Corporate Documents in M2

1. Corporate Documents in M2 Ms. Dawn Sexton Kennell and Associates dsexton@kennellinc.com

2. Objectives • Objectives: • After completing this session the attendee can: • Describe the process of retrieving a corporate report. • If an M2 user, retrieve and modify a corporate report. • List TMA corporate reports. • Use TMA Corporate Report documentation. FOR OFFICIAL USE ONLY

3. Corporate Reports in M2 • Envisioned as a method for dissemination of reports. • Purposely not tied to IT development or other approval processes. • Intended for rapid turnaround if needed. • Reports are developed by authorized functional users. • TMA, TROs, and Service HQ were given the authority to identify report writers. • TMA has published many reports • Resource Management and Chief Medical Officer FOR OFFICIAL USE ONLY

4. Corporate Reports in M2 • There has always been a set of corporate reports in M2 • With the implementation of DeskI, many of the reports have been better organized • To include multiple pre-built tables for easier analysis of the data • And many new reports have been added, especially in the clinical area. If you’ve used corporate reports before, they have changed! FOR OFFICIAL USE ONLY

5. Corporate Reports Handbook • Most of the TMA Corporate Reports have been documented in a handbook. • The handbook includes: • List of all reports • Purpose • Tips on how to use • List of data elements • List of data filters FOR OFFICIAL USE ONLY

6. Corporate Reports Handbook • For a copy: • Download from M2 • Or email Dawn at dsexton@kennellinc.com Corporate Reports Handbook in TMA/HA folder M2 tutorial is 1st section of Handbook 6 FOR OFFICIAL USE ONLY

7. Retrieving Corporate Reports FOR OFFICIAL USE ONLY

8. Corporate Reports in M2 • To use the corporate reports, you must first log on to M2 DeskI. • Once in DeskI, hit file/import from repository. FOR OFFICIAL USE ONLY

9. Corporate Reports in M2 • Navigate to the directory that you’d like to retrieve a report from. Ensure Folders is clicked or you won’t see the reports listed! FOR OFFICIAL USE ONLY

10. Select the report you want and click Retrieve Instance! to get the latest refresh of the report If ‘Retrieve Instance’ is greyed out, that means there aren’t multiple instances FOR OFFICIAL USE ONLY

11. Corporate Documents • Once you click retrieve, M2 will think for a bit while it retrieves the report you selected. • Some reports already contain data • Last update date is displayed • Just hit refresh if you’d like more current data and it’s available in the database. • Other reports contain user prompts • The user is asked a question, such as “which MTF”, or “what year”. • The handbook indicates whether each report is prompted. FOR OFFICIAL USE ONLY

12. Using M2 Corporate Documents • Use the M2 Data Dictionary to understand code-sets associated with pre-built reports • Select the tab that corresponds to the data source for the report • Can be obtained from report handbook • For most elements, the M2 DD will list the values: • Most can be obtained directly from M2 DD • Others are available as appendices to the DD • Some are available in M2 reference tables • Others may only be available via Internet Search or other source. • To download the M2 DD go to: http://www.tricare.mil/ocfo/BEA/functional_specs.cfm FOR OFFICIAL USE ONLY

13. FOR OFFICIAL USE ONLY

14. Available Reports FOR OFFICIAL USE ONLY

15. Case Management/Medical Management Reports FOR OFFICIAL USE ONLY

16. Case Management Reports • Case Management FTEs (How many Case Managers are there?) • Case Management Patient List (How many patients are in CM?) • Case Management CAPERs • Health Care Summary (What care are the case managed patients receiving?) • Includes Inpatient and Outpatient, Direct and Purchased Care, ER and SDS. FOR OFFICIAL USE ONLY

17. Case Management Reports • All case management reports assume that the MTF is following coding guidance in Appendix E of the UBU Coding Guidelines for case management. • MEPRS codes must be FAZ2, ELAN or ELA2 • Diagnosis Codes must indicate start/continuation or stop of CM services (V4989*) • Procedure code must indicate the CM acuity of the patient (G Codes) • The data in these reports serves as the basis for a report to Congress on MHS CM. FOR OFFICIAL USE ONLY

