,141 616 65%

0110 AA MEDICAL CARE 372.8 488.2 43%

Ft. Hood AB SURGICAL CARE 623.3 218.6 74%

AC OBSTETRICAL AND GYNECOLOGICAL CARE 1,032.1 498.0 67%

AD PEDIATRIC CARE 378.1 634.9 37%

AE ORTHOPEDIC CARE 187.5 433.9 30%

AF PSYCHIATRIC CARE 213.5 72.0 75%

AG FAMILY PRACTICE CARE 141.9 193.0 42%

0110 Total 2,949 2,539 54%

SIDR/LCA Match

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• Aggregate Provider Work RVUs reported

• Match by Fiscal Year, MEPRS-B, and Parent DMISID

• Provider Salary data from MEPRS

Matching CAPER/LCA – MTF Aggregate

Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent

DMIS ID Name Yes No Pct

0014 Travis 308,691 17,175 95%

0038 Pensacola 402,542 30,104 93%

0110 Ft. Hood 684,940 111,132 86%

CAPER/LCA Match

Parent DMISID

NameFY11 Provider

SalaryTotal Prov Salary

per WKRVU

Potential Salary Cost Not

Accounted

0014 Travis $14,963,792 $48 $832,550

0038 Pensacola $15,515,363 $39 $1,160,312

0110 Ft. Hood $29,516,805 $43 $4,789,113

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• Aggregate Total RWPs reported

• Match by Fiscal Year, MEPRS-A, and Parent DMISID

• Provider Salary data from MEPRS

Matching SIDR/LCA – MTF Aggregate

DMISID Name Yes No Pct

0014 Travis 4,272 1,696 72%

0038 Pensacola 1,474 321 82%

0110 Ft. Hood 4,158 1,330 76%

SIDR/LCA Match

Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent

Parent DMISID NameFY11 Provider

SalaryTotal Prov

Salary per RWP

Potential Salary Cost Not

Accounted

0014 Travis $2,773,556 $649 $1,101,217

0038 Pensacola $2,141,886 $1,453 $466,005

0110 Ft. Hood $3,499,324 $842 $1,119,388

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• Comparison of Providers with labor hours reported in MEPRS-B Cost Centers vs. CAPER workload

• Match by Parent DMISID, MEPRS-B, EDIPN, and NPI

• Participating in Readiness or supporting non-clinical administrative services?

• Per DoD6010-13M APP3, non-clinical administration hours should be recorded in overhead (E) Cost Centers

Matching LCA MEPRS-B FTEs in CAPER

Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent

Facility Skill Type Yes No Pct

0014 - Travis 1 102.2 1.9 98%

2 45.8 2.6 95%

0014 Total 148.0 4.5 97%

0038 - Pensacola 1 58.5 2.8 95%

2 74.1 16.2 82%

0038 Total 132.6 19.0 87%

0110 - Ft. Hood 1 92.3 12.5 88%

2 141.2 31.2 82%

0110 Total 233.5 43.7 84%

LCA FTE in CAPER

Facility Skill Type Personnel SalaryAnnual Cost per

FTEPersonnel Cost w/o Workload

0014 - Travis 1 $11,286,927 $92,325 $175,525

2 $3,676,865 $103,445 $270,522

0014 Total $14,963,792 $95,148 $429,717

0038 - Pensacola 1 $8,267,696 $181,198 $505,264

2 $7,247,667 $112,419 $1,821,046

0038 Total $15,515,363 $142,692 $2,709,321

0110 - Ft. Hood 1 $12,481,722 $196,640 $2,452,367

2 $17,035,083 $83,874 $2,618,116

0110 Total $29,516,805 $124,473 $5,437,76326

Page 27: Preparing for an Audit:  DMHRSi Time vs. Workload Reporting

Matching LCA MEPRS-A FTEs in SIDR

Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent

Facility Skill Type Yes No Pct

0014 - Travis 1 14.6 5.5 73%

2 0.8 2.3 26%

0014 Total 15.4 7.8 66%

0038 - Pensacola 1 7.8 7.7 51%

2 0.8 0.0 100%

0038 Total 8.7 7.7 53%

0110 - Ft. Hood 1 15.6 1.4 92%

2 4.1 1.8 70%

0110 Total 19.7 3.1 86%

LCA FTE w/ SIDR Wkld by MTF, FM, MEPR3 • Comparison of Providers with labor hours reported in MEPRS-A Cost Centers vs. SIDR workload

• Match by Parent DMISID, Fiscal Month, 3rd-Level FCC, NPI, EDIPN

• Participating in Readiness or supporting non-clinical administrative services?

