TRICARE Regional Office Business Planning & the Direct Care System

1. TRICARE Regional OfficeBusiness Planning & the Direct Care System CAPT Elizabeth NelsonBusiness OperationsTRO-N (pls insert logo) COL Douglas DudevoirBusiness OperationsTRO-W CAPT William PerryBusiness OperationsTRO-S 25 August 2004

2. Outline • Introduction • Overarching Theme of Presentation • How TROs Can Assist Services and MTFs with Business Plans • Information required from Services and MTFs • Suggested Next Steps to Improve the Process • TRO Business Planning POCs • Summary / Discussion

3. Overarching Themes in Presentation • Provide ideas for how TROs can assist the services and MTFs in business plan development, modification and execution. • Indicate what information TROs will need from the Services and the MTFs to do so effectively. 

4. TRO Assistance to Services/MTFs • Business plans and initiatives • ID opportunities for optimizing care in the MTFs and assist as indicated • ID venture capital opportunities reflected in the MTF and MSMO business plans • Serve as a forum for the identification and sharing of good ideas • Provide assistance as requested by MTFs and Services in analyzing business plan deviations

5. TRO Assistance to Services/MTFs, cont • Liaison: Serve as a liaison between Guard, Reserve, Coast Guard, Services/MTFs, HSSC, VA • Medical • Provide HSSC medical management data and expertise to ID focal points for MTF efforts • Support GME by encouragingpatients with desired conditions to seek care at MTF

6. TRO Assistance to Services/MTFs , cont • Data • Link with HSSC to provide more timely PSC data • Monitor private sector care data to ID • Enrollment trends for recapture • Admission trends to ID medical management opportunities • Referral trends to ID increases in demand for early intervention • Assist with analysis and projections (limited)

7. TRO Assistance to Services/MTFs , cont • Resource sharing • Work with MTFs, Services and HSSC to ID resource sharing/clinical support opportunities • Assist with development of agreements

8. Information Required from Services and MTFs • General – TROs need information necessary to complete business plans and meet responsibilities defined in the Governance Plan to include: • Serve as Health Plan Manager • Integrate business plans • Support MTF Commanders in their efforts to • Optimize • Manage Non-MTF Enrollees (NMEs) • Make determinations on venture capital funding • “Make recommendations to the Svcs on the flow of dollars” • Ensuring Contract support for MTF optimization • xx • xx

9. Business Plan Information Required from Services & MTFs • MTF and MSMO narratives • MTF plans for Medical Management and the projected capacity to be freed up • MTF benchmarks and plans for improvement in productivity • MTF identification of Resource Sharing / Clinical Support / Staffing Augmentation opportunities

10. Business Plan Information Required from Services & MTFs • MTF identification of venture capital initiatives • MTF rationale/linkage between aggregate capacity and FTE trends and explanations of divergent trends • MTF changes impacting health care capacity to include: • MILCON projects (e.g., OR closures) • Service decisions (e.g., Gyn service closure)

11. Business Plan Information Required from Services & MTFs • Strategic issues/changes impacting health care delivery in the MTF: • Capacity and capability changes associated with deploying or redeploying staff • Anticipated deferrals/costs to network associated with deploying or redeploying staff • Demand changes in terms of both volume and capability associated with deploying or redeploying units

12. Business Plan Information Required from Services & MTFs • Service guidelines on macro level issues such as: • Enrollment levels to include both aggregate and per provider guidance (i.e.,beneficiary/PCM enrollment ratios) • Care for other MTF enrollees (to include plans for 65+ pop’n) • Expansion of Space-A care

13. Suggested Next Steps to Improve the Process • Service, TRO, and TMA reps should meet in Sept to establish protocols and processes ref Business Planning that will: • Embrace the best ideas from the current “independent process” • Allow the plans to easily build upon one another • Allow for new/transferred personnel to integrate more easily • Convey a seamless coherent message to senior leadership

14. Information Required from Services and MTFs • Summary: • Information is critical for us to serve in our support role • Context is everything .. i.e., TROs need to know overarching policy that is driving local decisions (not our job to change them .. just to understand them and work within those parameters) • We only have assets to assist in focused areas … broad understanding of the MHS dynamics will help us assess where we should apply our assets and those of the HSSC to assist MTFs and help us “cowboy up” .. We don’t want the following scenario to become reality … next slide …

16. TRICARE Regional OfficesBusiness Planning POCs • TRO-North • CAPT Elizabeth Nelson (703) 681-2889 (x6710) • LTCOL Roger Price 703-681-2889 (x6702) • TRO-West • COL Douglas Dudevoir 619-532-6172 • MAJ Linda Guardado-McRandall 619-532-?TBD • TRO-South • CAPT William Perry 210-292-3201 • MAJ(P) Sharon Pacchiana 210-292-3245

17. Summary Discussion