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Understanding Meaningful Use - 26Feb2010
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Understanding Meaningful Use - 26Feb2010

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Wondering about the meaning of Meaningful use? Pulse offers a brief overview of the forthcoming Meaningful Use requirements and what you need to do as a physician to be eligible to receive ARRA ...

Wondering about the meaning of Meaningful use? Pulse offers a brief overview of the forthcoming Meaningful Use requirements and what you need to do as a physician to be eligible to receive ARRA Stimulus money when it becomes available.

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Understanding Meaningful Use - 26Feb2010 Understanding Meaningful Use - 26Feb2010 Presentation Transcript

  • ARRA HITECH Meaningful Use Update
  • What Does it All Mean to You?
    Two programs with substantial incentive payment programs
    Medicare offers up to $44,000 per physician
    Medicaid offers up to $63,750 per physician
    Non-participation leads to reimbursement penalties
    1% penalty in 2015
    2% penalty in 2016
    3% penalty in 2017
    5% penalty in 2019
    Qualification requires:
    Certified Complete EHR
    Meaningful Use
  • What Do Physicians Need to Do?
    2010 2011
    2
    3
    4
    5
    1
    Choose a Certified Complete EHR
    Utilize all meaningful use measures for at least 90 consecutive days
    Choose Medicare or Medicaid incentive program
    Attest to meaningful use and name of Certified Complete EHR
    Implement and train usage to all meaningful use measures
    Receive first payment
  • Lots of Questions
    How will I prove I’m meeting Meaningful Use measures?
    How long do I have to prove Meaningful Use measures?
    How will I prove I’m using a Certified Complete EHR?
    Will the incentive payments be made to physicians or practices?
    How often will payments be made?
    Which incentive program is best for me…Medicare or Medicaid?
    What if my local HIE isn’t live yet?
    Many questions are ready to be answered today, this presentation will address many of the most common questions encountered.
  • When will it all be finalized?
  • Where Is It All Leading?
    2015
    2013
    2011
    Enable significant and measurable improvements in population health through a transformed delivery system.
    Adapted from Health Information Technology Meaningful EHR Use Workgroup, June 16, 2009
  • Building An Electronic Healthcare Network
    Personal Health Records
    Health Vault/Google Health
    Electronic Health Records
    Certified Complete EHR
    $20 billion Incentive payments available
    Health Information Exchanges/Regional Health Information Organizations – Connecting Patient Data within Medical Trade Areas
    $564 million grants issued Feb. 12th, in all 50 states
    National Health Information Network – A network of networks
    HIE grants earmarked with NHIN funding
    SureScripts™ - National clearing-house for prescriptions
    Regional Centers – Consulting with Primary Care Practices
    $250 million in grants issued Feb. 12th in 39 regions
    Community College Consortia to Educate Information Technology Professionals in Health Care
    $70 million to be awarded March ‘10
  • What Do Physicians Need to Do?
    2010 2011
    2
    3
    4
    5
    1
    Choose a Certified Complete EHR
    Utilize all meaningful use measures for at least 90 consecutive days
    Choose Medicare or Medicaid incentive program
    Attest to meaningful use and name of Certified Complete EHR
    Implement and train usage to all meaningful use measures
    Receive first payment
  • Utilize Certified EHR Technology
  • HHS Certification Process
    Rules expected in February to define process for how certifying bodies will be named, certified and issue certifications
    CCHIT will almost certainly be a certifying body
    Already aligned certification criteria with proposed MU measures
    Dr. Mark Leavitt, CCHIT Chair: “Unless they pass a law saying that certifying bodies cannot start with the letter C, we will be a certifying body.”
  • What is a Certified Complete EHR?
    CCHIT mapped latest proposed requirements to 2011 Comprehensive Certification
    Pulse EHR first to fully certify for CCHIT 2011 Ambulatory Comprehensive Certification without any restrictions
  • What Do Physicians Need to Do?
