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Financing Army Medicine: Driving the System for Health · • Improved IPSRs by 267 additional per...

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1 23-Mar-16 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address COL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016 Slide 1 of 15 UNCLASSIFIED COL Anthony S. Cooper, CDFM, FACHE, DFMCP3 MAJ Deepak J. Mathew, CDFM, DFMCP2 31 March 2016 Financing Army Medicine: Driving the System for Health UNCLASSIFIED UNCLASSIFIED 23-Mar-16 Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address COL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016 Slide 2 of 15 UNCLASSIFIED UNCLASSIFIED Purpose and Outline Outline: 1. Army Medicine 2. Our Environment 3. Integrated Resource and Incentive System 4. Impact of Budget Methodologies 5. Final Thoughts Purpose: To describe the journey of the U.S. Army Medical Command’s paradigm shifts in its resourcing model and the impact to our system for health.
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23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 1 of 15

UNCLASSIFIED

UNCLASSIFIED

COL Anthony S. Cooper, CDFM, FACHE, DFMCP3MAJ Deepak J. Mathew, CDFM, DFMCP2

31 March 2016

Financing Army Medicine: Driving the System for Health

UNCLASSIFIED

UNCLASSIFIED

23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 2 of 15

UNCLASSIFIED

UNCLASSIFIED

Purpose and Outline

Outline:

1. Army Medicine

2. Our Environment

3. Integrated Resource and Incentive System

4. Impact of Budget Methodologies

5. Final Thoughts

Purpose: To describe the journey of the U.S. Army Medical Command’s paradigm shifts in its resourcing model and the impact to our system for health.

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23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 3 of 15

UNCLASSIFIED

UNCLASSIFIED

Army Medicine

Military Medicine Mission Areas -- Priorities

Combat Casualty Care: Medical personnel, services, and doctrine that save Service members’ and DoD Civilians’ lives and maintain their health in all operational environments.

Readiness and Health of the Force: Medical personnel and services that maintain, restore, and improve the deployability, resiliency, and performance of Service members.

Ready & Deployable Medical Force: Military personnel who are professionally developed and resilient, and with their units, are responsive in providing the highest level of healthcare in all operational environments.

Health of Families and Retirees: Medical personnel and services that optimize the health and resiliency of Families and Retirees.

Health of Families & Retirees

Readiness of the Force

Readiness of the Medical

Force

Casualty Care

• An interdependent and overlapping mission set

• An effective integrated system ofcomprehensive care

• Providing many services not found in privatesector healthcare

• Driven by service, not profit

23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 4 of 15

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UNCLASSIFIED

United States Army Medical Command

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23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 5 of 15

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PersonnelAMEDD Total OTSG/MEDCOM

Total AC 53,879 27,178Civilian (All Medical) 50,849 42,219Contractors ~7,784 ~5,554Compo 2/3 43,650 1,391Total 156,162 76,342

BeneficiariesActive Duty (AD) 546KFamily Members (AD) 856KDependant Survivor 229KEligible NG/RC 128KFamily Members of NG/RC 202KRetired 775KFamily Members Retired 909KInactive G/R 89KFamily Member IGR 140KOther 29KTotal 3.90M

FY14 SRC08 EAB TOE Units

Active / Reserve

Combat Spt Hosp (CSH) 10 / 16

FWD Surg Tm (FST) 16 / 22

Other Active Units 90 / 0

Other Army NG Units 0 / 52

Other Army AR Units 0 / 134

AC / NG / AR Deployable

Units

116 / 52 / 172

(340 Total)

ResourcingFY15 Funded: $11.7B(all appropriations)*MEDCOM Appr Funds Only (No LN/NAF), OTSG CS-W00LAA, and All Army CP53

Army TDA FacilitiesMedical Centers 8Community Hospitals 15Health Centers 10Primary Care Clinics 110Occupational Health Clinics 29Dental Clinics 137Veterinary Facilities 77Research & Development Laboratories 24Laboratory Support Activities 5Over 1000 individual administrative and healthcare buildings totaling over 24 million square feet

AMEDD at a Glance

23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 6 of 15

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Average Day in Direct Care - MEDCOM

Babies

42 BirthsFY15 (Oct14-May15)

Laboratory33,792 Lab Services

FY15 (Oct14-May15)

Radiology7,339 Rad Services

FY15 (Oct14-May15)

Outpatient Care 30,851 Clinic Visits

FY15 (Oct14-May15)

Vaccines5,140 Immunizations

FY15 (Oct14-May15)

RX

30,749 Prescriptions FY15 (Oct14-May15)

Inpatient Care706 Beds Occupied

234 Patients DischargedFY15 (Oct14-May15)

Personnel Deploying100s of Soldiers and CiviliansIncludes all global engagements: Kuwait, Afghanistan, Africa, Germany, Pacific, others.

