This document discusses changes to Meaningful Use Stage 1 requirements for eligible professionals in 2014. Key changes include reducing the EHR reporting period to 3 months, removing one core objective, modifying measures for CPOE and vital signs, and providing more flexibility for public health objectives and clinical quality measures. Eligible professionals must also upgrade to 2014 certified EHR technology and may be subject to Medicare payment adjustments if Meaningful Use requirements are not met.
Gain added clarity about your 2014 Meaningful Use attestation options to avoid Medicare payment adjustments, including timeline and impacts of recent CMS proposed rule changes. Preview the new interactive decision tool and understand compliance exemptions.
Meaningful Use Stage 2 Summary of Care Data Exchange with Practice FusionPractice Fusion
Stage 2 of Meaningful Use requires that providers complete three Summary of Care measures related to sending referrals. Practice Fusion has enabled providers to complete these measures through our new referral workflows.
To learn about how these referral workflows work (including Direct messaging) and how these workflows relate to Meaningful Use, review the slideshow. This detailed guide will walk you through understanding Direct and how to enable it, the variety of ways to send a referral in Practice Fusion, and how to achieve the related Meaningful Use measures.
New clinical quality measure reporting in Practice Fusion [slides]Practice Fusion
Learn about the new data elements, which quality measures they can be used for, and information on reporting quality measures using Practice Fusion for Meaningful Use, PQRS EHR Reporting, and other quality improvement programs.
Gain added clarity about your 2014 Meaningful Use attestation options to avoid Medicare payment adjustments, including timeline and impacts of recent CMS proposed rule changes. Preview the new interactive decision tool and understand compliance exemptions.
Meaningful Use Stage 2 Summary of Care Data Exchange with Practice FusionPractice Fusion
Stage 2 of Meaningful Use requires that providers complete three Summary of Care measures related to sending referrals. Practice Fusion has enabled providers to complete these measures through our new referral workflows.
To learn about how these referral workflows work (including Direct messaging) and how these workflows relate to Meaningful Use, review the slideshow. This detailed guide will walk you through understanding Direct and how to enable it, the variety of ways to send a referral in Practice Fusion, and how to achieve the related Meaningful Use measures.
New clinical quality measure reporting in Practice Fusion [slides]Practice Fusion
Learn about the new data elements, which quality measures they can be used for, and information on reporting quality measures using Practice Fusion for Meaningful Use, PQRS EHR Reporting, and other quality improvement programs.
Using Practice Fusion for PQRS EHR Reporting in 2014Practice Fusion
This presentation is an overview of PQRS requirements in 2014, requirements for PQRS EHR reporting, and measure selection and EHR reporting applicability. The presentation will also give a deep dive into using Practice Fusion for PQRS reporting.
Meaningful Use Stage 2 and Health Information Exchange (HIE)MassEHealth
Transformational intent of Meaningful Use (MU) and the increased trend toward interoperability in MU Stage 2 (MU2); MU2 objectives with an HIE component and their MU2 measures; Approaches to achieving the transitions of care; Available public health registries and their current status and submission pathway; How to find a trading partner and best practices to engaging
Did you know that ALL of your Medicare reimbursements will be docked if you don't participate in the PQRS reporting program? This applies to mental / behavioral heath and substance abuse providers - get the full scoop in our guide.
PYA Consulting Manager Linda ClenDening helped connect the dots between the data at the 2013 AHIMA Convention and Exhibit in Atlanta. She spoke during the Innovation educational track on the topic: “Beyond Meaningful Use: Connecting Quality Data Requirements to Business Operational Improvements.”
UHealth in Korea for Health and Wellness by Jongtae Park3GDR
OECD Expert Consultation 2016
헬스케어실증단지사업현황및발전계획
UHealth in Korea for Health and Wellness
Oct. 5, 2016
Jongtae Park
Kyungpook National University
Daily Healthcare Demonstration Complex Construction Agency jtpark@ee.knu.ac.kr
As providers face increasing regulation, it is critical to understand the driving forces behind these laws, the barriers to adoption, and the practical ways these new rules can be turned into opportunities. Learn the history and importance of recent legislation (including ARRA and HITECH), the purpose and practical implications of Meaningful Use, an overview of requirements for Meaningful Use Stage 1 and updates on Stage 2.
