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MEDICAL MANAGEMENT PROCESSING SYSTEM 101

MEDICAL MANAGEMENT PROCESSING SYSTEM 101. An Operational Force at Home and Abroad. MMPS Purpose.

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MEDICAL MANAGEMENT PROCESSING SYSTEM 101

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  1. MEDICAL MANAGEMENT PROCESSING SYSTEM 101 An Operational Force at Home and Abroad

  2. MMPS Purpose • The Medical Management Processing System (MMPS) provides a baseline structure for case management of Soldiers with unresolved medical issues to assist in achieving medical recovery and increase unit readiness • Comprehensive medical case management structure • from identification of condition to finaldisposition • (i.e return to duty or processed through a board action). 2

  3. MMPS Roles/Responsibilities • Case management support (main body) • Medical Readiness NCOs (MRNCO), Care Coordinators (CC), and Case Managers (CM) • MRNCO(BN) • Provide a monthly list to BN command of Soldiers that are tracked through MMPS • Assist the Soldier with tasks to include/not limited to: obtaining an LOD, a temporary profile, and collecting pertinent medical records (in coordination with the HSS) 3

  4. MMPS Roles/Responsibilities • Care Coordinators (CC) • Report to CM • Assist the Soldier with appointments and obtaining medical documents etc • Case Managers (CM) • Report to DSS • Arrange case meetings, advise CCs as required, develop Medical Action Plan to ensure progression through the prescribed medical plan of care • HSS/Military Providers(State Surgeons/PAs/Dentists) 4

  5. MMPS Process Flow Overview Case Manager(CM) -reviews case - assigns to Care Coordinator (CC) MRNCO -assist SM w records/profiles - BN monthly report - hand off to CM CC continues to - assist SM CC continues to - assist SM - coordinate w CM/MRNCO as needed - coordinate w CM/MRNCO as needed 0 MO NLT 3 MO NLT 6 MO NLT 9 MO NLT 12 MO Temp profile written (issue found by self report, PHA, PDHA, PDHRA) Case meeting #1CMD/SS/G1 and CM Case meeting #2 CMD/SS/G1and CM Case meeting #3 CMD/SS/G1 and CM MRDP Not reached MRDP ? May get ONE TIME temp prof extension per SS Each case meeting assures: 1)temp profile updated as warranted 2)eval for AD orders for medical care (WTU/RCMC) 3) evalfor MMA assignment (option for CMD) 5

  6. MMPS Process - IDES Reporting MRNCO -assist SM w records/profiles - BN monthly report - hand off to CM Case Manager(CM) -reviews case - assigns to Care Coordinator (CC) CC continues to: assist SM coordinates with CM/MRNCO as needed 0 MO 2MO 4MO 6MO 8MO 12MO MRDP Case meeting #1 Case meeting #2 Case meeting #3 Case meeting #4 SM issued temp profile Profile issued or RTD CO CMD participation BN CMD participation BDE CMD participation SNR CMD participation (BN)MRNCO – performs monthly report for Commands Per IDES EXORD:T3/4 profile/status review to CMD 6

  7. MMPS Process MRNCO -assist SM w records/profiles - BN monthly report - hand off to CM Case Manager(CM) -reviews case - assigns to Care Coordinator (CC) assist SM coordinate w CM/MRNCO CC continues to: 0 MO 2 MO 4 MO 6 MO 8 MO 12 MO Case meeting Case meeting Case meeting Case meeting SM issued temp profile MRDP Medical Retention Decision Point (SM RTD and/or gets permanent profile) Case meeting agenda: 1) temporary profile reviewed 2)evaluate for WTU/RCMCactive duty orders for care* 3) evaluate for Medical Management Activity assignment * *Requires acknowledgement from: CMD/SS/G1 and CM* 7

  8. Active Duty Options for Medical Care 1)Reserve Component Managed Care (RCMC) • RCMC-Mfor mobilized (OCONUS/T10 illness/injury) • RCMC-T for training (CONUS AT or IADT illness/injury) • 2)Warrior Transition Unit (WTU) • ADME (CONUS AT or IADT illness/injury) • MRP2 (OCONUS/T10 illness/injury)

  9. Active Duty Options for Medical Care • 1)Reserve Component Managed Care (RCMC) • Currently an ARNG pilot program (14 states) • State Managed orders for local care of simple/low complexity medical conditions • Orders for up to 179 days of medical treatment with a goal of condition resolution • NOT for: complex cases • issues found NOT in the Line of Duty

  10. Active Duty Options for Medical Care • 2) Warrior Transition Unit (WTU) • Packets submitted for placement into a WTU for full time care/treatment as determined by provider diagnosis and treatment plan. For complex medical care and/or care that will take more than 6 months to complete 9

  11. M-Day Options for Medical Care • IN Line of Duty: • LODDetermination period - initial evaluation to obtain a diagnosis and/or stabilization of emergent condition. This is at no cost to the Solider UNTIL an LOD determination is made. • Treatment period - for any illness/injury that is found In Line of Duty a Solider can obtain medical care (coordinated through Health Service Support (HSS) section through the Military Medical Support Office (MMSO). • INCAP – to cover gaps between/while awaiting medical orders or for Soldiers receiving medical care (cannot perform civilian job). Applied for retroactively. • PDHRA funds cover pay and travel for the day of a medical appt for a post deployment medical issue. (Limited to seven visits). 10

  12. M-Day Options for Medical Care • NOT in Line of Duty: • TRICARE Reserve Select – SM purchased health insurance to obtain care for medical issues that ARE NOT ILD. Premium = $53.16/mo. • * MAXIMUM out of pocket cost in 1yr = $1000.00/family member for any injury or illness incurred.

  13. MMPS vs MMA MMPSMMA • Medical Management Activity - Soldiers with medical issues that will most likely be separated from service are candidates for the MMA • Two elements of the MMA: • 3 cadre (admin supervision/support) • Main body (Soldiers with ongoing medical treatment or board action followed within MMPS) • Soldiers selected for the MMA: • assigned to vacant positions within the MMA host command (e.g. JFHQ/Med Det/Troop Cmd) or to a dedicated paragraph number via the Temporary TDA process (to create unit vacancies for backfill). *Case management system* *Para/line assignment* • A decision making process which provides direction for case management of Soldiers with unresolved medical issues or conditions to assist in achieving medical recovery and increase unit readiness. • Focuses on assisting medically non-available Soldiers to reach a final disposition of their medical condition. • Case management team includes: • Medical Readiness NCOs (MRNCO), Care Coordinators (CC), and Case Managers (CM).

  14. THE END CPT Paul TumminelloARNG Office of the Chief Surgeonpaul.d.tumminello@ng.army.mil703-607-7146

  15. Edited by Alex The Army Dog Productions

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