Massachusetts eHealth Institute eQuality Incentive Program (“eQIP”) Solicitation No. 2015-MeHI-01 Question & Answer Webinar November 12, 2014

1. Massachusetts eHealth Institute
eQuality Incentive Program (“eQIP”)
Solicitation No. 2015-MeHI-01
Question & Answer Webinar
November 12, 2014

2. Agenda
 Introduction
 Legal Considerations
 MeHI Overview
 eQuality Incentive Program (eQIP) Overview
− Eligibility Criteria
− Milestones
− Application Process and Timelines
 Questions
©2013 Massachusetts eHealth Institute. All Rights 2 Reserved. Confidential.

3. Introduction / Presenters
 Host: Judith Iwanski, Manager, eHealth eQuality Program
 Laurance Stuntz, MeHI Director
 Sean Kennedy, Director, Health Information Exchange
 Ross Venables, Grants and Contracts Administrator
Please hold all questions to the end
[May type questions into the “questions” section]
©2013 Massachusetts eHealth Institute. All Rights 3 Reserved. Confidential.

4. Legal Considerations

5. Legal Considerations
 The Solicitation has been posted to the MassTech
website & Comm-Buys, the Commonwealth’s
procurement portal.
 To the extent anything stated/presented in this webinar
is inconsistent with the RFP, the Solicitation written
documents shall govern.
 MassTech reserves all rights to amend, modify or
otherwise clarify the Solicitation & any written answers to
questions presented.
©2013 Massachusetts eHealth Institute. All Rights 5 Reserved. Confidential.

6. Legal Considerations (cont.)
 It is the Respondent’s responsibility to check MassTech
and/or Comm-Buys websites for addenda or modifications
to the Solicitation.
 Please review the Solicitation carefully.
− Non-responsive applications will be rejected.
©2013 Massachusetts eHealth Institute. All Rights 6 Reserved. Confidential.

7. MassTech Overview
 The Massachusetts Technology Collaborative
(MassTech) was established pursuant to Massachusetts
General Laws Chapter 40J. MassTech is an independent
authority of the Commonwealth of Massachusetts.
 MeHI (Massachusetts eHealth Institute) is a non-divisible
component of MassTech. MeHI functions as a business
division of MassTech
©2013 Massachusetts eHealth Institute. All Rights 7 Reserved. Confidential.

8. MeHI is the designated
state agency for:
 Coordinating health care
innovation, technology and
competitiveness
 Accelerating the adoption of
health information technologies
 Promoting health IT to improve
the safety, quality and efficiency
of health care in Massachusetts
 Advancing the dissemination of
electronic health records
systems in all health care
provider settings
MBI
MASSACHUSETTS
BROADBAND INSTITUTE
MeHI is a division of the Massachusetts
Technology Collaborative, a public
economic development agency
8
MeHI Overview
THE INNOVATION INSTITUTE
at the MassTech Collaborative
MeHI
MASSACHUSETTS
eHEALTH INSTITUTE
• Tech Hub Collaborative
• Big Data Consortium
• Advanced Manufacturing
Collaborative
• Innovation Index
• Mass Broadband 123
• MassVetsAdvisor
• Interoperable EHR Adoption
• Connected Communities
• eHealth Services & Support
• eHealth Cluster
Massachusetts eHealth Institute

9. MeHI | Vision, Mission, Goals
©2013 Massachusetts eHealth Institute. All Rights 9 Reserved. Confidential.

10. 10
eHealth
Services &
Support
MeHI Initiatives 2014 - 2015
Connected
Communities
eHealth
eQuality
Outreach &
Operations
eHealth
Cluster
Development
CORE VALUES
Innovation • Insight • Collaboration • Accountability

11. Overview of the eHealth
eQIP Solicitation

12. eHealth eQuality Program / Background
 MeHI Goal:
− Advancing dissemination of EHRs in all provider settings and
− Facilitate networking through Mass HIway
 Recent survey of MA providers:
− BH organizations behind other sectors in EHR adoption
• Primary care providers – 96% adoption rate
• Among specialty providers – 86% adoption rate
• Among BH organizations – 55% adoption rate
− 50% among independent BH orgs (100% among affiliated)
 c. 224, Acts of 2012:
− MeHI to give priority to organizations that are:
• Generally not eligible for Medicare or Medicaid EHR Incentive Programs &
• Lack access to other resources to implement interoperable EHRs
− Including mental health facilities & community-based BH providers
©2013 Massachusetts eHealth Institute. All Rights 12 Reserved. Confidential.