Dental 13,816 Services

FY15 (Oct14-May15)

Veterinary Services (FY14)1,583 Veterinary Outpatient Visits$38.7 Million of Food Inspected

328 Food Safety Visits

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23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 7 of 15

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UNCLASSIFIED

What is our Environment

TSG Guidance

AM2020CPAssessment

National StrategicGuidance

MEDCOM TNG

SecArmyPriorities

Key LeaderEngagement

Congressional Calendar

CSAPriorities

- Smaller Army, Personnel Reductions, Fiscal Uncertainty- MHS, though losing flexibility, is still well resourced – Labor a

constraint- Military Compensation & Retirement Modernization

Commission (2015)- Stakeholders want change; Willing to be innovative & even

radical

IRISSpecial

ProgramsHiring Cap

TDA/PSM

UBO

DMHRSiMEPRs

SOOService Lines

Performance Plan

Core

• IRIS• Special Programs• Hiring CAP• TDA/PSM• DMHRSi• Service Lines• UBO• MEPRS• SOO• Where is my Core!

What! Why!

POM DHA President’s Budget eMSMs

Per Capita Cost

Congressional Action

Operating Company

Model

Small Hospital Study

23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 8 of 15

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MTF Business Plan

Strategy:Objectives, Initiatives,

Measures

Performance

ReadinessAccessQualityPatient SafetySatisfactionEnrollmentEfficiencyData Quality….Productivity

MTF Execution

MTF Budget

Performance

Management FrameworkPerformance Planning Lifecycle

FARMs

CampsRADaR

Campaign Assessment

Campaign Synchronization

IRIS

RADaR

Service Lines

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23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 9 of 15

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Historical Resourcing Method

• Medical Care Composite Unit

(MCCU) (up to 1990)

• Gateway to Care (1991-1993)

• The Years Adrift (1994-2001)

• The Early War Years (2002-

2004)

• DoD Perspective Payment

System (PPS) (2004-2012)

– Performance Based Budgets

(PBB) (2004-2006)

– Performance Based Adjustment

Model (PBAM) (2006-2013)

• Integrated Resourcing and

Incentive System (IRIS) (Oct

2013-present)

23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 10 of 15

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Integrated Resourcing and Incentive System

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23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 11 of 15

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Execution Tracking Dashboards

23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 12 of 15

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Why we use IRIS

Enhance Experience of Care• APLSS considerably increased thought the enterprise.

• TRISS improved within enterprise.

Increase Readiness Cost Capture • Capture and show scattered Readiness data within work centers

• Established Framework to have dimensional look of efforts towards Readiness

Improve Population Health• Improved IPSRs by 267 additional per month.

• Average HEDIS compliance improved by 7 throughout MEDCOM

Reduce Per Capita Cost• Standardized unit price set stage for defining unit of allocation.

• Accounting accuracies are improved considerably.• Controlled PMPM drastic negative shift of PMPM

+ 24%

+ 1%

+ 7

+ 6%

MILPAY

PMPM

APLSS + 7%

TRISS

+ 18%Continuity

HEDIS + 267

IPSRs

Data based on2010 to 2015

PBAM/IRIS trends

PMPM is comparing FY14Q2 to FY15Q2 with No Retail RX

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23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 13 of 15

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Impact of Performance-based Budgeting

TROSS: Satisfaction with Healthcare

HEDIS Performance over time

HEDIS Performance Over Time

PMPM by Service

23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 14 of 15

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Final Points

• Massive organizational paradigm and culture shifts toperformance based budgeting.

• Paying for performance works.

• Education/Knowledge of our staff.

• Cultivâtes an entrepreneurial culture that enhance a positivepatient expérience.

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23-Mar-16Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email addressCOL Anthony S. Cooper/ e-mail :[email protected] / 210-295-3812 31 March 2016Slide 15 of 15

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Guidance


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