• ICU workload in SIDR in A-FCCs vs. DJ* in LCA

• Per DoD6010-13M APP3, non-clinical administration hours should be recorded in overhead (E) Cost Centers

Facility Skill TypePersonnel

SalaryAnnual Cost

per FTE

Personnel Cost w/o Workload

0014 - Travis 1 $2,508,653 $123,695 $681,427

2 $264,903 $147,284 $334,824

0014 Total $2,773,556 $125,903 $979,808

0038 - Pensacola 1 $1,477,215 $73,723 $565,664

2 $664,671 $26,972 $0

0038 Total $2,141,886 $59,690 $457,993

0110 - Ft. Hood 1 $2,679,874 $170,247 $230,429

2 $819,451 $96,127 $168,438

0110 Total $3,499,324 $150,881 $468,599

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Page 28: Preparing for an Audit:  DMHRSi Time vs. Workload Reporting

Matching LCA MEPRS-A FTEs in SIDR

Color Key0 - 84 Percent

85 - 94 Percent

95 - 100 Percent

• Comparison of Providers with labor hours reported in MEPRS-A Cost Centers vs. SIDR workload

• Match by Parent DMISID, NPI, EDIPN

• Significant improvement over 3rd-Level FCC comparison

• Almost all MEPRS-A Provider FTEs in LCA report some SIDR workload

Facility Skill Type Yes No Pct

0014 - Travis 1 20.1 0.0 100%

2 2.0 1.1 66%

0014 Total 22.1 1.1 95%

0038 - Pensacola 1 15.5 0.0 100%

2 0.8 0.0 100%

0038 Total 16.3 0.0 100%

0110 - Ft. Hood 1 16.9 0.1 100%

2 5.4 0.4 93%

0110 Total 22.3 0.5 98%

LCA FTE w/ SIDR Wkld by MTF

Facility Skill TypePersonnel

SalaryAnnual Cost

per FTE

Personnel Cost w/o Workload

0014 - Travis 1 $2,508,653 $123,695 $185

2 $264,903 $147,284 $154,903

0014 Total $2,773,556 $125,903 $132,603

0038 - Pensacola 1 $1,477,215 $73,723 $1,737

2 $664,671 $26,972 $0

0038 Total $2,141,886 $59,690 $1,406

0110 - Ft. Hood 1 $2,679,874 $170,247 $13,867

2 $819,451 $96,127 $40,844

0110 Total $3,499,324 $150,881 $76,399

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Page 29: Preparing for an Audit:  DMHRSi Time vs. Workload Reporting

Clinic-Level vs. Aggregate Analysis

• MHS policy prescribes workload, labor, and expense data reporting by functional cost center (clinic-level)

• However, some analytical applications rely on inpatient and outpatient aggregates

Clinic-Level MHS Cost Data Applications

“Make vs. Buy” Analysis

Program Evaluation (i.e., PCMH)

Product-line Performance Metrics

Patient-Level Costs for M2/MDR

Business Planning

Inpatient / Outpatient Aggregate Cost Data

Applications

Annual MERCHF Reconciliation

Third Party Collection ASAs

PMPM Calculations

PPS Analysis

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Page 30: Preparing for an Audit:  DMHRSi Time vs. Workload Reporting

Study Conclusions

Next Steps

30

• Study demonstrates ability to link reported labor hours by provider to specific workload production

• Unquestionable problem dictating further attention and examination

• Follow-on study will seek to validate initial results and expand analyses

• Explore centrally developed metrics to monitor:• DMHRSi Labor vs. workload match• DMHRSi Available FTE vs. EASIV Available FTE

Page 31: Preparing for an Audit:  DMHRSi Time vs. Workload Reporting

Review of Objectives

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Objectives Review

32

After completing this session the attendee can:

• Describe the Defense Medical Human Resources Reporting System internet (DMHRSi).

• Characterize data that can be analyzed with DMHRSi not available in MEPRS.

• Characterize the extent to which workload and timesheet reporting differs at MTF and MEPRS Code level in Navy Medicine.

• Describe methods that can be used to test the extent to which timesheet and workload reporting differ.

Page 33: Preparing for an Audit:  DMHRSi Time vs. Workload Reporting

Preparing for an Audit: DMHRSi Time vs. Workload Reporting

Herb EscobarEscobar Analytics and Services, Inc.

[email protected]

Navy Resources Symposium4 June 2012