Introduction to Costing with PPM Amanda Oliver2008 PPM User Conference
Overview • Features • Navigation • General Ledger Processes • ETVL Processes • Patient Costing
Features • Java application, browser-based client • Embedded integration engine • Embedded business rules engine • Reporting integrates with other applications • Easy and open access to all data • Web-based reporting and data analysis • OLAP functionality • Email and SMS alerts.
Navigation – Screen Map Current COA & GL Menu bar Function Menu Tab functions Current Function Screen area Screen buttons Status bar Current user
GL Cost Allocation • Centered around Chart of Accounts • Allows users to define hospital-wide standard costing rules • Hospital financial information • Statistical information ― allocating dollars from overhead (non direct patient care areas) to patient care areas • Enables detailed exceptions to the standards when desired • Finalised General Ledger suitable for patient costing (matching dollars to patient activity) • Built-in reconciliation and audit reports.
General Ledger • Import financial information • Cost Centres, Accounts, General Ledger • Import statistical data (overhead allocation) • Bed Days, Admissions, FTE, Floor Area, Cleaning Time, etc • Set up Cost Allocation rules • Non-Standard Cost Definitions (exceptions) • Reclass Rules (move GL values) • Define Allocation Statistics and Assign Statistics • Roll-up Cost Outputs (if required) • Validate GL setup data • Run Validation processes to check integrity of table data • Run GL cost allocation.
Importing Data - Workshop • Select Import at bottom of Cost Centre Definitions screen. • Click … to browse for import file. • Specify a reject file name and location. • Data import:comma delimited with 1 header lines to skip, and“” as a text Qualifier • Fields pertaining to overwriting existing Cost Centre Definitions set to Always.
Importing Data - Workshop • Select Import at bottom of General Ledger screen – allows 1-3 import files • Click on ellipsis to browse for import file • Specify a reject file name and location • Data import:comma delimited with 1 header lines to skip, and”” as a text qualifier.
Setup Validation - Workshop • Tick Run boxes for processes 1-6 • Select Run • View Report for Cost Centre Definitions • In Cost Centre Definitions screen enter details for new Cost Centre • Tick Run box for process 1 and select • Tick Run boxes for process 7.
ETVL Module • Processes data from various information systems into PPM patient database • Data used by Patient Cost Allocation module to allocate dollar amounts from General Ledger Module • Patient Activity matched to dollars from providing Patient Care Area • Detailed patient costing.
ETVL • ExtractionImport data from source systems • TransformationPerform any necessary data transformation • ValidationEnsure data quality • Data LoadLoads and links data into PPM data repository.
Create New Interface • No limit to number of Interfaces that can be implemented • Sites decide what constitutes a separate interface • Data Junction translations are written for each interface.
Extraction and Transformation • No pre-specified import format • ETVL performs all required field calculations ― OBDs calculated from Ward Transfer file • Allows users to compare imported values internal reference tables ― ICD-10 • Logic to link external feeder system data to episode of care.
Extracting Data - Workshop • From Interface drop down menu, select 2. Patient Data Load • Select Run • Select Audit and view results.
Validation Two types of validation rules: • FormulaUser-defined formula that combines logical and conditional flows • Reference tableValues for a given field checked against values stored in reference table.
Validation Rules Define data fields as critical or non-critical for reporting purposes Validate data against internal reference tables Review expected results for a single patient during setup
Loading Data - Workshop • In Load data tab, select Load. • View results displayed on screen.
Scheduler • Automate various processes within PPM • Set up queue of batch jobs in pre-defined order • Run queue manually, or automatically at specified times • Monitor progress of queue while running • Review log of jobs.
Patient Cost Allocation Module • Brings together data from ETVL and General Ledger Modules • Patient activity from ETVL matched to dollars from providing Patient Care Area in General Ledger • Detailed and flexible cost allocation methodologies • Weights and volumes • Integrated reconciliations between General Ledger and Patient Cost Allocation processes.
Patient Costing • Define and map Service Codes • Patient Database Configurations • Build Patient Database • Allocate Costs • Calculate Weighted Activity • Reports.
Database ConfigurationDatabase Filter Define filters for the database: • Date ranges for episode and service data • Patient types • Specific hospitals.
Database ConfigurationDRG Weight File • Data imported via CSV file • Allows for DRG weights to have an effective date range • Manage situations where weight changes occur during financial year • Only needs to be imported into PPM once.
Database ConfigurationDetailed Weight File • Data imported via CSV file • Allows for Detailed Weights against individual Service Codes within various patient care areas • Internal weight studies • Allows effective date ranges.
Allocated by Cost Outputs • For each cost output defined in GL process, a volume and allocation statistic can be defined • These default rules are applicable for each Cost Output across all Areas, UNLESS exceptions to these rules have been defined in • Allocate by Patient Care Area • Allocate by Detailed Definition • Useful as default to allocate expenditures from an area that cannot be costed otherwise due to lack of activity.
Allocated by Patient Care Area • Optional screen • Overrides Allocated by Cost Outputs • Each Patient Care Area can have Volume and Weight measure assigned • Useful when an entire Area is costed the same across all Cost Outputs • Eliminates entering significant amount of details when unnecessary.
Allocated by Detailed Definition • Optional screen • Overrides Allocated by Patient Care Area and Allocated by Cost Outputs • Enables defining of standard allocation rules for each Patient Care Area and Cost Output combination: • Most detailed costing methodology level.
Weighted Activity • Select ReportSelect Costing Reconciliation by Area • View how results link back to GL Cost Allocation • Reports: • Costing Reconciliation by Area • Weighted Activity Reconciliation • Unweighted Activity Reconciliation • Patient Cost by Area • Weighted activity by Cost Output • Average Cost per Service Code.
Outputs – Digital DashboardLOS < 2 Days, Total Cost > $10,000 • Identify unusual cases to determine why high costs incurred for such a short length of stay • Filter to exclude factors such as patients transferred to another organisation or deceased discharge status
Conclusion GL Process • Import financial and statistical data • Setup cost allocation rules including reclass rules and non-standard cost definitions • Allows for GL setup validation ETVL Process • No pre-specified import format • ETVL performs all necessary calculations • Logic to link external feeder systems data to correct episode of care.
Conclusion Patient Cost Allocation • Define Service Codes and mappings • Filter database: • specific date ranges of episode & service data • patient types and/or • specific hospitals • Define specific cost allocation rules by ― cost output, patient care area or detailed definition • Detailed weighted activity reports easily generated.