TRI-SERVICE MEPRS CONFERENCE HOW TO ANALYZE AND IDENTIFY OUTLIER AVAILABLE FTE DATA IN OUTPATIENT ‘B’ ACCOUNTS Presented by Burma Barfield, Nicole Meyers, and Darrell Dorrian

TRISERVICE MEPRS ANALYSIS OF EASIV REPOSITORY OUTPATIENT ‘B’ FTES  FTEs generate the largest expense element in the operation of MTF/DTF direct patient care.  This presentation will provide two methodologies that can be used by ‘local MEPRS Managers/Analysts’ to identify outlier available FTE data reported in Outpatient ‘B’ MEPRS/FCC accounts in EASi. Please use caution when requesting description fields in EASIV queries. 1)The first methodology measures the average ratios for support staff per credentialed/privileged provider with a skill type of 1 or 2. This analysis can be performed at the 3 rd level MEPRS/FCC or 4 th level MEPRS/FCC. This metric compares the combined available FTEs for personnel with a skill type of 3, 4, and 5 to the combined available FTEs for personnel with a skill type of 1 and 2. Although different organizations may have different formulas for support staff ratios, the methodology and formulas provided in this presentation are for the purpose of evaluating potential FTE reporting problems in EASi that need to be corrected at the local level. A step-by-step guide is provided for calculating Support Staff Ratios and is based on FTE data in Class 7 FTE in the EASIV Repository at the 4 th level MEPRS/FCC. 2) The second methodology measures the average number of count visits per credentialed/privileged provider with a skill type of 1 or 2 per available hour. This analysis can be performed at the 3rd level MEPRS/FCC or 4th level MEPRS/FCC. Although different organizations may have different formulas for calculating productivity, the methodology and formulas provided in this presentation are for the purpose of evaluating potential FTE reporting problems in EASi. A step-by-step guide is provided for calculating the average number of count visits per provider per available hour and is based on FTE data in Class 7 and count visits in Class 21 in the EASIV Repository at the 4 th level MEPRS/FCC.

HOW TO DEVELOP SUPPORT STAFF RATIOS FOR OUTPATIENT ‘B’ ACCOUNTS

STEP 1: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS NOTE: Select Class 7 Personnel Detail for FTE data elements, Class 5 Common Expense Elements for SEEC, Class 1 for Parent DMIS ID Name and Child DMIS ID Name, and Class 11 for 4 th level MEPRS/FCC Description.

STEP 2: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – COPYING THE EASIV QUERY RESULTS NOTE: WHEN THE QUERY FINISHES, THEN SELECT EDIT, AND COPY ALL

STEP 3: OUTPATIENT ‘B’ SUPPORT STAFF RATIOS – PASTING EASIV QUERY RESULTS INTO EXCEL NOTE: OPEN BLANK EXCEL WORKSHEET, PLACE CURSOR IN CELL A1, SELECT EDIT, AND PASTE

STEP 4: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – CALCULATING TOTAL AVAILABLE FTES IN EXCEL NOTE: BEFORE BUILDING PIVOT TABLE, ADD AVAILABLE AND PURIFIED AVAILABLE FTES TO CALCULATE TOTAL AVAILABLE FTES

8 STEP 5: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS CREATING A PIVOT TABLE IN EXCEL NOTE: HOLDING DOWN SHIFT KEY, USE CURSOR KEY TO HIGHLIGHT ALL DATA IN THE EXCEL SPREADSHEET, THEN SELECT DATA, AND PIVOT TABLE AND PIVOT CHART REPORT

9 SELECT ‘NEXT’ AGAIN AT THIS STEPSELECT ‘NEXT’ AT THIS STEP STEP 5a: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – CREATING A PIVOT TABLE IN EXCEL (CONTINUED)

10 STEP 5b: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – CREATING A PIVOT TABLE IN EXCEL (CONTINUED) WHEN YOU SELECT NEW WORKSHEET AND LAYOUT, THEN A BLANK LAYOUT WILL APPEAR

11 STEP 5c: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – CREATING A PIVOT TABLE IN EXCEL (CONTINUED) IN THE ROW FIELD, YOU CAN SELECT 3 rd OR 4 th LEVEL MEPRS/FCC OR MEPRS/FCC DESCRIPTION. IN THE COLUMN FIELD, SELECT SKILL TYPE CODE. IN THE DATA FIELD, SELECT TOTAL AVAILABLE FTES. THEN PRESS OK.

