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Identifying the
population age distribution “pie” is the 1st step to developing a
business case analysis (BCA) to ensure you have the right resources,
especially in competition with everyone else. The key is to list how all your
military treatment facilities (MTFs) are the same, before you start figuring
how they are different from others. The first way to compare facilities is to
determine the population mix, to include those over 65 years old who are
worth more ‘equivalent lives’ and so require more resources to care for them
(the optimization model in 2003 suggested they require 10 visits per year, or
2.5 more resources Vs the 4 visits for younger adults) and the newborns and
infants (who require well-baby visits and therefore 2x the support). The
acuity, or illness severity, of a given population may increase (or decrease)
the overall demand for healthcare, even for active duty if the post truly has
a unique mission(s) (I.e. Ft. Bragg – jumping out of perfectly good
airplanes, will likely need more FTEs of orthopedics). It is exceedingly
important to not only count the TRICARE Prime enrollees (E=AD and their
dependents) currently enrolled at your DMIS-code MTF, but also the (1) number
of AD trainees (T) that depend on your MTF for care (because while they are
registered in DEERS they are NOT enrolled to any given MTF until they pass
initial training and are assigned somewhere); (2) the non-TRICARE prime
(space-available) users (NP) the command is allowing in for care; and (3) the
TRICARE Prime enrolled-elsewhere users (EE) being seen at the
facility, and any “other” unusual populations that by regulation or policy we
are caring for (I.e. overseas seeing embassy patients). 1,2, 3 and “others” visits should be
divided by ‘4’ (the average number of visits our patients utilize each year)
to come up with the number of “1.0 FTEs” of population count that needs to
have FTEs of provider team to care for them! Once the truly reliant population
and their needs are identified, you can move on to figure how much gap there
is in resources to see them, and align resources (and funding) accordingly.
(What you can’t see with quality should be sent to the network!)
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