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TRICARE Regional OfficeBusiness Planning &

the Direct Care System

CAPT William PerryBusiness Operations

TRO-S

25 August 2004

CAPT Elizabeth NelsonBusiness Operations

TRO-N

(pls insert logo)

COL Douglas DudevoirBusiness Operations

TRO-W

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Introduction

Overarching Theme of Presentation

How TROs Can Assist Services and MTFs with Business Plans

Information required from Services and MTFs

Suggested Next Steps to Improve the Process

TRO Business Planning POCs

Summary / Discussion

Outline

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Overarching Themes in Presentation

Provide ideas for how TROs can assist the services and MTFs in business plan development, modification and execution.

Indicate what information TROs will need

from the Services and the MTFs to do so effectively. 

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TRO Assistance to Services/MTFs

Business plans and initiatives ID opportunities for optimizing care in the MTFs and

assist as indicated ID venture capital opportunities reflected in the MTF

and MSMO business plans Serve as a forum for the identification and sharing of

good ideas Provide assistance as requested by MTFs and

Services in analyzing business plan deviations

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Liaison: Serve as a liaison between Guard, Reserve, Coast Guard, Services/MTFs, HSSC, VA

Medical Provide HSSC medical management data and

expertise to ID focal points for MTF efforts Support GME by encouraging patients with

desired conditions to seek care at MTF

TRO Assistance to Services/MTFs, cont

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TRO Assistance to Services/MTFs , cont

Data Link with HSSC to provide more timely PSC data Monitor private sector care data to ID

Enrollment trends for recaptureAdmission trends to ID medical management

opportunitiesReferral trends to ID increases in demand for early

interventionAssist with analysis and projections (limited)

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TRO Assistance to Services/MTFs , cont

Resource sharing

Work with MTFs, Services and HSSC to ID resource sharing/clinical support opportunities

Assist with development of agreements

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Information Required from Services and MTFs

General – TROs need information necessary to complete business plans and meet responsibilities defined in the Governance Plan to include: Serve as Health Plan Manager Integrate business plans Support MTF Commanders in their efforts to

Optimize Manage Non-MTF Enrollees (NMEs)

Make determinations on venture capital funding “Make recommendations to the Svcs on the flow of dollars” Ensuring Contract support for MTF optimization

xxxx

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Business Plan Information Required from Services & MTFs

MTF and MSMO narratives

MTF plans for Medical Management and the projected capacity to be freed up

MTF benchmarks and plans for improvement in productivity

MTF identification of Resource Sharing / Clinical Support / Staffing Augmentation opportunities

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Business Plan Information Required from Services & MTFs

MTF identification of venture capital initiatives

MTF rationale/linkage between aggregate capacity and FTE trends and explanations of divergent trends

MTF changes impacting health care capacity to include:

MILCON projects (e.g., OR closures)

Service decisions (e.g., Gyn service closure)

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Business Plan Information Required from Services & MTFs

Strategic issues/changes impacting health care delivery in the MTF:

Capacity and capability changes associated with deploying or redeploying staff

Anticipated deferrals/costs to network associated with deploying or redeploying staff

Demand changes in terms of both volume and capability associated with deploying or redeploying units

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Business Plan Information Required from Services & MTFs

Service guidelines on macro level issues such as:

Enrollment levels to include both aggregate and per provider guidance (i.e., beneficiary/PCM enrollment ratios)

Care for other MTF enrollees (to include plans for 65+ pop’n)

Expansion of Space-A care

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Suggested Next Steps to Improve the Process

Service, TRO, and TMA reps should meet in Sept to establish protocols and processes ref Business Planning that will:

Embrace the best ideas from the current “independent process”

Allow the plans to easily build upon one another

Allow for new/transferred personnel to integrate more easily

Convey a seamless coherent message to senior leadership

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Information Required from Services and MTFs

Summary:

Information is critical for us to serve in our support role

Context is everything .. i.e., TROs need to know overarching policy that is driving local decisions (not our job to change them .. just to understand them and work within those parameters)

We only have assets to assist in focused areas … broad understanding of the MHS dynamics will help us assess where we should apply our assets and those of the HSSC to assist MTFs and help us “cowboy up” .. We don’t want the following scenario to become reality … next slide …

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TRICARE Regional OfficesBusiness Planning POCs

TRO-North CAPT Elizabeth Nelson (703) 681-2889 (x6710) LTCOL Roger Price 703-681-2889 (x6702)

TRO-West COL Douglas Dudevoir 619-532-6172 MAJ Linda Guardado-McRandall 619-532-?TBD

TRO-South CAPT William Perry 210-292-3201 MAJ(P) Sharon Pacchiana 210-292-3245

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Summary

Discussion