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The Medical Advantage MU v2 Quick Pitch


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The Medical Advantage MU v2 Quick Pitch

  1. 1. “The Medical Advantage ” TM A HEALTH CARE TECHNOLOGY AND TRAINING COMPANYConfidential Property of The Medical Advantage, Inc. formerly a certified Allscripts Reseller
  2. 2. EMR: Why Wait - The Time is Now! 2
  3. 3. There is an Urgent Need US Healthcare Market Large And Troubled $2.2 Trillion Spent in Healthcare $700 Billion in Waste 1000’s of Medical Errors3
  4. 4. The OpportunityInefficiencies: Information and Practice Management• Our healthcare system is largely a paper driven industry (similar to the way financial services used to be)• Inefficient use of staff and physician time means less profitability. practice management automation can help with improvements that can result in an increased number of patient visits and office profitability• Claims processing is an inefficient and manual process for many physicians leading to delayed payments and high cost (a measurable revenue enhancement opportunity resulting from more complete and automated information)• Lack of integration across physicians, hospitals, clinics, labs, pharmacies, and patients leads to errors and waste• Estimates of 20-35 million additional people will likely be in the healthcare system as a result of healthcare reform which makes achieving greater efficiency more critical 01/14/13 Confidential Property of The Medical Advantage and Gregory French 4
  5. 5. Growing pressure on reimbursements, you need to be more cost efficientPhysicians Working Harder Source: Modern Medicine 5
  6. 6. Funding- HITECH Act $19 billion in incentives require proof of "meaningful" use – Allow patients to access their health records in a timely manner; – Develop capabilities to exchange health information where possible; – Implement at least one clinical decision support rule for a specialty or clinical priority; – Provide patients with electronic copies of discharge instructions and procedures; – Submit insurance claims electronically; and – Verify insurance eligibility electronically when possible Those that adopt first will benefit the most (declining incentives)  Physicians can earn between $44,000 to $64,000 over five years from Medicare / Medicaid if they are utilizing an EHR in 6 2011
  7. 7. What You Need To Do: General Program DetailsHITECH - The Approach Stage 3 Stage 2 Stage 1 2013 2015 2011 Exchange of Improved Capture & clinical data Outcomes Share Data (Advancement of processes)
  8. 8. Medicaid Incentive Program8
  9. 9. Who is eligible?› Medicare › Medicaid 1. Doctor of medicine or 1. Physicians (MDs and DOs) osteopathy 2. Dentists 2. Doctor of dental surgery or 3. Certified nurse-midwives medicine 4. Nurse practitioners 3. Doctor of podiatric 5. Physician assistants medicine practicing in an FQHC or RHC 4. Doctor of optometry that is so led by a physician 5. Chiropractor assistant 9
  10. 10. “MEANINGFUL USE”In order to qualify for the incentive payments physicianshave to demonstrate “meaningful use” of an EHR byProving three things: – Use of an EHR with ePrescribing capability that meets current HHS standards – Connectivity to other providers to improve access to the authorized patient health history – Ability to report on their use of the technology to HHS 10
  11. 11. Meaningful Use Stage 1 Meaningful Use ObjectivesCore Objective Menu Set (Pick 5, 1 must be Pop Health)Computerized Provider Order Entry (CPOE) for medication orders directly Implement drug-formulary checksentered by any licensed healthcare professional who can enter orders intothe medical record per state, local and professional guidelinesImplement drug-drug and drug-allergy checks Lab resultsMaintain an up-to-date problem list of current and active diagnoses Generate lists of patient based on specific conditions to use for quality improvement, reduction of disparities, research or outreach.Generate and transmit permissible prescriptions electronically (eRx) Send reminders to patients based on patient preferences and selected by specific criteriaMaintain active medication list Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, medication allergies) within 4 business days of the information being available to the EPMaintain active medication allergy list Provide access to patient-specific education resources upon requestRecord the following demographics: preferred language, gender, race and The EP who receives a patient from another setting of care or provider of careethnicity, and date of birth or believes an encounter is relevant should perform medication reconciliationRecord and chart vital signs Provide summary care record for each transition of careRecord smoking status for patients 13 and over Capability to submit electronic data to immunization registriesReport ambulatory clinical quality measures to CMS (or, for EPs seeking the Capability to submit electronic syndromic surveillance data to public healthMedicaid incentive payment, the states) agenciesImplement one clinical decision support rule relevant to specialty or highclinical priority along with the ability to track compliance with that ruleProvide patients with an electronic copy of their health informationClinical summaries provided to patients for all office visitsCapability to exchange key clinical information among providers of care andpatient authorized entities electronicallyProtect Health Information
  12. 12. How will I submit proof & required reports? › First opportunity to actually file for the incentives will be April 2011 › New web-based portal is being developed through which all required reports will be submitted › Note: Must keep records of all qualification & reports for six years following each Reporting Year (similar to HIPAA)12
  13. 13. How will Meaningful Use be measured? › Two required components under HITECH statute › EHR Functional (operational) metrics › Clinical Quality Metrics › Can opt out of some metrics if they are irrelevant for your practice / patients › No longer any manual chart review required to determine if you’ve met the thresholds – everything can now be reported out of the EHR13
  14. 14. What are the EHR Functional Metrics? › 15 Core measures › Required of everyone › 10 Menu Set measures › You choose five that best fit within your practice › Can attest that almost any of the metrics are irrelevant to your practice to remove it from the list and reduce the number of metrics you must report on14
  15. 15. Measures of EHR Use* See Allscripts web site for entire list 15
  16. 16. Measures of EHR Use* See Allscripts web site for entire list 16
  17. 17. Measures of EHR Use* See Allscripts web site for entire list 17
  18. 18. Measures of EHR Use* See Allscripts web site for entire list 18
  19. 19. Measures of EHR Use* See Allscripts web site for entire list 19
  20. 20. Why You Should Not Wait!  • Too much change for your practice at once….more change coming 2011-2015! – EMR Certification and implementation – Continued “Meaningful Use” requirements – ANSI 5010 – This covers certain electronic  health care administrative transactions  (claims, remittances, eligibility, claim status  request and response). – ICD 10 coding enhancements are coming – Regulatory health care changes20
  21. 21. The Path is Clear… “Were investing in electronic medical records and other technologies that can drive down healthcare costs.” - President Barack Obama “Cost savings from a mandatory requirement that Medicare providers adopt and use HIT as a condition of participating in the Medicare program…savings total $34 billion over 10 years from physicians and hospitals.” - CBO