13. eQIP: Definitions
 BH services
− Evaluate/treat people with mental health or substance use disorders
• Provided by a professional health care worker, or
• Substance abuse treatment services licensed or approved by MA DPH
 BH Providers
− Must provide direct patient care, and be:
• Licensed clinicians, or
• Authorized to provide care under supervision of a licensed professional
 Affiliated
– Entities under common control or governance (e.g. subsidiary) or
– Joined together contractually or through shared entity (e.g., LLC)
 Patient Services Revenue
̶ Net PSR (from 3rd party payers), PLUS
̶ Revenue under a state or local contract to provide BH services
 MeHI reserves the right to further define terms used in this Solicitation
©2013 Massachusetts eHealth Institute. All Rights 13 Reserved. Confidential.

14. eQIP: Program Requirements
 All organizations receiving eQIP grant must:
− Use CEHRT
• 2011, 2014 or voluntary certification acceptable
− Submit a questionnaire to HIMSS A-EMRAM
• To determine EHR adoption baseline
− Generate Transformation Plan
− Commit to achieving all milestones
− Submit reports & attend annual in-person event
©2013 Massachusetts eHealth Institute. All Rights 14 Reserved. Confidential.

15. eQIP: Eligibility Criteria
 Organizations must meet all 7 criteria:
1) Provide clinical care
2) Provide primarily BH services
− >50% patient services revenue from BH services in MA
3) Hold valid license to provide BH programs and services, or
− Clinical providers have valid professional licenses
4) Be organized as a not-for-profit corporation
5) Have no financial relationship/affiliation with health care system
− Some exceptions apply
6) Serve a large proportion of public payer clients
− >50% patient service revenue is public payer
7) Not eligible for the EHR Incentive Payment Programs
− Some exceptions apply
 Attestation of compliance required
©2013 Massachusetts eHealth Institute. All Rights 15 Reserved. Confidential.

16. 16
eQIP | Detailed Eligibility Criteria
Eligibility Criteria Method of Substantiation*
1.
Provide BH clinical care services in MA Statement of Operations/Income Statement
indicating Patient Service Revenue* (PSR)
for any month (6/1/14 through 9/30/14)
2.
Hold license to provide BH clinical care
programs/services in MA, OR
Its providers have valid professional
licenses
Currently valid license(s) to provide BH
clinical care programs/services (by DPH) or
MA DMH certification as provider of BH
services
3.
Provide primarily BH services
(>50% of annual PSR from BH
services in MA)
Documentation indicating
(1) Percent of PSR for last SFY and
(2) Source/amount for all BH PSR (private
payer(s), Medicaid, Medicare etc.)
4.
Is a not-for-profit corporation Certificate of Good Standing for a not-for-profit
corporation in MA
** Patient Services Revenue = NPSR (3rd party payers) + revenue under a state or local
contract to provide BH services

17. 17
eQIP | Detailed Eligibility Criteria (cont.)
Eligibility Criteria Method of Substantiation
5.
No financial relationship/affiliation to a
health care system
Corporate org chart showing ownership,
governance & operational structure
5A.
 Organizations that are part of a
system meet this criteria . . . IF:
 Annual PSR of parent org is <$25M
Documentation: annual PSR of parent org
is <$25M
6.
Serve large proportion of public payer
clients
(>50% of PSR is public payer )
Documentation: portion of PSR from public
payer for last SFY
7.
Not an Eligible Hospital (“EH”) and
providers are not Eligible Professionals
(“EPs”)
Documentation: is not an EH and its
providers are not EPs
7B.
 Organizations that have some EPs
meet this criteria . . . IF:
 Number of EPs >30% of clinical staff,
and
 Is either independent or annual PSR
of parent org is <$25M
Documentation: total clinical staff &
percent of EPs AND
Documentation: no financial
relationship/affiliation or annual PSR of
parent org is <$25M

18. eQIP: Other Factors
 MeHI will consider how the organization intends to use
EHR/health IT in light of MA health care policy objectives
− Will look favorably on applicants:
• Using health IT to integrate BH with primary care
• Serving underserved populations or in medically underserved
areas
 MeHI will contract with those Applicants that:
– Meet the eligibility criteria
– Clearly describe approach feasibility, organizational ability &
capacity, & anticipated impact; and
– Sufficiently demonstrate organizational need & commitment
©2013 Massachusetts eHealth Institute. All Rights 18 Reserved. Confidential.

19. eQIP: State Innovation Model (SIM) Funding
 EOHHS SIM Mass HIway Grant
− Collaborating with EOHHS (companion grant to eQIP )
− Additional funding to maximize EHR interoperability capabilities to
achieve interoperability across the continuum of care
 eQIP Milestone 4 requires:
− Connection/use of Mass HIway to exercise use case in production
with at least one unaffiliated trading partner &
− Approach to operationalizing “opt in” for Mass HIway
 Additional SIM funding will assist grantees to:
− Achieve greater volume of transactions on the Hiway, &
− Increasingly sophisticated use of the HIway
 NOTE: Closely aligned to eQIP, but a separate funding program
− Will require second application through EOHHS
©2013 Massachusetts eHealth Institute. All Rights 19 Reserved. Confidential.