Using Practice Fusion for PQRS EHR Reporting in 2014Practice Fusion
This presentation is an overview of PQRS requirements in 2014, requirements for PQRS EHR reporting, and measure selection and EHR reporting applicability. The presentation will also give a deep dive into using Practice Fusion for PQRS reporting.
Meaningful Use Stage 2 and Health Information Exchange (HIE)MassEHealth
Transformational intent of Meaningful Use (MU) and the increased trend toward interoperability in MU Stage 2 (MU2); MU2 objectives with an HIE component and their MU2 measures; Approaches to achieving the transitions of care; Available public health registries and their current status and submission pathway; How to find a trading partner and best practices to engaging
Did you know that ALL of your Medicare reimbursements will be docked if you don't participate in the PQRS reporting program? This applies to mental / behavioral heath and substance abuse providers - get the full scoop in our guide.
PYA Consulting Manager Linda ClenDening helped connect the dots between the data at the 2013 AHIMA Convention and Exhibit in Atlanta. She spoke during the Innovation educational track on the topic: “Beyond Meaningful Use: Connecting Quality Data Requirements to Business Operational Improvements.”
UHealth in Korea for Health and Wellness by Jongtae Park3GDR
OECD Expert Consultation 2016
헬스케어실증단지사업현황및발전계획
UHealth in Korea for Health and Wellness
Oct. 5, 2016
Jongtae Park
Kyungpook National University
Daily Healthcare Demonstration Complex Construction Agency jtpark@ee.knu.ac.kr
As providers face increasing regulation, it is critical to understand the driving forces behind these laws, the barriers to adoption, and the practical ways these new rules can be turned into opportunities. Learn the history and importance of recent legislation (including ARRA and HITECH), the purpose and practical implications of Meaningful Use, an overview of requirements for Meaningful Use Stage 1 and updates on Stage 2.
MPCA HIPAA Compliance/Meaningful Use Requirements and Security Risk Assessment Series: HIPAA/HITECH Requirements for FQHCs and the New Omnibus Rule (Part 1)
The Medicare and Medicaid EHR Incentive Programs offer financial incentives for the
“meaningful use” of certified EHR technology to improve patient care. Read More.. www.curemd.com
Important Events & Dates for Medical Practices in 2014Manage My Practice
This year will have many challenges and one of them is keeping up with important dates to be met. Here is an overview of the most pertinent dates and a way to download a handy calendar of these dates to keep nearby.
Meaningful Use: Programs, Penalities, and PaymentsBen Quirk
Meaningful Use is not dead!
MIPS may be just around the corner, but MU is still very much in the picture. There is enough time, however, for your practice to optimize 2016 reporting and increase 2018 payments and avoid penalties.
This presentation takes you through the steps needed to successfully attest for 2016 and be prepared for upcoming changes.
Understanding the Physician Quality Reporting System (PQRS) Requirements in 2014Practice Fusion
This webinar, Understanding the Physician Quality Reporting System (PQRS) Requirements in 2014, goes over which reporting options are available, what the incentives and penalties are for participating, reporting requirements, and how to choose quality measure for reporting.
Slides presented at the July 13, 2010 press conference announcing the final rules for Meaningful Use. These rules define what qualifies for stimulus incentive payments under the ARRA/HITECH legislation.
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.
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.
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.
The CMS Innovation Center hosted a special webinar featuring Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality and CMS Chief Medical Officer, on Monday, November 10, 2014 from 10:30am – 11:30 am ET. Dr. Conway will provided an update about the work of the CMS Innovation Center and the models being tested to improve better care for patients, better health for our communities, and lower costs through improvement for our health care system. Opportunities for questions were provided.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
In 2010 Mercy Hospital sought community partnerships to assist in meeting the needs of individuals presenting to the hospital’s emergency room repeatedly who, due to their substance use disorders, mental health disorders, and/or co-occurring disorders, were not able to successfully access and engage in community-based services to address needs. This webinar will chronicle the process of development of the project by community stakeholders, implementation, highlight challenges and successes, delineate measurable one-year outcome data and return on investment.
