Navy Performance Based Budget (PBB) Indices

1. Navy Performance Based Budget (PBB) Indices January 2008 POCs: BUMED PA&E (M81) LCDR Matt Bouma, MSC, (202)762-3533, DSN 762 Mr. Robert Willis, (202)762-3542 BUMED (M8)

2. PBB Definitions

3. PBB Adjustment Scales/Indices Adjustment will be based upon 4 areas: 1) Evidenced Based Health Care 2) Bed Capacity Fill Rate 3) Individual Medical Readiness 4) Public Health Each will produce a weighted score that when summarized correspond to the adjustments recommended in the Adjustment Table below. After these adjustments are done a mitigation is considered for each MTF to recognize staffing issues caused by deployments.

4. PBB Metric Data Collection • Bed Capacity • Data is pulled from M2, SIDR files (Health Care Services, Direct Care, Inpatient Admissions Summary) for Bed Days, Raw. • A rolling 12 is calculated for Bed Days, Raw. A 4-month delay is built in (e.g. a 1 Dec pull would skip the previous 4 months and use Aug06-Jul07 as a rolling 12). • Bed Fill Rate is calculated as (Sum of Bed Days)/(Available Beds * 365). • Adjustment Rates are then based upon the percent fill rate – Unique scales are used based upon Bed Capacity size of the facility (Large, Medium, Small). • EBHC • Data is from the MHS Population Health Portal (MHSPHP) via DoDPHP Aggregate Metric Tables. • A rolling 3 average for each EBHC measure is calculated based upon the most current 3 months of data. Typically there is about a 3-month lag in data. • The rolling 3 is compared to the 2006 HEDIS 90th and 75th percentile Goal as stated in the MHSPHP Methodology and Measurement documentation. • IMR • Data is from the Medical Readiness Reporting System (MRRS) Navy/Marine Corp IMR Reports. • Data is pulled each month and current month is the basis for comparison to metric goal. • Indeterminate ratios are recorded for each MTF and scored according to IMR scale. • Public Health • Data is from SMART, Public Health PE 0807705. • Data is pulled quarterly from SMART, for the most currently completed 4 quarters. • Certified Obligations+Commitments is compared to the Obligation Plan over the 4 quarters to produce the Execution to Plan % amount. • This Execution to Plan % produces a PBB adjustment based upon Public Health scale. • PPS Recon • Data is from PPS Reconciliation provided from OSD(HA). • Data most recent report provided. Typically, there is a 2-month lag in reports. • Workload data and deltas are loaded into the PBB model for annotation purposes. • Any remaining FY07 values (75% * PPS Delta) are converted to FY08 values (100% * PPS Delta). • Deployment Mitigation • See Deployment Mitigation Flowchart.

5. Deployment Mitigation Objective: To recognize lost workload at MTFs caused by provider deployment in support of GWOT. PPS Recon Status Sum GDA* FTEs PPS Value > GWOT MTF Lost RVUs FY07 PPS RVU Rate GDA PPS Value Deployment Adjustment X = X = Yes No FY06 RVUs per FTE FY07 GWOT Contract Backfill $$$ No Adjustment • Notes: • Sum of GDA FTEs (MEPRSRolling 12) is taken for each Parent MTF. FTEs considered are Skill Type I and II Providers. Source: EAS-IV. • B RVUs per B Available Skill Type I and II providers for FY06 is calculated for each Parent MTF. Source: M2-RVUs, EAS-IV-Avail B FTEs. • GDA FTEs is multiplied by RVU rate per FTE to calculate a prospective lost RVU amount for each MTF. • MTF Lost RVUs are multiplied by the FY07 Avg RVU Rate given in PPS for each individual MTF to produce a GDA PPS Value: • GDA PPS Value = MTF Lost RVUs x FY07 PPS RVU Rate x PPS FY08 Navy O&M Factor (45%). • PPS Recon Evaluation: • If an MTF has a Negative PPS Recon, this is the maximum deployment credit they may be given. • If an MTF has a Positive PPS Recon, they are not eligible for deployment credit. • GWOT Funding is FY07 GWOT Dollars provided to each MTF for Contract Backfill • GWOT funding is compared to calculated GDA PPS Value for final adjustment: • If PPS Value < GWOT, No deployment credit/adjustment is given. • If PPS Value > GWOT, Deployment credit/adjustment is given as follows: • GDA PPS Value – GWOT Contract Backfill $$$