18. Case Management Patient List • Let’s walk-through using a corporate document with a prompted filter. • We’ll review this report: • Number of Patients in Case Management • tma.rm.cm.patientlist.rep • Lists patients in Case Management at an MTF you specify when you run the report, for the specified time period • Patient-level report • Shows patient’s acuity level (1-5) with start and end dates 18

19. Case Management/Medical Management Reports • You assist the clinical chief at your MTF. She is concerned about staffing for case management and whether it is adequate. Using the data from January 2012, she wants to know: • How many patients were in case management? • How many case managers were managing them? • What is the staffing-to-patient ratio for case management? • Does this seem appropriate for the case load and acuity levels? FOR OFFICIAL USE ONLY

20. From the Corporate Documents Handbook • 2.3.3 Report 3: Number of Patients in Case Management • 1. Report Name: tma.rm.cm.patientlist.rep • 2. Report Description: Creates a list of patients that are in case management for a desired period at a desired case management location. • 3. Data Source: M2 / Health Care Services /Case Management • 4. Data Elements in Report: • • Case Management DMIS ID • • Case Management DMIS ID Military Service • • Case Management DMIS ID Name • • Case Manager ID 1 • • Case Manager ID 2 • • Case Manager ID 3 • • Person ID • • Acuity Level Begin Date • • Acuity Level End Date • • # of Records FOR OFFICIAL USE ONLY

21. From the Corporate Documents Handbook • 5. Filters: • • Acuity Level Begin Date is less than or equal to the latest date in the period for which you want data • • Acuity Level End Date is greater than or equal to the earliest date in the period for which you want data • • Case Management DMIS ID is a prompted filter • 6. Notes/Comments: • • Ease of Update: Easy • • Users should input the dates for which they want a list of patients. For example, if the user wants a list of patients in case management in April 2009, then the user would enter 4/1/2009 in the first date prompt and 4/30/2009 in the second date prompt. FOR OFFICIAL USE ONLY

22. FOR OFFICIAL USE ONLY

23. FOR OFFICIAL USE ONLY

24. FOR OFFICIAL USE ONLY

25. Prompts you for info FOR OFFICIAL USE ONLY

26. Populated report based on how the user answers the prompt FOR OFFICIAL USE ONLY

27. FOR OFFICIAL USE ONLY

28. FOR OFFICIAL USE ONLY

29. You can Slice and Dice any report!

30. FOR OFFICIAL USE ONLY

31. Case Management/Medical Management Reports • Heavy ER Users report • tma.ocmo.medmgmt.heavy_er.rep • Contains person-level ER utilization • Prompts for MTF Service Area • = 40-mile radius around any MTF • Direct Care & Purchased Care ER - Session# AN-W-3-C on Wed Allison Russo FOR OFFICIAL USE ONLY

32. Case Management/Medical Management Reports • Heavy ER Users report • Excessive use of ER • For an MTF population • – likely means access problem • For certain individuals • – may need Case Management or may be unenrolled • TMA counts a higher # ER visits for Purchased Care • Consultation E&M Codes are counted as an additional ER visit FOR OFFICIAL USE ONLY

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34. FOR OFFICIAL USE ONLY

35. Heavy ER Users report Top 2 ER users at this Navy MTF Person ID FOR OFFICIAL USE ONLY

36. Case Management/Medical Management Reports • Medical Management Patient Health Care Summary • tma.ocmo.medmgmt.healthcare.summary.rep • Contains patient-level healthcare utilization information • Combines data from many sources: • Purchased Care Institutional • Purchased Care Non-Institutional • Direct Care Inpatient • Direct Care Ambulatory • Pharmacy • Prompts for Person ID FOR OFFICIAL USE ONLY

