Medical Management Guide, 2009, Version 3.0 - Tricare

Medical Management GuideVersion 3.0Medical Management ToolsPage 139• Top 25 CPT for Same Day Surgery for ActiveDuty• Top 25 DRG by Case Weighted Product forActive Duty• Top 25 DRG by Frequency for Active Duty• Top 25 ICD-9-CM for Non-Same Day Surgeryfor Active Duty• Top 25 ICD-9-CM for Same Day Surgery forActive DutyThese reports are available for all DoD and VAregional commands and medical facilities. Data areposted once a year, usually in January or February,for the previous fiscal year.7. Military Health System Population Health Portal:*Restricted access• Chlamydia screening• High cardiovascular risk• Lipid riskBy generating provider-level action lists of patients,the Portal enables risk stratification and targetingof provision of services to the enrolled population.The ability of the Portal to identify individuals whoare considered “high utilizers” directly supports MMactivities and encourages collaboration betweenUM, CM, and DM.The Portal also assists in the evaluation of the MMprogram by providing:• Aggregate measures (e.g., HEDIS ® ) to assess theperformance of a branch clinic or MTF.• Action lists to enable other critical analyses atthe patient, provider, clinic, or MTF level.The Military Health System Population Health Portal(MHSPHP) allows MM professionals to identifyand assess their populations, forecast and managedemand, and provide evidence-based care toindividuals needing clinical preventive services andDM. Although the tool has a common log-in page,each Service has a unique name and home pagefor its application — the Army Population HealthInformation Connection, the Navy Population HealthNavigator, and the Air Force Population HealthPortal.This tool provides patient demographic informationand identifies patients requiring clinical preventiveservices, including but not limited to:• Cancer screeningo Breast cancero Cervical cancero Colon cancerHealth Assessment Review Tool — formerlyHealth Enrollment Assessment ReviewThe Health Assessment Review Tool (HART),formerly known as the Health EnrollmentAssessment Review (HEAR), is a DoD automatedhealth assessment tool. Information from the HARTcan be used to help establish prevalence of healthrisk behaviors and to set MM priorities accordingly.CD-ROM Resource MMT-2 describes variousaspects of the tool, and CD-ROM ResourceMMT-3 records the change from HEAR to HART perthe Assistant Secretary of Defense for Health Affairs(ASD [HA]) in 2005.