MHS Business Planning Update Translating Strategy without hesitation

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MHS Business Arranging Overhaul "Making an interpretation of System without hesitation". Tri Administration Symposium 13 July 2006 MHS Business Arranging Workgroup. Motivation. Why Business Arranging? Foundation MHS Key Change Current Status Basic Activity Advancement Why Offices?

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MHS Business Planning Update "Making an interpretation of Strategy without hesitation" Tri Service Symposium 13 July 2006 MHS Business Planning Workgroup

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Agenda Why Business Planning? Foundation MHS Strategic Transformation Current Status Critical Initiative Development Why Facilities? FY08-FY10 Business Planning Cycle MILCON Planning Vs. Business Planning Analytic Components PPS Approach PPS relationship to Business Planning Facilities Business Planning Horizon Questions

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Why Business Planning? Should have the capacity to gauge social insurance needs and obtained mind prerequisites Coordinate care in multi-advertise districts Place responsibility for care at MTF Quantify deviations from plan Base spending plans on yields, not inputs Justify spending plan

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Background Planning, resourcing, execution and execution observing have verifiably worked as isolated capacities inside the MHS To fulfill the mission viably, these capacities must be incorporated Since 2004, the MHS has tried to: Integrate the procedures supporting the business arranging capacity over the endeavor Link business arranging with resourcing, execution, and execution checking

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Integrating MHS Strategic Transformation and Business Planning Outputs Inputs Initiatives Outcomes Level of Effort Full Time Equivalents and subsidizes by venture (activity) Capital Investments DoD/VA Roadmap Joint, interoperable deployable restorative abilities BRAC – Joint MTFs and joint preparing Performance based administration Shape the Benefit Fit and Protected Force Death, wounds and sicknesses decreased amid military operations Improved Satisfaction Reduced Growth in Health Care Costs for DoD Healthy Communities Strategic Transformation LONG TERM Long-term Outcomes Resources Measures Critical Few Mission Effectiveness Performance Based Culture Sustainable Benefit Measures Many Outcomes Inputs Outputs Fully prepared deployable medicinal units Healthy Communities Beneficiary Satisfaction Reduced cost per enlisted recipient Committed workforce Infrastructure; Aligned & Maintained Level of Effort Full Time Equivalents and finances by practical action or program component DoD/VA Collaborations Training for deployable therapeutic units IMR Activities RVUs/RWPs GME/CME Activities Business Planning/Operations NEAR TERM

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Dynamic model, TriService Direct Care Focus Informal, SG-coordinated Portion of assets connected to Plan and Execution at HA level Driven by Purchased Care contracting cycle Service-particular, Tool-centered Stabilized, TriService Direct Care Focus, Unified approach Chartered BP Workgroup Greater segment of assets connected to Plan and Execution Driven by POM cycle and connection to assets Service-particular & Market centered Current Status 06-08 Planning Cycle 07-09 Planning Cycle Training Schedule PPS WG Tool

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Critical Initiative Development Eight Critical Initiatives of the MHS Strategic Plan Access to Care Referral Management Documented Value of Care Labor Reporting Pharmacy Management Evidence Based Health Care Provider Productivity Contingency Planning Critical Enablers Facilities Management Equipment Management Venture Capital

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Why Facilities? We should connect offices to the venture Infrastructure is not figured into MTF Business Planning process MTF Commanders don't have capacity to esteem/estimate their offices We do not have an extensive posting of advantages We do not have the capacity to decide office limit and efficiency We need capacity to connection office speculations with execution objectives explained in business arranging QDR – 8 "Change the Infrastructure" Asset perceivability Physical & useful condition Process to gauge office condition change Link office speculations with execution objectives Transform MILCON prepare

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FY08 – FY10 Business Planning Cycle Begin to get perceivability of MHS MTF portfolio by shadowing DMLLS New office segment fields in Business Planning Tool Number of exam rooms (by division) Number of inpatient beds Designed Reported Introduce office inquiries in the BPT Is the measure of clinical treatment space adequate to permit the coveted measure of direct care workload? Does the arrangement of clinical space permit the coveted level of staff profitability? Is it accurate to say that you are buying care because of deficient space? Create office inquiries for MHS overview utilize What do our clients think about our offices?

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MILCON Planning Vs. Business Planning Health Care Requirements Analysis (HCRA) and Market-Based Business Planning are adjusted in goal yet contrast in execution "An efficient, quantitative way to deal with designating medicinal services assets in light of the size and statistic qualities of a populace measured against suitable options." Population Staffing and Resources Space or Facilities Healthcare Demand

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Analytic Components for HCRA and Business Planning Should be Congruent Population Options Service Locations Performance Goals Delivery System Decision Analysis Criteria Other Impacts Utilization and Demand Planning Parameters Market definitions Time skylines Background inquire about Key inquiries Demand/Supply Imbalance Services Supply and Capacity Facilities and Staff Recommendations ANALYSIS

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A Prospective Payment Approach Direct care costs taken specifically from M2 But, PPS FFS repayment rates utilized as a part of EA as applicable future expenses to the framework, bad habit current recorded costs Key supposition: PPS FFS estimations of future workload yield is best measure of framework costs going ahead (What TMA will pay for care conveyed) PPS-based cost appraises in experiment EA were essentially lower than genuine cost-based evaluations

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A Prospective Payment Approach PPS repayment esteem ≈31% < Current Full Cost

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PPS Relationship to Business Planning Funds MTF depends on strategy for success yields (presently mixed) Inpatient Relative Weighted Products (RWP's) Mental Health bed days Outpatient Relative Value Units Quantify deviations from the arrangement Bases spending plans on yields, not inputs

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Facilities Business Planning Horizon Reconcile DMLLS and MEPERS Develop limit/through put RVU per square foot By exam room Provide MTF's capacity to decide appropriate division measuring Provide MTF's capacity to accommodate as of now announced limit with foundation limit (ranges) Develop proportion ranges for non-procuring income space and income acquiring space

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