    2010 2011
    2
    3
    4
    5
    1
    Choose a Certified Complete EHR
    Utilize all meaningful use measures for at least 90 consecutive days
    Choose Medicare or Medicaid incentive program
    Attest to meaningful use and name of Certified Complete EHR
    Implement and train usage to all meaningful use measures
    Receive first payment
  • New: Staged Approach to Meaningful Use
    First Payment Year
  • Proposed Meaningful Use Measures: Stage 1
  • Proposed Meaningful Use Measures: Stage 1
  • Proposed Meaningful Use Measures: Stage 1
  • Comments? You Have Until March 15th
    Federal eRulemaking Portal: http:// www.regulations.gov
    Identified by RIN 0991-AB58
    Regular, Express, Overnight Mail, Hand Delivery or Courier
    Department of Health and Human Services
    Office of the National Coordinator for Health Information Technology
    Attention: HITECH Initial Set Interim Final Rule
    Hubert H. Humphrey Building, Suite 729D
    200 Independence Ave., SW.
    Washington, DC 20201
    All comments received before the close of the comment period will be available for public inspection at http://www.regulations.gov
  • Comment Sample…Health IT Policy Committee
    Allow providers to defer up to five proposed measures from 2011-13
    Providers could not defer all measures from a single priority area
    No deferrals in the privacy and security priority area
    Certain meaningful use measures should remain mandatory, such as:
    Using computerized physician order entry systems
    Providing patients with electronic copies of discharge instructions
    Recording patient demographics as structured data
    Transmitting certain prescriptions electronically
  • Stage 2 Preview
    HHS anticipates redefining objectives to include not only the capturing of data in electronic format but also the exchange of that data in increasingly structured formats
    Stage 2 meaningful use criteria preview:
    “CPOE use” will include not only the percentage of orders entered directly by providers through CPOEs but also the electronic transmission of those orders
    “Incorporate clinical lab-test results into EHR as structured data” will be expanded, where feasible
    Measures that currently require the performance of a capability test will be revised to require the actual submission of that data
    Measures that currently allow the provision and exchange of unstructured data will require the provision and exchange of electronic and structured data, where feasible
  • How will Meaningful Use be proven?
    Attestation to CMS
    Complete EHR Certification information (supplied by Pulse)
    Describe performance on all functional measures required for Meaningful Use
  • Clinical Reporting Measures
  • Core Clinical Reporting Measures
    Reports on patient care from administration and medical record data
    Allows identification of patterns in diagnosis and treatment
    All reporting must use a Certified Complete EHR to capture and calculate results
    All Physicians are required to report information on Core measures
    Proposed Required Core Clinical Reporting Measures
    Inquiry Regarding Tobacco Use
    Blood pressure measurement
    Drugs to be avoided in the elderly
  • Specialty Specific Proposal Measures
    • Specialty measures will be limited to a required subset of 3 to 5 measures based on the availability of electronic measure specifications and comments received
    Cardiology
    Pulmonology
    Endocrinology
    Oncology
    Surgery
    Primary Care
    Pediatrics
    OB GYN
    Neurology
    Psychiatry
    Ophthalmology
    Podiatry
    Radiology
    Gastroenterology
    Nephrology
  • How will Clinical Quality Measures be Submitted?
    For 2011, an attestation methodology will be used to submit summary information to CMS on clinical quality measures as a condition of demonstrating meaningful use of Certified EHR Technology
    HHS and State CMS Technology is expected to be ready to receive data electronically starting in 2012
    Many Health Information Exchanges are considering offering physicians the service of packaging and submitting meaningful use data.
  • What Do Physicians Need to Do?
    2010 2011
    2
    3
    4
    5
    1
    Choose a Certified Complete EHR
    Utilize all meaningful use measures for at least 90 consecutive days
    Choose Medicare or Medicaid incentive program
    Attest to meaningful use and name of Certified Complete EHR
    Implement and train usage to all meaningful use measures
    Receive first payment
  • Who Qualifies?
    Medicare
    Eligible Providers (EP)
    Doctor of medicine or osteopathy
    Doctor of dental surgery of medicine
    Doctor of podiatric medicine
    Doctor of optometry
    Chiropractor
    Medicaid
    Eligible Providers (EP)
    Physicians
    Dentists
    Certified nurse – midwives
    Nurse practitioners
    Physicians assistants in FQHC or RHC led by a Physician assistant
  • Medicare
    Up to $44,000 over 5 years
    75% of submitted allowable charges to Medicare, up to the capped amount for that year
    Part B claims for the Fee for Service program
    Items in the Medicare Physician’s Fee Schedule
    “Professional” components only, no “Technical” components
    Medicaid
    Up to $63,750 over 6 years
    Flat fees to cover 85% cost of purchasing, implementing and maintaining an EHR
    Average allowable cost for EHR purchase, including implementation and hardware is $54,000
    Average allowable annual cost for maintenance is $20,610
    How are the Incentives Calculated?