When it comes to behavioral health/primary care integration, we are often forced to fly into unchartered areas in an effort to meet the needs of our patients and ongoing health care reform. Newaygo County Mental Health (NCMH) and Family Health Care (FHC) have been working collaboratively since 2010 to provide integrated health care. NCMH clinicians provide outpatient therapy services within two FHC federally funded Teen School-based Health Centers. NCMH recently added two Integrated Behavioral Health Clinicians to the FHC health center in White Cloud. This webinar will provide an overview of how primary care health centers and community mental health centers can partner to improve physical and behavioral health for their community.
Care4life is a personalized mobile health program that gives ongoing support to people with type 2 diabetes using the core principles of diabetes care. Care4life includes education about diabetes, tips for managing diabetes, reminders to test blood glucose, take medications, and record weekly progress on weight, exercise, and medication adherence.
Health centers are non-profit private or public entities that serve designated medically underserved populations/areas or special medically underserved populations comprised of migrant and seasonal farmworkers, the homeless or residents of public housing. This presentation provides a summary of the key health center program requirements.
This webinar will provide an overview of the evaluation study being done at the Durham Clinic, an integrated health home run by Cherry Street Health Services in Grand Rapids, Michigan. The study seeks to determine whether the delivery of health care through a multi-disciplinary team using the chronic care management model delivers better symptom management and reduced impact of the
illness on patients’ desired functioning.
During this webinar you will get an overview of Michigan’s publicly funded mental health, substance abuse, and developmental disabilities system. This will include the management and delivery structure of Community Mental Health Service Providers (CMHSPs), Prepaid Inpatient Health Plans (PIHPs), and substance abuse Coordinating Agencies (CAs), as well as primary funding sources and priority service populations.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
The hemodynamic and autonomic determinants of elevated blood pressure in obes...
Meaningful Use Stage 1 Changes for Eligible Professionals in 2014
1. Meaningful Use Stage 1 Changes
for Eligible Professionals in 2014
Michelle Brunsen, Sr. Health IT Advisor
2. Today’s Objectives
ARRA Background and Incentive Program Statistics
2014 Timelines for EHR Vendors and Eligible Professionals
Changes to Stage 1 Meaningful Use
Clinical Quality Measures
Payment Adjustments and Hardships
Medicaid Program Specific Changes
2
4. Where Did Meaningful Use Begin?
American Reinvestment and Recovery Act of 2009
“Stimulus Bill”
HITECH Act: All healthcare providers must adopt electronic
health records by 2015
CMS EHR Incentive Program established for Meaningful Use
Office of the National Coordinator Funded 60+ RECs
ONC Funded the creation of Health Information
Exchanges in every state
ONC website: www.healthit.hhs.gov
4
6. Payments to Eligible Professionals
National Payments as of October 2013
130,669 payments to Medicaid Eligible Professionals (33.9%)
255,282 payments to Medicare Eligible Professionals (66.1%)
Total Medicare and Medicaid payments of $6.428B
6
8. Payments to Eligible Professionals
Michigan Payments as of October 2013
3,365 Medicaid Eligible Professionals have been paid (27.8%)
8,737 Medicare Eligible Professionals have been paid (72.2%)
