Medical Management Guide, 2009, Version 3.0 - Tricare

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Page 140Medical Management Tools Version 3.0Medical Management GuideMHS InsightMHS Insight is an exceptionally powerful yet easy-touseMHS performance management tool to supportthe periodic review of performance measures toactively manage business, operational, and clinicalactivities from the ASD (HA); the TMA; and theArmy, Navy, and Air Force medical departments(including local MTFs, intermediate Commands, andheadquarters). This Web-based solution improvesthe ability of the MHS to set, monitor, and achievestrategic performance goals; and to quickly andaccurately communicate performance informationto all levels of the MHS. Contact your supervisor ordepartment head for more information.Prospective Payment SystemThe Prospective Payment System (PPS) is a modular,performance-based budgeting system that facilitatesthe ability of the MHS to provide incentives andfinancial rewards for efficient management. Eachmodule of the application is designed to leverageinformation technology that has already been builtby the Services as part of their business planning.Protected Health Information ManagementToolThe Protected Health Information ManagementTool (PHIMT) is a Web-based application that assistsin complying with the HIPAA Privacy DisclosureAccounting requirement. It enables the MHS tosimplify its compliance tasks and reduce associatedcosts through the use of sophisticated HIPAAprocess automation features and centralized datamanagement.Information on the PHIMT is available through theTRICARE website at http://www.trow.tma.osd.mil/TMAPrivacy/hipaa/hipaacompliance/tools-training/PHIMT.htm.To obtain access to the tool, contact EIDS@mhshelpdesk.com.SERVICE-LEVEL INFORMATION SYSTEMSThe Army, Navy, and Air Force have developedService-specific websites that providemeasures supporting the Defense HealthProgram (DHP), as well as other measures of interestfor MM. The tools described below allow Service-,regional-, and MTF-level views of their respectivemeasures, to assist MM teams in extracting relevantmeasures to support their MTFs’ MM and businessplans.• Army — The Army’s Office of the SurgeonGeneral (OTSG) maintains a dashboardof clinical and business measures on theCommand Management System (CMS), and theMedical Operational Data System (MODS).MODS provides the Army Medical Department(AMEDD) with an integrated automation systemsupporting all phases of human resource lifecycle management during both peacetime andmobilization. It provides Commanders, staff,and functional managers of AMEDD organizationswith a real-time source of informationon the qualifications, training, special pay, andreadiness of AMEDD personnel. Measures areavailable from the MEDCOM level to the childDefense Medical Information System (DMIS)
Medical Management GuideVersion 3.0Medical Management ToolsPage 141level and are presented in a red-amber-greenstoplight with contributing data available fordownload. Access to the site is restricted tothose with a CAC: https://cms.mods.army.mil/.• Navy — In direct support of Tri-Service businessplanning, and of the Navy’s PerformancebasedBudget (PBB) and current MM policy, thePopulation Health Navigator (PHN) dashboarddisplays clinical quality performance datagenerated by the MHSPHP. In addition to theHEDIS-like performance measures, other clinicalPBB measures are also displayed. The PHNdashboard design allows for benchmarkingwith Navy and external standards as well as forcomparisons with children’s healthcare clinics,Navy Medicine regions, or similar MTF types.Access is restricted to those with a CAC:http://www-nehc.med.navy.mil/Data_Statistics/Clinical_Epidemiology/pophealthnav.aspx.assessment)o Financials (business plan, primecontainment).A significant innovation is the "Push Report,"a feature on the SG/EGL website that allowscustom reports to be pushed directly to Air Forcecustomers’ email inboxes. These reports contain thesame information as what is available on the EGLwebsite, but the data are sent in an attachment sousers receive updated information when the site isrefreshed.SG/EGL and Virtual Analyst have becomethe benchmarks of Web-based performancemeasurement improvement efforts within the AFMS.Access is granted through a ".mil" domain. Ausername and password are required to enable fullnavigation: https://www.egl.afms.mil andhttps://eglva.afms.mil.• Air Force — The Air Force Medical Service(AFMS) offers the Surgeon General ExecutiveGlobal Look (SG/EGL) and the SG/EGL VirtualAnalyst, which provide performance measuresfor all Air Force MTFs. Each of the SG/EGLmeasures directly supports the objectivesand initiatives of the Air Force SG and MajorCommand (MAJCOM) Surgeons General (SGs)for each MTF in the AFMS. The tool tracksmeasures such as:o Readiness (dental and individual readiness)o Quality HEDIS ® measurements on cancerscreenings, diabetic management, andchildhood immunizations)o Efficiency (access and coding)o External customer service (deliveryBUSINESS PLANNING TOOLSAs discussed throughout this Guide,developing a clear and coherent businessplan is a central function of today’sMM programs (see also Section I, MedicalManagement Essentials).Tri-Service Business PlansBusiness plans consist of the following four primarysections:1. Enrollment Forecasts2. Inpatient Demand and Workload3. Outpatient Demand4. Workload and Manpower Requirements
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Medical Management Guide, 2009, Version 3.0 - Tricare

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