STEP 6: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS -PIVOT TABLE IS CREATED ON A SEPARATE EXCEL TAB NOTE: TOTAL AVAILABLE FTES FOR THREE MONTHS ARE SORTED BY SKILL TYPE CODE AND 3 rd LEVEL MEPRS/FCC DESCRIPTION.

STEP 7: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – CALCULATE FORMULAS FOR SUPPORT STAFF RATIOS

STEP 8: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – HOW TO SORT DATA IN DESCENDING ORDER NOTE: BECAUSE THE CELLS HAVE FORMULAS EMBEDDED, SOMETIMES IT IS DIFFICULT TO SORT DATA IN EITHER ASCENDING OR DESCENDING ORDER. USER SHOULD HIGHLIGHT THE DATA IN THE PIVOT FOR SUPPORT STAFF RATIOS, THEN SELECT EDIT AND COPY. THEN THE USER SHOULD GO TO NEW BLANK EXCEL ROWS, AND SELECT PASTE SPECIAL, AND SELECT ‘VALUES AND NUMBER FORMATS’. THIS WILL COPY THE EXACT SAME DATA WITHOUT THE FORMULAS SO THAT THE DATA CAN BE SORTED IN DESCENDING ORDER. NOW THE USER CAN START TO SORT THE STAFFING RATIOS. THE FIRST STEP IS TO SELECT DATA, AND THEN SORT.

STEP 8a: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – HOW TO SORT DATA IN DESCENDING ORDER NOTE: AFTER YOU SELECT SORT, A WINDOW WILL APPEAR TO ALLOW YOU TO SELECT EITHER ASCENDING OR DESCENDING ORDER. ALSO, THERE IS A DROPDOWN MENU TO SELECT WHICH DATA ELEMENT SHOULD BE THE PRIMARY SORT. MAKE SURE THAT HEADER ROW IS SELECTED, AND ENSURE THAT THE AVG MTF TOTAL SUPPORT RATIO ROW IS NOT HIGHLIGHTED.

STEP 9: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – FINAL SUPPORT STAFF RATIO CALCULATIONS NOTE: AFTER THE DATA IS SORTED IN DESCENDING ORDER, THE USERS CAN BETTER IDENTIFY OUTLIER FTE DATA. ALTHOUGH THIS ANALYSIS USED SUPPORT STAFF RATIOS GREATER THAN 3:1 AND LESS THAN 1:1 AS AN EXAMPLE, MEPRS PERSONNEL SHOULD COORDINATE AT THE LOCAL LEVEL TO IDENTIFY EXPECTED RANGE OF SUPPORT STAFF RATIOS PER CLINICAL SPECIALTY.

STEP 10: SAMPLE OF CLASS 7 EASIV REPOSITORY QUERY FOR SUPPORT STAFF RATIOS – CREATE A CHART FROM EXCEL WORKSHEET NOTE: HIGHLIGHT DATA IN EXCEL SPREADSHEET, SELECT CHART WIZARD, AND BUILD A CHART OF SUPPORT STAFF RATIOS.

HOW TO DEVELOP AVERAGE NUMBER OF VISITS PER PROVIDER (SKILL TYPES 1 & 2) PER AVAILABLE HOUR FOR OUTPATIENT ‘B’ ACCOUNTS

STEPS 1 – 4: SAMPLE OF OUTPATIENT ‘B’ FTES FOR AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR User can create another EASIV Repository query from Class 7 or use the same EASIV Repository Query from Class 7 that was used in ‘Calculating Support Staff Ratios’. Using the same query, repeat STEPS 1 through 4 from Calculating Support Staff Ratios. Copy and paste FTE data into Excel and calculate Total Available FTEs. In case a site has retransmitted, recommend using the same query so the FTE data will always match in both analyses shown in this presentation.