Total Medicare and Medicaid payments to Michigan of $572M
8
12. Starting in 2014
Changes
EHRs Meeting ONC 2014 Standards – Starting in 2014, all
EHR Incentive Program participants will have to adopt
certified EHR technology that meets ONC’s Standards &
Certification Criteria 2014 Final Rule
12
13. What does this mean for EPs?
Pay your annual maintenance/support with your EHR vendor
Speak with a representative from your EHR vendor to get in
the queue to receive the 2014 upgrade
Install the 2014 EHR version as soon as possible
Start educating your patients about the patient portal,
collecting email addresses
13
14. 2014 Reporting Period
Reporting Period Reduced to Three Months
To allow providers time to adopt 2014 certified EHR
technology and prepare for Stage 2
Regardless of Meaningful Use stage or year
14
15. What does this mean for EPs?
All participants will have one calendar quarter reporting
period in 2014
Medicare and Medicaid = 1 quarter
Jan – Mar, Apr – June, July – Sep, Oct – Dec
Stage 1 Year 1 attesting for first time – MUST attest NO LATER
THAN 10/1/14 to avoid a disincentive and use reporting
period of Q1, Q2 or Q3
15
17. Meaningful Use: Stage 1 in 2014
Eligible Professionals
2013
2014
14 Core Objectives
13 Core Objectives
5 of 10 Menu Objectives
5 of 9 Menu Objectives
19 Total Objectives
18 Total Objectives
17
18. Stage 1 Meaningful Use Core Objectives - 2014
Core Set: Must Do All 13
E-prescribing
Drug-drug & drug allergy
checks
Medication list
Allergy list
CPOE
Problem list
Clinical decision support rule
Record demographics
Smoking status
Vital signs
Clinical summaries to patient
View, download & transmit
Protect health information
18
19. Changes to Stage 1: CPOE
Current Stage 1 Measure
Denominator
Unique patient with
at least one
medication in the
medication list
New Stage 1 Option
Denominator
Number of orders
during the EHR
Reporting Period
The optional CPOE denominator is available in 2013 and beyond for Stage 1.
Includes Certified Medical Assistants beginning in 2013.
19
20. Changes to Stage 1: Vital Signs in 2014
2013 Stage 1 Measure
Age Limits
Age 2 for BP
and
Height/Weight
Exclusion
All 3 elements
not relevant to
the scope of
practice
2014 Stage 1 Measure
Age Limits
Age 3 for BP,
NO age limit
for
Height/Weight
Exclusion
BP to be
separated from
height/weight
The vital signs changes are required starting in 2014
20
21. Changes to Stage 1: Testing of HIE
Current Stage 1 Measure
One test of electronic
transmission of key clinical
information
Stage 1 Measure Removed
Requirement removed for
2013
The removal of this objective is effective in 2013
21
22. Changes to Stage 1: View, Download and
Transmit (VDT) Health Information
2013 Stage 1 Objective
Objective
2014 Stage 1 Objective
Provide patients
with e-copy of
health information
upon request
Provide electronic
copy of health
information
Objective
Provide patients
with the ability to
view online,
download and
transmit their
health information
The measure of the new objective is 50 percent of patients have online access to their
information
The change in objective takes effect in 2014 to coincide with the 2014
certification and standards criteria
22
23. Changes to Stage 1: eRx and Public Health
eRX
– Addition of an exclusion: Any EP who does not have a pharmacy
within their organization and there are no pharmacies that accept
electronic prescriptions within 10 miles of the EP’s practice location at
the start of his/her EHR reporting period.
– 2013 onward
Public Health Objectives
– Addition of “except where prohibited” to the objective text for the
public health objectives
– 2013 onward
23
24. Stage 1 Meaningful Use Menu Objectives - 2014
Menu Set: Must do 5 of 9
Implement drug-formulary
checks
Generate patient list
Incorporate clinical labs
Medication reconciliation
Send reminder
Patient-specific education
Summary of care record
Submit electronic data to
immunization registry*
Submit electronic syndromic
surveillance data*
*At least one public health objective
must be selected.
24
26. How Do CQMs Relate to the CMS
Incentive Programs?
Although reporting CQMs is no longer a core objective of the
EHR Incentive Programs, all providers are required to report
on CQMs in order to demonstrate meaningful use
In 2014 and beyond, reporting programs (i.e., PQRS, eRx
reporting) will be streamlined in order to reduce provider
burden
26
27. CQMs in 2014 and Beyond
CQMs change in 2014
*Regardless of the stage of meaningful use, all providers will complete this number of
CQMs in 2014
27
28. CQM Alignment with HHS Priorities
All Providers Must Select CQMs from at least 3 of
the 6 HHS National Quality Strategy domains
Patient and Family Engagement
Patient Safety
Care Coordination
Population and Public Health
Efficient Use of Healthcare Resources
Clinical Processes/Effectiveness
28
29. CQMs in 2014 and Beyond
www.cms.gov/EHRIncentivePrograms
A complete list of 2014 CQMs and
their associated National Quality
Strategy domains is posted on the
CMS EHR Incentive Programs
website
CMS has posted a recommended
core set of CQMs for EPs that focus
on high priority health conditions
29
31. Reporting CQMs in 2014 and Beyond
Beginning in 2014, all Medicare-eligible providers in
their second year and beyond of demonstrating
meaningful use must electronically report their CQM
data to CMS
Michigan Medicaid providers will possibly electronically
report their CQM data to their state in 2015.
