2010 UBO/UBU Conference 1 Title: Productivity Metrics/Tools Session: R

Objectives To show the different data available in MEPRS including: – Expenses – how your money is being spent – Personnel – where your folks are spending their time – Workload – how much work they are producing Why so many codes and how they are used How to take a look at your time How to identify potential problems How “straight 8s” look in the big picture How to look at an entire clinic of providers’ time 2

“A”Inpatient “B”Outpatient “C”Dental “D”Ancillary “E”Support “F”Special “G”Readiness MEPRS Codes Available MEPRS Information

Stepdown Expense What is Stepdown? – The distribution of expenses from one work center to another based on the percentage of workload requested – Example Pharmacy total workload 1,000 prescriptions Family Practice wrote 500 prescriptions 50% of Pharmacy work was to Family Practice Pharmacy total expenses were $10,000 So 50% of Pharmacy expenses ($5,000) will be added to Family Practice total expense 4

4th Level FCC 4th Level FCC Description Service Unit Cost Total ExpenseStat Amount BALANUTRITION CLINIC$82.95$1, BCBAGYNECOLOGY CLINIC$291.10$100, BDAAPEDIATRIC CLINIC$622.14$32, BFDAMENTAL HEALTH CLINIC$551.82$73, BFFASUBSTANCE ABUSE CLINIC$454.90$5, BGAEFAMILY PRACTICE/EAGLE TEAM$316.81$383, , BGAWFAMILY PRACTICE CLINIC BHOP$112.09$2, BHCAOPTOMETRY CLINIC$815.45$33, BJAAFLIGHT MEDICINE CLINIC$339.87$136, BLAAPHYSICAL THERAPY CLINIC$116.11$44, CAAADENTAL CARE$145.68$166, , CBAADENTAL LABORATORY SERVICE$26.06$11, DAAAPHARMACY$44.89$279, , DBAACLINICAL PATHOLOGY$39.27$58, , DCAADIAGNOSTIC RADIOLOGY$143.73$32, Cost Table Summary Report

Total Expenses $383, Total Visits 1, Cost Per visit $ Clinician Total $19, Direct Care Prof $28, Registered Nurse $36, Direct Care Para Pro $92, Administrative Clerical $93, Total Personnel Expense $270, Expense w/o Personnel Direct $10, Support $19, Ancillary $83, Total Exp w/o Personnel $113, Total Detail Expenses$383, Family Practice Information

Total Exp Direct $ 134, Total Exp Support $ 89, Total Exp Ancillary $ 159, $ 383, Total from Phar $ 111, Total from Lab $ 32, Total from Rad $ 15, $ 159, Total from Command $ 3, Total from Squadron $ 2, Total from RMO $ 3, All other "E" codes $ 79, $ 89, Expense Breakdown

Pharmacy StepdownExpense Distribution Womens Health $ 20, Pediatrics $ 3, Mental Health $ 1, Family Practice $ 111, Optometry $ 1, Flight Med $ 15, Physical Therapy $ Dental $ 6, Public Health $ Outside providers $ 117, Total Phar Exp $ 279, Pharmacy Expense Distribution

Assigned FTEs Available FTEs Sick FTE 1.16 Leave FTE 2.51 Other FTE 1.48 Available Hours 3, Sick Hours Leave Hours Other Hours Total Avail $$ $93, Total Non Avail $$ $30, Total Personnel Exp.$124, Assigned Drs 1.85 Available FTEs 2.03 Sick FTE 0.00 Leave FTE0.05 Other FTE 0.06 Available Hours Sick Hours0.00 Leave Hours 9.00 Other Hours Total Avail $$ $17, Total Non Avail $$ $1, Total Dr. Salary$18, FTE = 168 Hours Personnel Information

Ben Cat Stat Amount Activity Duty AD Fam Member Retired Ret Fam Member Other5.00 Total Visits Family Practice Visits Pharmacy Scripts GYNECOLOGY CLINIC PEDIATRIC CLINIC76.00 MENTAL HEALTH CLINIC25.00 FAMILY PRACTICE/EAGLE TEAM OPTOMETRY CLINIC44.00 FLIGHT MEDICINE CLINIC PHYSICAL THERAPY CLINIC4.00 DENTAL CARE PHARMACY7.00 MILITARY PUBLIC HEALTH PROGRAM1.00 ANCILLARY SUPPORT NON-DOD PROV Total Workload

Time Accounting 11 EBAA CAAA DBAA FBIA EEAA GFAA BGAA_DMIS_FF GBAA EBCA FCGA FALA CODES!! CODES!! CODES!! WHY SO MANY? HOW ARE THEY USED?

MonthProvider Fact to Face Non Face to Face Non ClinicalClinic Hrs. E Hours (Support) G Hours (Readiness) F hours (Special) Non avail (Lv, sick, other) Total Hours OctPokey NovPokey DecPokey JanPokey FebPokey Each Code Tells a Story 12 MonthProvider Fact to Face Non Face to Face Non ClinicalClinic Hrs. E Hours (Support) G Hours (Readiness) F hours (Special) Non avail (Lv, sick, other) Total Hours OctJones NovJones DecJones JanJones FebJones Accurate Time Accounting

Charts for Providers 13

Straight 8s 14 MonthProvider Fact to Face Non Face to Face Non Clinical Clinic Hrs. E Hours (Support) G Hours (Readiness) F hours (Special) Non avail (Lv, sick, other) Total Hours OctNovo NovNovo DecNovo JanNovo FebNovo The Great “Caught You” Not a good way to keep time! If you say you are working too long and hard, the data doesn’t back that up.

Source; DMHRSi & M2 Family Medicine DMHRSi Data

Review To show the different data available in MEPRS including: – Expenses – how your money is being spent – Personnel – where my folks are spending their time – Workload – how much work they are producing Why so many codes and how they are used How to take a look at time accounting How to identify potential problems How “straight 8s” look in the big picture How to look at an entire clinic of providers’ time 16

Questions 17 QUESTIONS?