STEP 5: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – FORMATTING EXCEL SPREADSHEET FOR FTES AND VISITS – DELETING EXCESS FTE DETAIL NOTE: Highlight the Nonavailable FTEs and delete from excel spreadsheet that has all of the Class 7 FTE data. Also, highlight and delete all other extra information from the original query that is not needed for this analysis. The only detailed FTE data needed is skill type code, skill type suffix, and total available FTEs (available + purified available).

STEP 5a: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – FORMATTING EXCEL SPREADSHEET FOR FTES AND VISITS - DELETING EXCESS FTE DETAIL NOTE: TO DELETE ALL FTES FOR SKILL TYPE 3, 4, & 5 PERSONNEL, HIGHLIGHT THE HEADER, SELECT DATA, FILTER, AND AUTO FILTER.

STEP 5b: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – FORMATTING EXCEL SPREADSHEET FOR FTES AND VISITS - DELETING EXCESS FTE DETAIL NOTE: SELECT DROPDOWN MENU FOR SKILL TYPE CODE, SELECT CUSTOM, SELECT DROPDOWN MENU FOR : IS GREATER THAN, SELECT DROPDOWN MENU AND SELECT ‘2’.

STEP 5c: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – FORMATTING EXCEL SPREADSHEET FOR FTES AND VISITS - DELETING EXCESS FTE DETAIL NOTE: HIGHLIGHT THE COLUMN WITH SKILL TYPE CODES OF 3, 4, & 5. RIGHT CLICK ON MOUSE AND SELECT DELETE ROW TO DELETE ALL FTES FOR SKILL TYPE CODES 3, 4, & 5.

STEP 5d: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – FORMATTING EXCEL SPREADSHEET FOR FTES AND VISITS - DELETING EXCESS FTE DETAIL NOTE: SELECT OK TO DELETE THE ENTIRE ROW. THEN SELECT THE DROPDOWN MENU TO RESTORE THE FILTER TO ‘ALL’.

STEP 5e: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – FORMATTING EXCEL SPREADSHEET FOR FTES AND VISITS - DELETING EXCESS FTE DETAIL NOTE: SELECT OK TO DELETE THE ENTIRE ROW. THEN SELECT THE DROPDOWN MENU TO RESTORE THE FILTER TO ‘ALL’.

STEP 6: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – CREATE CLASS 21 EASIV REPOSITORY QUERY TO EXTRACT VISIT DATA NOTE: CREATE A QUERY FOR VISITS FROM CLASS 21, FCC SUMMARY. SELECT PARENT DMIS ID NAME AND CHILD DMIS ID NAME FROM CLASS 1, 3 rd LEVEL MEPRS/FCC DESCRIPTION FROM CLASS 3, AND 4th LEVEL MEPRS/FCC DESCRIPTION FROM CLASS 11.

NOTE: WHEN THE QUERY FINISHES, THEN SELECT EDIT, AND COPY ALL STEP 7: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – COPYING THE CLASS 21 EASIV QUERY RESULTS

NOTE: OPEN EXCEL WORKSHEET THAT HAS THE CLASS 7 FTE DATA, REMOVE FILTER, PLACE CURSOR IN COLUMN A IN A BLANK ROW BELOW THE CLASS 7 FTE DATA. STEP 8: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – PASTING THE CLASS 21 EASIV QUERY RESULTS INTO THE EXCEL SPREADSHEET THAT HAS ALREADY HAS THE CLASS 7 FTE DATA FOR SKILL TYPES 1 & 2

