2010 ubo/ubu conference health budgets & financial policy 1 briefing: dq statement roundtable...

2010 UBO/UBU Conference

Health Budgets & Financial Policy

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Briefing: DQ Statement Roundtable

Date: 25 March 2010

Time: 1010–1200

2010 UBO/UBU ConferenceTurning Knowledge Into Action

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Objectives

Purpose of the DQMC Review List and DQ Statement Roundtable– Increase community awareness

Background and historyTMA Data Quality Management Control (DQMC)

Program – Introduce Service initiatives– Discuss issues

2010 UBO/UBU ConferenceTurning Knowledge Into Action DQMC Background & History

Why Worry about Data Quality?

One reason is external scrutiny...

DoD IG GAO

AuditAgencies

Congress

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2010 UBO/UBU ConferenceTurning Knowledge Into Action DQMC Background & History

TMA DQMC Program improves data quality and ensures that the MTF receives credit for properly recorded workload.

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DQMC Background & History

Typically Data Quality is formulated as an IT problem– Errors in transmission– Errors in processing– Unsynchronized databases

But our most difficult problems with data quality are often not directly attributable to IT, nor readily fixed by IT solutions– Standardization of business rules and policies across

Services, between agencies– Inconsistency of choices for codes, weights, and

algorithms– Expectations of low data quality


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Data Quality Management Control (DQMC) Program was created to alleviate DoD IG’s identification of material management control weaknesses within MHS– DoD IG report concerning the FY 1998 Retirement

Liability Estimate– GAO Medicare Subvention Demonstration report

Elements of the DQMC Program– TMA DQMC Program, collaboration between

TMA POC 3 Service POCs

– Policy Memorandum (29 Nov 2000)– DoDI 6040.40 (26 Nov 2002) updated annually

DQMC Review List Data Quality Statement


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Start with the DQMC Review List– Enclosure 1 of DODI 6040.40

Monthly Data Quality Statement – Subset of DQMC Review List sent to Service DQ

managers and the TMA DQMC Program Manager [Enclosure 2 of DODI 6040.40]

– Commander approval– Used to create TMA Summary

Tri-Service view of dataBriefed to both the Resource Management Steering

Committee (RMSC) and TMA Senior Leadership and Service DSGs (CFOIC), twice a year


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How are these metrics used?– Timely feedback to the Commanders about the quality

of their data– Discussed monthly at DQMC Workgroup meetings

Service DQ POCs and TMA meet at TMA-MC&FSService and TMA wide issues discussed and

documented

– Posted on the TMA – OCFO, MC&FS – Web site, DQMC Web pagehttp://www.tricare.mil/ocfo/mcfs/dqmcp.cfmMetrics & ReportsImportant reference material


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TMA Comments

Example of the TMA Summary Sheet


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TMA Comments

Metric Standards (colors) are as follows:Green – 95-100

Yellow – 80-94

Red – 0-79 Except for 8e and 9, which is Green for 80 and above 3c, 3d, and 10a do not yet have a standard – no color

Metric colors – Generally move from red status to green status over the

fiscal year, indicates data quality matures over the year– Sometimes “RED” is good, revealing a system-wide

problem– Sometimes there is no coloring to indicate a new question

or one for which a goal is not yet established


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Example of TMA Summary –FY10 Metric Questions


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Example of TMA Summary –FY10 Metric Questions


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TMA Comments

TMA Initiatives this year– Added DMHRSi questions (DQ Statement 3d and 3e)– Clarified existing questions to strive for tri-Service

uniformity in answers– Removed one question

DQ Statement question 1a – close every clinicReplaced with what was 1b – close every record


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Army Comments

Data Quality Management Control (DQMC) Program Review– Defense Medical Human Resources System-

internet (DMHRS-i)MTFs submitting MEPRS data without 100% of

personnel timecards. DMHRS-i allows for Medical Command level review

of what MTFs are submitting for timecards.Army MTFs will be penalized under Performance

Based Adjustment Measures for not meeting monthly MEPRS submission date. Penalty is $10.00 per available FTE per reporting month.


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Army Comments

– Other Health Insurance (OHI), DD Form 2569Currently no Army wide solution for development of

an electronic DD Form 2569.Army sites using a contracted vendor to identify

beneficiaries with OHI have reported increase in beneficiaries identified with OHI .

Army sites using outside vendor reporting increased revenue collections.

Army Medical Command considering several different models for Third Party Collections.


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Army Comments

– Coding Army using Code Auditing and Reporting Application

(CARA).Coding audits conducted under Patient

Administration Systems and Biostatistics Activity (PASBA) oversight.

