Understanding Meaningful Use - 26Feb2010
Upcoming SlideShare
Loading in...5
×
 

Understanding Meaningful Use - 26Feb2010

on

  • 1,798 views

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.

Statistics

Views

Total Views
1,798
Views on SlideShare
1,793
Embed Views
5

Actions

Likes
0
Downloads
55
Comments
0

1 Embed 5

http://www.slideshare.net 5

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    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