NOTE: PASTE. ENSURE THAT DATA FROM CLASS 7 AND CLASS 21 ARE ALIGNED. STEP 8a: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – PASTING THE CLASS 21 EASIV QUERY RESULTS INTO THE EXCEL SPREADSHEET THAT HAS ALREADY HAS THE CLASS 7 FTE DATA FOR SKILL TYPES 1 & 2

NOTE: CREATE NEW HEADER FOR ‘TOTAL VISITS’. HIGHLIGHT THE TOTAL VISITS DATA, CUT, SELECT CELL ON THE SAME ROW IN THE NEW COLUMN LABELED TOTAL VISITS AND PASTE. STEP 8b: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – COMBINING CLASS 7 & CLASS 21 DATA ON THE SAME EXCEL SPREADSHEET

NOTE: DELETE THE BLANK ROWS BETWEEN CLASS 7 & CLASS 21 DATA, AND DELETE THE TITLE AND HEADER INFORMATION FROM CLASS 21 AFTER ALIGNING DATA. STEP 8c: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – COMBINING CLASS 7 & CLASS 21 DATA ON THE SAME EXCEL SPREADSHEET

NOTE: HIGHLIGHT ALL DATA IN THE EXCEL SPREADSHEET, SELECT DATA, PIVOT TABLE AND PIVOT CHART, SELECT ‘NEXT’, AND THEN SELECT ‘NEXT’ AGAIN. THEN SELECT NEW WORKSHEET, AND LAYOUT. STEP 9: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – CREATING INDIVIDUAL PIVOT TABLES FOR FTES AND VISITS

NOTE: LAYOUT FOR TOTAL VISIT PIVOT TABLE. STEP 9a: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – CREATING TWO INDIVIDUAL PIVOT TABLES FOR FTES AND VISITS

NOTE: LAYOUT FOR TOTAL AVAILABLE FTES PIVOT TABLE. THE TWO PIVOT TABLES SHOULD BE ON THE SAME EXCEL WORKSHEET, AND PASTED ON THE SAME ROW SO THE MEPRS/FCC ARE ALIGNED. STEP 9b: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – CREATING TWO INDIVIDUAL PIVOT TABLES FOR FTES AND VISITS

NOTE: THE TWO PIVOT TABLES SHOULD BE ON THE SAME EXCEL WORKSHEET, AND PASTED ON THE SAME ROW SO THE MEPRS/FCC DESCRIPTIONS ARE ALIGNED. STEP 9c: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – CREATING TWO INDIVIDUAL PIVOT TABLES FOR FTES AND VISITS

STEP 10: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR – CALCULATE AVERAGE NUMBER OF VISITS PER PROVIDER PER HOUR

STEP 11: SAMPLE OF AVERAGE NUMBER OF VISITS PER PROVIDER PER HOUR – CALCULATE AVERAGE NUMBER OF VISITS PER PROVIDER PER HOUR NOTE: HIDE THE EXTRA 3 rd LEVEL FCC DESC COLUMN. COPY THE PIVOT TABLES AND CALCULATIONS, PASTE SPECIAL, SELECT VALUES AND NUMBER FORMAT, AND SORT REPORT IN DESCENDING ORDER TO IDENTIFY OUTLIERS. (REFER TO STEP 8 IN THE SUPPORT STAFF RATIO ANALYSIS.) THIS SAMPLE HIGHLIGHTS VISITS PER PROVIDER PER AVAILABLE HOUR > 4 AS OUTLIER DATA THAT NEEDS TO BE RESEARCHED. MEPRS PERSONNEL SHOULD COORDINATE WITH LOCAL MTF PERSONNEL TO DEVELOP OUTLIER RANGE FOR THIS ANALYSIS.

STEP 11: SAMPLE OF CHART OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR NOTE: HIGHLIGHT DATA IN EXCEL SPREADSHEET, SELECT CHART WIZARD, AND BUILD A CHART OF AVERAGE NUMBER OF VISITS PER PROVIDER PER AVAILABLE HOUR.