  • Payment Calendars
    Medicare Calendar
    First Attestation Year
    Medicaid Calendar
    Medicaid incentive qualification must start by 2015, no payments beyond 2021
  • Medicare
    Full incentive payment in 2011 requires allowable charges of $24,000
    Lower allowable charges result in lower incentive payments
    Eligible Providers in a Health provider shortage area (HPSA) can claim an additional 10% incentive payment bonus
    Medicaid
    30% of all patient encounters must be attributable to Medicaid over any continuous 90-day period within a calendar year
    Short-term outreach programs not applicable
    Must re-attest annually
    20% requirement for Pediatricians
    33% lower available incentive
    How are the Incentives Calculated?
  • What is the Timing?
    Medicare
    Medicaid
    First year (2011) requires continuous 90-day period within the payment year which can attest to Meaningful Use
    Cannot cross calendar years
    Can begin as early as 2010 if the state has filed an indication of readiness to capture electronic information
    90-day attestation period would apply to both 1st and 2nd years in states approved for 2010 incentive
    Cannot cross calendar years
    Physician must demonstrate actual full installation to qualify in 2010
    If you have already implemented and are ready to prove Meaningful Use, the program will begin in 2011
  • Other Unique Medicaid Differences
    Outside funds, other than State or local funds, such as through a Stark program, that are directly tied to payment for an EHR will be subtracted
    Average Allowable Costs in Medicaid program allow ability to accept up to $29,000 in first year and $10,610 in following years without impacting
    Physicians must choose only one state to apply for Medicaid payments
    State choice may be changed annually at re-attestation
  • Switching Incentive Programs
    Physicians may switch between programs only once during the shared program periods (last year to switch is 2014)
    After switching, the EP continues at the next ‘program year’
    Example: After 2 years in Medicare program, an EP would start in year 3 in Medicaid program
  • What Do Physicians Need to Do?
    2010 2011
    2
    3
    4
    5
    1
    Choose a Certified Complete EHR
    Utilize all meaningful use measures for at least 90 consecutive days
    Choose Medicare or Medicaid incentive program
    Attest to meaningful use and name of Certified Complete EHR
    Implement and train usage to all meaningful use measures
    Receive first payment
  • Getting Paid
    Tracking will be done by NPI (National Provider Identifier)
    A single annual payment
    Medicare will pay via CMS
    Medicaid will pay from State Medicaid or designated organization
    Payments will be made on a rolling basis as Meaningful Use is reported
    End of reporting period and/or threshold for maximum payment is reached
    Payments can be reassigned to any entity with a valid employment agreement with the EP
    Cannot split re-assignment across multiple entities
    A single database will track participation for both programs
    Application for each program will include:
    Identify Medicare or Medicaid program participation
    Name, NPI, business address and business phone
    Taxpayer ID Number of payment destination
  • The time to get started is now!
  • Prepare An Organized Plan to Implement Now
    2010 2011
    2
    3
    4
    5
    1
    Choose a Certified Complete EHR
    Utilize all meaningful use measures for at least 90 consecutive days
    Choose Medicare or Medicaid incentive program
    Attest to meaningful use and name of Certified Complete EHR
    Implement and train usage to all meaningful use measures
    Receive first payment
  • Get Started Now
    If you are not using EHR currently, consider only CCHIT 2011 Comprehensive Certified solutions
    Pulse EHR is fully CCHIT 2011 Comprehensive Certified
    Currently installed version meets and exceeds all proposed HHS Complete EHR Certification requirements
    If you are using an EHR today, perform practice usage gap analysis against proposed measures
    Expand CPOE usage
    Discreet data capture
    Coded systems are key to interoperability use
    Evaluate which incentive program is best for you
    Develop a plan for re-assignment of incentive payments
  • Consider Pulse EHR
    Easier to buy.
    Easier to implement.
    Easier to learn.
    Easier to use.
    Easier to adopt.
    An easier way to meaningful use.
  • Let’s get started.Contact me directly: browley@pulseinc.comwww.pulseinc.com1.800.444.0882