37. FOR OFFICIAL USE ONLY

38. Some data sources might not return data for the Person ID you entered -- that’s OK. FOR OFFICIAL USE ONLY

39. Electronic Event Record Report Individual tabs detailing history by source FOR OFFICIAL USE ONLY

40. FOR OFFICIAL USE ONLY

41. Person ID FOR OFFICIAL USE ONLY

42. Data Quality Reports FOR OFFICIAL USE ONLY

43. Data Quality Reports • Data Completeness (is all my workload reported?) • Inpatient and Ambulatory • Improper reporting (is my workload reported correctly?) • Ungroupable MS-DRGs, Unspecified Provider Specialty Codes, Improperly Coded Case Management Acuity Levels • Lab and Rad records (is my ancillary workload consistently reported?) • Child and Parent Level • % of Encounters Captured in AHLTA • CAPER Workload with No Staff FOR OFFICIAL USE ONLY

44. CAPER CompletenessAction Report • Provides record level report of missing CAPERs • Includes MTF and Appointment Identifier so that MTF may retrieve information about missing records and fix the problem! • Also includes estimate of lost RVUs due to lack of CAPER • Prompted filter report: • Data not already run; user is prompted to enter MTF DMISID; then report runs FOR OFFICIAL USE ONLY

45. CAPER CompletenessAction Report • Let’s walk-through using a corporate document without a prompted filter. • Ambulatory Reporting Compliance, Action Report • Shows missing coded CAPERs = charity care! • No PPS $ credit • By program (ACV Group), Year, Month and Bencat • Contains things like record ID, service date, MEPRS code, provider ID = actionable FOR OFFICIAL USE ONLY

46. From the Corporate Documents Handbook • 2.2.5 Report 5: Ambulatory Reporting Compliance, Action Report • 1. Report Name: tma.rm.dq.dcop.rep.comp.actionrep.rep (PROMPTED REPORT) • 2. Report Description: This report can be used to identify particular records where the appointment has been reported as completed, but the CAPER has not been received. This report includes data elements such as the appointment ID number, the MEPRS code, the provider ID, and an estimate of what the RVUs would have been had the record been received (based on previous reporting at the MTF for that type of appointment). • 3. Data Source: M2 / Health Care Services / Direct Care / Professional Encounters (CAPER) / Professional Encounters • 4. Data Elements in Report: • • Fiscal year and fiscal month • • Treatment DMIS ID • • Compliance Status • • Provider ID • • Service Date • • MEPRS 3 Code • • Record ID FOR OFFICIAL USE ONLY

47. From the Corporate Documents Handbook • • PPS Potential Earnings • • Encounters • • Enhanced Work RVU (13) • • Enhanced Practice Expense RVU (13) • • Enhanced Total RVU (13) • 5. Filters: • • MEPRS 1 Code equal to “B” or MEPRS 3 Code is equal to “FBN” • • Treatment DMIS ID=Prompted Filter • • Compliance Status=”I” • Provider Specialty not between 910 and 999 • • FY greater than or equal to 2009 • 6. Notes/Comments • • Ease of Update: Easy • • This is the action report for the prior report, • • Effective FY10, the M2 'PPS Earnings' shown here reflect the PRIOR YEAR rate structure and are to be used only as an estimated dollar amount. Enhanced RVUs are now used for PPS and thus accurately represent workload as used for PPS. Due to this, PPS Earnings for Physical Therapy will be underestimated and ER will be overestimated. • • Should you desire reporting at a “higher level” than what is displayed, in the query panel open up each query panel and drag over additional data elements. Please note that adding additional elements not found in both files will affect the report display if brought in to the report. Upon making any changes, you can save the report to your local hard drive, but that will not replace the report in corporate documents.

48. Sliced and Diced to remove the FM and other columns • Then sort to see highest RVU per MEPRS Code at top

50. Medical Management Reports • Provider Radiology Profile Report • For a given condition (e.g. low back pain), what % of tests ordered by a given provider are • MRI • CT Scan • X-ray • Ultrasound • Enter desired FY and diagnosis • Diagnosis should be entered as wildcard, e.g. 7242% (low back pain) FOR OFFICIAL USE ONLY