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FY10 Flag / SES Offsite Business Discussion 5 July 2009

FY10 Flag / SES Offsite Business Discussion 5 July 2009. Agenda. Overview PBB Discussion IT Discussion What works / challenges / other Contracts Discussion Items. PBB…what is it?. Controlled introduction of quality and effectiveness performance elements.

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FY10 Flag / SES Offsite Business Discussion 5 July 2009

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  1. FY10 Flag / SES Offsite Business Discussion5 July 2009

  2. Agenda Overview • PBB Discussion • IT Discussion • What works / challenges / other • Contracts • Discussion Items

  3. PBB…what is it? • Controlled introduction of quality and effectiveness performance elements. • An internal management control tool--links budget to performance. • Will adjust/reallocate funds during execution year (at mid-year) and potentially effect programming years. • Creates incentives for desired performance

  4. PBB FY08-09 Differences 45% 5% 10% 5% N/A PPS IMR EBHC Bed Capacity Public Health Deployment Mitigation PPB FY08 = + + + + + Workload --RVUs --RWPs --MH Bed Days % Indeterminate --MTFs Measures: Asthma Diabetes A1c level Diabetes A1c test Diabetes LDL Breast Screening Colorectal & Cervical Cancer Screening (Shadow) Ratio of beds filled to bed capacity Shadowed: Execution rate of Public Health P.E. Positive adjustment for deployed personnel and correlated to lost PPS workload. 49% 5% 5% 10% 5% Proposed PPB FY09 = PPS IMR EBHC Performance Incentives Public Health Deployment Mitigation + + + + + OB Production Targets -- Birth volume -- In MTF -- Referrals % Indeterminate -- MTFs -- NMSC -- BUMED Asthma -- Spirometry -- Hospital --- Admissions --- ER Visits Perinatal -- 3rd & 4th degree tears -- Readmissions -- AOI (shadow) Tobacco Cessation -- Screening (Y/N) --- Percent users -- Diagnostic (shadow) -- Interventions (shadow) --- Consult --- Prescription

  5. PPS Adjustments

  6. PBB Awards

  7. PBB Awards - HEDIS

  8. PBB Discussion • What are the behaviors we want to incentivize? • Current method: • PAE engages advisory boards, M3 staff, regions / field activities to gather ideas • M3/M8 preview enroute to CEB • Measures must have public data to support • Limited number of measures • CEB approves

  9. PBB Discussion • What are the behaviors we want to incentivize? • For the future: • How broad a discussion do we want? (ownership) • Are advisory boards acceptable? • How / where do we throttle inputs to focus efforts? • How do we react to “gaming”?

  10. PBB Discussion • What are the behaviors we want to incentivize? • Challenges: • Stability vs flexibility • IMR—quality measures? Link to EMPARTS? • Measure-worthy but difficult: • GME • Training • Others??

  11. IT Discussion

  12. FY09/10 Major Procurements $3.56B $3.47B $70M Medical Backfill $43M Medical Backfill $867M Contractors $872M Contractors • Other = Utilities, Rent & Communication; Travel Transportation, Fuels and Equip Maintenance • Includes all sources Budget, OCO, WW, MERCHF

  13. Contracting Discussion

  14. Wrap-up Discussion • How can we improve our contracting processes to ensure seamless support to activities where / when required? • Contracting liaison at regions? • Streamlined / integrated with workload plan, to create an ‘acquisition plan’ for healthcare professionals? (Funding and SOWs could flow from the workload plan….). • Other? • How can we better align resources to limit sub-optimization and ensure integration with deployments, operational requirements, and the benefit mission? • How can we expand ownership of PBB in Navy Medicine? • What are the critical IT issues for the next 18 months?

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