20. eQIP: Milestones
Milestone Deliverable
1 Approved Transformation Plan
 How org will prepare & transform practice to
maximize health IT investments to achieve
identified outcomes
Meet Required A-EMRAM Stage 1 & 2 Criteria
©2013 Massachusetts eHealth Institute. All Rights 20 Reserved. Confidential.
Transformation Plan (due within 3-months)
Completed HIE Use Case Development Form
Email from MeHI indicating achievement of
required A-EMRAM Stage 2 criteria
2 Meet Required A-EMRAM Stage 3 criteria Email from MeHI indicating achievement of required
A-EMRAM Stage 3 criteria
Description of certified EHR technology
3 Meet Required A-EMRAM Stage 4 & 5 criteria Email from MeHI indicating achievement of
required A-EMRAM Stage 5 criteria
Updated description of certified EHR technology
4 Transacting on the Mass HIway Copy of Mass HIway participation agreement
Attestation from that production transactions are
being sent/received for the use case
Approach to operationalize “opt in” for the Mass
HIway

21. eQIP: Transformation Plan
 Transformation Plan shall describe, at a minimum:
− Anticipated Outcomes
• Operational and/or clinical outcomes being targeted
• Better integration of behavioral with physical health care
− Current Health IT State
− Desired Future IT State
− Gap Analysis
− Grant Approach
• Approach to meeting each milestone
• How advancements in use of health IT will support achieving
identified operational and/or clinical outcomes
• How organization will protect electronic health information
• The timeline of major activities
− Including dates to meet M1, M2, M3 and M4
 Plan shall incorporate A-EMRAM gap assessment findings
©2013 Massachusetts eHealth Institute. All Rights 21 Reserved. Confidential.

22. 22
eQIP | Milestones
 Milestone 1 (15% of total incentive) = required EMRAM* Stage 1 & 2
– Desktop access to clinical information, unstructured data, multiple data sources,
intra-office/informal messaging
– Beginning of a CDR with orders and results, computers may be at point-of-care,
access to results from outside facilities
 Milestone 2 (25% of total incentive) = required EMRAM* Stage 3
– Electronic messaging, computers have replaced the paper chart, clinical
documentation and clinical decision support
 Milestone 3 (35% of total incentive) = required EMRAM* Stage 4 & 5
– Computerized Provider Order Entry, Use of structured data for accessibility in
EMR and internal and external sharing of data
– Personal health record, online tethered patient portal
________________________
 HIway Milestone 4 (25% of total incentive) = Transacting on Mass HIway
– “Floating” Milestone
– Organizations can meet the HIway Milestone at any time after meeting M-1
– Must be integrated into the EHR
*NOTE: some requirements may not be applicable to BH organizations

23. eQIP: A-EMRAM Stages – overview
23
HIMSS Ambulatory EMR Adoption Model (A-EMRAM)
̶ Focus on key IT systems that need to be implemented for achieving higher levels of access,
quality, efficiency and safety
US Ambulatory EMR Adoption Model SM
eQIP
Milestone
Stage Cumulative Capabilities
Stage 7 HIE capable, sharing of data between the EMR and community based EHR, business
and clinical intelligence
Stage 6 Advanced clinical decision support, proactive care management, structured messaging
M-3
Stage 5 Personal health record, online tethered patient portal
Stage 4 CPOE, Use of structured data for accessibility in EMR and internal and
external sharing of data
M-2
Stage 3 Electronic messaging, computers have replaced the paper chart, clinical
documentation and clinical decision support
M-1
Stage 2 Beginning of a CDR with orders and results, computers may be at point-of-care,
access to results from outside facilities
Stage 1 Desktop access to clinical information, unstructured data, multiple data
sources, intra-office/informal messaging
Stage 0 Paper chart based

24. eQIP: Tiered & Graded Payment Structure
©2013 Massachusetts eHealth Institute. All Rights 24 Reserved. Confidential.
REVENUE TIERS
Small Organizations $1 Million up to 10 Million
Medium Organizations $10 Million + up to 25 Million
Large Organizations $25 Million + up to 50 Million
Very Large Organizations Greater than $50 Million
Milestones
Org. Size M-1 M-2 M-3
Small $ 4,950 $ 8,250 $ 11,500
Medium $ 7,425 $ 12,375 $ 17,325
Large $ 9,900 $ 16,500 $ 23,100
Very large $ 12,375 $ 20,625 $ 28,875
M-HIway (floating milestone) Total
Small $ 8,250
Organizations can meet the HIway
Milestone at any time after meeting M-1.
$ 33,000
Medium $ 12,375 $ 49,500
Large $ 16,500 $ 66,000
Very large $ 20,625 $ 82,500