CARA coding results will be incorporated into Army Production Based Adjustment Model.

CARA results will be used by all Army MTFs to populate DQMC Program DQ Statement.

– DQMC Program Changes for ArmyNew Web-based application, to include Web-based

Review List.Added three Army-only questions to DQ Statement.

2010 UBO/UBU ConferenceTurning Knowledge Into Action Navy Comments

References– Navy FY10 DQMC Guidance

10% Improvement Required in DDFM 2569 Collection for Outpatient Encounters

– Inpatient and APV Records DDFM 2569 Required on Admission, MANMED Chapter: ????

– Coding Timeliness, Coding AccuracyAudit policy is in concert with Patient Administration

Standard Audit Guidelines

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2010 UBO/UBU ConferenceTurning Knowledge Into Action Navy Comments

Data Quality Assurance Teams at all levels– BUMED

Program Manager, Provide Policy – Regions: NCA, NMW, NME

Monitor Execution, Training/Assist Visits – MTF

Program Execution and Reporting– NMSC

NAVMISSA/EDQ Web site and IT Support

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

FY Average DDFM 2569 Availability in the Medical Record

FY09

FY08

FY07

FY06

FY05

FY04

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•Although improving, Red is Red•Drilling down to some MTFs shows the opposite

Navy Comments


• What Can You Do to Improve

• Stop doing the MINIMUM Requirement

• Enhance your local program• Use technology to help

• Report Accurately• Use the comments section to

report.• Don’t just explain the issue• It’s up to you to fix or

request help• Don’t be afraid to be Red

• It simply means “we have an issue”

• Sometimes you have to lose a battle to win the war

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WK DATE OPPONENT Score

1 13-Sep JACKSONVILLE JAGUARS 14 - 12 W

2 21-Sep @ Miami Dolphins 27 - 23 W

3 27-Sep @ Arizona Cardinals 31 - 10 W

4 4-Oct SEATTLE SEAHAWKS 34 - 17 W

5 11-Oct @ Tennessee Titans 31 - 9 W

6 18-Oct BYE -

7 25-Oct @ St. Louis Rams 42 - 6 W

8 1-Nov SAN FRANCISCO 49ERS 18 - 14 W

9 8-Nov HOUSTON TEXANS 20 - 17 W

10 15-Nov NEW ENGLAND PATRIOTS 35 - 34 W

11 22-Nov @ Baltimore Ravens 17 - 15 W

12 29-Nov @ Houston Texans 35 - 27 W

13 6-Dec TENNESSEE TITANS 27 - 17 W

14 13-Dec DENVER BRONCOS 28 - 16 W

15 17-Dec @ Jacksonville Jaguars 35 - 31 W

16 27-Dec NEW YORK JETS 15 - 29 L

17 3-Jan @ Buffalo Bills 7 - 30 L

18 10-Jan BYE -

19 16-Jan BALTIMORE RAVENS 20 - 3 W

20 24-Jan NEW YORK JETS 30 - 17 W

21 7-Feb NEW ORLEANS SAINTS 6:30 PM

2009 REGULAR SEASON

Navy Comments

2010 UBO/UBU ConferenceTurning Knowledge Into Action Air Force Comments – HAF

AF Organizational Structure – HAF (policy) – AFMOA (execution)

Data Quality Manager’s User Guide (MUG)– Primary AF guidance to support AF DQ Manager’s – Clarification of all DQ Statement Questions

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Air Force Comments – AFMOA

DQFoundation

DQ Umbrella


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Roundtable Topics

Are you providing the DQ Manager at your MTF the information needed?– DQMC Review List applicable to UBO

A.6, B.4, C.5, C.6, C.7, E– DQMC Review List applicable to UBU

A.5, B.4, B.6, C.2, C.5, C.6, C.7, E What are the pitfalls to collecting updated DD-2569s

(Other Heath Information (OHI))– Civilian clinics won’t treat without full insurance

information, including OHI

2010 UBO/UBU ConferenceTurning Knowledge Into Action Roundtable Topics

DQ Statement Metrics – FY 2009 data

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Roundtable Topics

Late tables. Are you coding when you shouldn’t be? Are you attempting to bill?– FY10 ICD-9 code table updates were delayed– Must wait for the table update before completing

SIDRs and grouping



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What are your success stories?

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2010 ubo/ubu conference health budgets & financial policy 1 briefing: dq statement roundtable...

Documents

dqmc program tma dqmc

tmamcfs service

tma poc

tma ocfo

dqmc review list enclosure

tma summary sheet slide

tma comments example

tma wide issues