* FY2001 through FY2004 from DoD Component Summary of PB FY2004-2005.

Metric Description. Civilian force costs are currently being reported annually to the Office of Personnel Management (OPM) in a Work Years and Personnel Costs Report (WYPC). Reports are required on three forms: Basic and Premium Work Years and Pay; Cost of Employees' Benefits; and Leave Earned and Used. Work years and cost data identifythe various components of basic pay, premium pay, benefits, separation incentive pay, and severance pay for federal civilian employment. (These elements are defined below.) This metric can be used to provide a broad overview of civilian compensation costs. It is not an effective measure of the success of any individual personnel program or benefit. For example, additional benefit costs do not indicate successful use of recruitment or retention incentives. Even increased recruitment bonus or retention allowance payment amounts would only measure usage rates, not the change in recruitment or retention based on payment of the incentive.

The following definitions are provided for the reader:

Basic Pay (identified by Office of Management and Budget (OMB) Object Classes 11.1 and 11.3) represents the aggregate personnel compensation for full-time permanent, full-time temporary, and part-time/intermittent appointments.

Premium Pay (identified by Office of Management and Budget (OMB) Object Class 11.5) represents personnel compensation for the following premium pay categories: Overtime, Holiday, Sunday, Night Differential, Hazardous Duty, Post Differential, Staffing Differential, Supervisory Differential, Physicians Comparability Allowance, Remote Work Site Allowance, Cash Awards, and Other.

Benefit Pay (identified by Office of Management and Budget (OMB) Object Class 12.1) represents personnel compensation for the following benefit pay categories: Health Insurance, Life Insurance, Retirement, Social Security, Workers' Compensation, Uniform Allowances, Overseas Allowances, Non-Foreign COLA, Retention Allowance, Recruitment Bonus, Relocation Bonus, and Other.

Separation Pay (identified by Office of Management and Budget (OMB) Object Class 13.0) represents personnel compensation to involuntarily separated employees and payments made through the $25,000 Voluntary Separation Incentive (VSI) Program (i.e., Buyout Bonuses, etc.).

V&V Method. OPM indicates that "Agencies should establish appropriate internal coordination procedures to ensure that the data is reconciled." Data on payments are compiled by component and object class from the Defense Finance and Accounting Service payroll records. Data input into the system are subject to stringent time and accounting rules and procedures.

Performance Results for FY2002. The OPM report will be published in December 2003.

Performance Metric: Outpatient-market share (lagged indicator)

(lagged indicator)

· Data were not mapped according to clinic market areas in FY1998, so actual number are not available.

b While data are available for FY2001 results, no target was ever established.

The metric calculation was changed only in FY2002, so the FY2002 target is not comparable.

Metric Description. Outpatient visits represent the majority of contacts between the Military Health System (MHS) and its beneficiaries, and accordingly, the market share metric looks at how much of the care is delivered in the direct system rather than being purchased. Since there is a large fixed cost of manpower related to the medical readiness mission, it is vital for proper program management to utilize these resources efficiently and effectively during peacetime operations. The goal is to initially stabilize market share around the Military Treatment Facilities (MTFs) and eventually recover market share losses that have occurred over the last couple of years related to changes in clinic capabilities.

Although medical care can be purchased at numerous locations throughout the United States and world, the focus of this measure is on locations around MTFs in the United States. The locations are around both bedded hospitals and outpatient care clinics. Due to the extensive medical capabilities of the hospitals compared with ambulatory clinics, the market share percentage will vary by MTF and Military Service. Hospitals are judged on 40-mile radius areas, and clinics are judged on 20-mile radius areas.

Over the past couple of years, the downsizing of small hospitals into ambulatory care clinics has affected the clinical capabilities of these facilities, and market share has decreased. This reduction is expected to continue for the next couple of years until the direct care system stabilizes.

Market share percentages for the Services are shown based on direct care visits compared to total purchased care plus direct care visits within the Service's hospital and clinic areas.

Due to claims processing times, purchased care workload is projected to completion 6 months after the fiscal year ends; final results will not be available for approximately 3 years. Purchased care workload does not place care delivered overseas into hospital or clinic areas, so overseas workload is excluded. To ensure consistency across the program years, purchased care excludes all resource sharing, supplemental care, continued health care benefit plan, and senior (age 65+) purchased care workload. Since data will not be available until 6 months after fiscal year end, this will be a lagging indicator.

As the MHS migrates to improved clinical comparability, this metric will be migrated to a measure based on relative value unit (RVU)' to more accurately compare the relative complexity of care instead of just a visit count. When this change occurs, the metric will have to be recalibrated, and new goals will have to be established.

V&V Method. As part of an agreement with the General Accounting Office, the Defense Health Program has established a Data Quality Management Control Program, which requires MTF commanders to certifymonthly that systems and processes are working properly. This is the source of data on direct care visits.

Purchased care claims go through extensive automated clinical coding reviews prior to processing for payment. Once processing is completed, zip codes are mapped to the data to define hospital and clinic areas. Due to claims processing and adjudication lag times, the workload data are projected to completion; and final numbers will not be available for approximately 3 years.

Performance Results for FY2002. Due to claims processing, results will lag actual performance by 6 months and will still be a projection until 3 years after the end of the fiscal year. This lag is related to the individual's submission of the claim and multiple adjudication issues once the claim has been submitted.

The RVUS approximate the physician resources used during the visit. For example, a returning visit by a patient with a simple problem might be 0.17 RVUS, whereas arthroscopic surgery of the knee might be 16.00 RVUS.

*FY1999/FY2000 clinical data are incomplete and not comparable to FY2001 and later.

The FY2002 target included overseas medical facilities and did not discount nurse practitioners and physician assistants. Accordingly, it is not comparable to FY2003 and later targets.

* FY2002 data were incomplete for Damall Army Community Hospital-Ft. Hood. Accordingly, estimates were used for the last 2 months of the fiscal year for this facility.

Metric Description. To run a premier Health Maintenance Organization (HMO), the critical focus area is primary care. The primary care provider frequently represents the first medical interaction between the beneficiary and the HMO. In this role, the primary care provider is responsible for the majority of the preventive care to keep beneficiaries healthy and away from more costly specialty care. While the HMO has a goal to reduce the overall number of encounters per beneficiary, an additional goal is to ensure that the dollars spent on medical care are used efficiently.

The targets for this metric represent stretch goals that were instituted to move the organization forward, but likely will not be achieved in FY2003 or FY2004. This metric looks at the complexity of care and the number of patients seen by the primary care providers each day, with a goal of increasing the complexity, number, or both, of patients seen each day by the provider. To measure the complexity of care, and not just the count of visits, the relative value unit (RVU) is used. Developed by the Centers for Medicare & Medicaid Services, the RVUS approximate the physician resources used during the visit. (For example, a returning visit by a patient with a simple problem might be 0.17 RVUs, whereas arthroscopic surgery of the knee might be 16.00 RVUS.)

Due to the nature of this data reporting, the metric results will lag the actual performance by one quarter.

V&V Method. As part of an agreement with the General Accounting Office, the Defense Health Program has established a Data Quality Management Control Program that requires Military Treatment Facility (MTF) commanders to certifymonthly that systems and processes are working properly. Two of the sections of the program are relevant to this metric. The first deals with a records review to ensure that records are coded properly, and the second is related to proper and timely reporting of manpower data.

Performance Results for FY2002. Improving productivity of primary care providers is a key performance objective for the Defense Health Program, and although the goal for FY2002 was not achieved, a better understanding of the objective and how to measure overall performance was achieved. For FY2003, the calculation of the metric was changed to focus on MTFs within