25. Application Process and
Evaluation Criteria

26. Application: Timeline Chart
Task Date
Solicitation Posted October 23, 2014
Webinars November 6, 2014 @ 12:00pm, EST
©2013 Massachusetts eHealth Institute. All Rights 26 Reserved. Confidential.
November 12, 2014 @ 12:00pm, EST
Final Questions Due November 17, 2014 @ 5:00pm, EST
Final Question & Answer File Posted November 21, 2014
Electronic Applications Due
Sent to proposals@masstech.org
December 11, 2014 @ 3:00pm EST
Hard Copy Applications Due December 11, 2014 @ 3:00pm, EST
Anticipated Awards Date January 28, 2015

27. Application Process
 The following must be submitted by December 11, 2014 at 3:00 p.m.:
 To: proposals@masstech.org:
− An electronic version (.pdf or .doc) of the Application, including the
Authorized Applicant’s Signature and Acceptance Form (Attachment B)
and Attachments – with signatures
− Include Solicitation number in subject heading
 To: MassTech offices (Westborough)
− 1 unbound original Application, including Acceptance Form (Attachment
B) and Attachments – with original signatures
− 1 unbound copy
− 4 bound copies (no three ring binders)
©2013 Massachusetts eHealth Institute. All Rights 27 Reserved. Confidential.

28. Application
 Application packages must include the following:
− Proposal Narrative (8-page limit)
̶ Substantiation Form
̶ Officer’s Certification Form
̶ Signed Organizational Approval Letter stating support for
the proposed project.
̶ Application Summary Sheet Form
̶ Authorized Application Signature and Acceptance Form
©2013 Massachusetts eHealth Institute. All Rights 28 Reserved. Confidential.

29. Proposal Narrative
 Abstract: Organization overview & summary of approach to objectives
− Current health IT state
− How planned IT advancements will support identified outcomes
− IMPORTANT: Abstract will serve as the proposal summary for
reviewers and contracting
 Statement of Need: Why organization needs these grant funds
 Project Approach: Approach to using health IT to meet each milestone
− Timeline to reach milestones & complete grant requirements (by 1/15/2017)
 EHR product: Complete EHR Current Product Table (if applicable)
− Vendor, product, version, CHPL #, status, care setting, extent used
 Mass HIway status:
− If currently using Mass HIway
• How connected (LAND, webmail, EHR Direct) & how using
− If not using Mass HIway, describe how intend to use the HIway
©2013 Massachusetts eHealth Institute. All Rights 29 Reserved. Confidential.

30. Proposal Narrative (cont.)
 Health System Integration: Efforts to integrate BH with other
medical care
− Examples: coordinated treatment plans; continuity of care
 In-Kind Resources: Resources organization intends to provide to
supplement or support incentive payments
− Provide estimated value
 Value of Investment: How incentive payments will achieve long-term
benefits & meet MA policy goals
− (Examples) Leverage HIT/interoperable EHR systems to improve patient
health, coordination of care across providers, transitions of care or provide
reduction in HC costs
 Anticipated Challenges: Outline anticipated challenges/problems
in meeting milestones
− Ways in which organization will address anticipated challenges
©2013 Massachusetts eHealth Institute. All Rights 30 Reserved. Confidential.

31. Evaluation Criteria
 Applications will be reviewed against the following criteria:
− Compliance:
• Applicant met each of the seven (7) eligibility criteria
– Need:
• Applicant described why the funding needed (how other funds/resources are
insufficient)
– Feasibility:
• Applicant described feasible approach to meeting milestones & achieving a
more advanced state of integration/use of health IT
– Ability:
• Applicant demonstrated ability to meet guidelines/conditions of Solicitation
– Capacity:
• Applicant indicated organization’s capacity to carry out approach to meeting
milestones
– Commitment:
• Applicant demonstrated commitment to Program intent & meeting all
milestones
− Impact:
• Applicant addressed how it will use HIT to support health care policy objectives
©2013 Massachusetts eHealth Institute. All Rights 31 Reserved. Confidential.

32. Solicitation – Questions?

33. Questions / Responses
 Questions may be submitted to the address set forth in Section 4.1 or
by e-mail to proposals@masstech.org
 All questions must be received by 5:00 p.m. on November 17, 2014
− Submission of questions by e-mail strongly encouraged
 Review Q&A File (posted on RFP page) prior to submitting questions
− Further questions/clarification may be added after the webinars
• Notification of updates will not be sent
• Applicants have responsibility to check website for updates
 Questions/Responses – posted by 5:00 p.m. on November 21, 2014
− On the MassTech and Comm-Buys websites
©2013 Massachusetts eHealth Institute. All Rights 33 Reserved. Confidential.

34. eHealth eQuality
Solicitation No. RFP-2015-MeHI-01
BH eQuality Incentive Program
“eQIP”
Thank you