31
32. EP CQM Reporting in 2014
EPs Reporting for the Medicare EHR Incentive Program
32
34. Payment Adjustments
The HITECH Act stipulates that for a Medicare EP, subsection
(d) hospitals and CAHs, a payment adjustment applies if they
are not a Meaningful User
An EP, subsection (d) hospitals and CAHs, becomes a
Meaningful EHR User when they successfully attest to
Meaningful Use under either the Medicare or Medicaid EHR
Incentive Program
– Adopt, Implement or upgrade for the Medicaid EHR Incentive Program
DOES NOT EQUAL Meaningful Use
– A provider receiving the Medicaid Incentive for AIU is still subject to
the Medicare payment adjustment
34
35. EP Payment Adjustments
% adjustment below assumes less than 75% of EPs are meaningful users by CY 2018+
2015
2016
2017
2018
2019 2020+
EP is not subject to the
payment adjustment for eRx
in 2014
99%
98%
97%
96%
95%
95%
EP is subject to the payment
adjustment for eRx in 2014
98%
98%
97%
96%
95%
95%
% adjustment below assumes more than 75% of EPs are meaningful users by CY 2018+
2015
2016
2017
2018
2019
2020+
EP is not subject to the
payment adjustment for eRx in
2014
99%
98%
97%
97%
97%
97%
EP is subject to the payment
adjustment for eRx in 2014
98%
98%
97%
97%
97%
97%
35
36. EP EHR Reporting Period
Payment adjustments are based on prior years' reporting periods
The length of the reporting period depends upon the first year of
participation
To avoid payment adjustments:
– EPs MUST continue to demonstrate meaningful use every year to avoid
payment adjustments in subsequent years
For an EP who has demonstrated meaningful use in 2011 or 2012
Payment Adjustment Year
2015
2016
2017
2018
2019
2020
Based on full year EHR
reporting period
2013
2014* 2015
2016
2017
2018
*Special three month reporting period
36
37. EP EHR Reporting Period
For an EP who demonstrates meaningful use
in 2013 for the first time
Payment Adjustment Year
2015
Based on 90 day EHR
reporting period
2013
Based on full year EHR
reporting period
2016
2017
2018
2019
2020
2014* 2015
2016
2017
2018
*Special three month reporting period
To avoid payment adjustments:
EPs MUST continue to demonstrate meaningful use every year to avoid
payment adjustments in subsequent years
37
38. EP EHR Reporting Period
EP who demonstrates meaningful use in 2014
for the first time:
Payment Adjustment Year
2015
Based on 90 day EHR
reporting period
2014* 2014
Based on full year EHR
reporting period
2016
2017
2018
2019
2020
2015
2016
2017
2018
* In order to avoid the 2015 payment adjustment, the EP must attest no later than 10/1/14, which
means they must begin their 90-day reporting period no later than 7/1/14
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39. Payment Adjustments for Providers
Eligible for Both Programs
If you are eligible to participate in both the Medicaid and
Medicare EHR Incentive Programs, you MUST demonstrate
Meaningful Use according to the timelines in the previous
slides to avoid the payment adjustments
You may demonstrate meaningful use under either program
– NOTE: Congress mandated that an EP must be a meaningful user in order to avoid a
payment adjustment; therefore receiving a Medicaid EHR Incentive Payment for
adopting, implementing or upgrading your certified EHR Technology would not exempt
you from the payment adjustments
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40. EP Hardship Exceptions
EPs can apply for hardship exceptions in the following categories:
1. Infrastructure
EPs must demonstrate they are in an area without sufficient
internet access or face insurmountable barriers to obtaining
infrastructure.
2. New EPs
Newly practicing EPs who would not have time to become a
meaningful user can apply for a 2-year limited exception to
payment adjustments.
3. Unforeseen
circumstances
Natural disaster or other unforeseeable barrier.
4. EPs must
demonstrate the
criteria
1. Lack of face-to-face or telemedicine interaction with
patients.
2. Lack of need for follow up with patients.
5. EPs who practice Lack of control of availability of CEHRT for more than 50% of
in multiple locations patient encounters.
must demonstrate
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41. Applying for Hardship Exceptions
Applying: EPs/EHs must apply for hardship exceptions to avoid
payment adjustments
Granting Exceptions: CMS will grant hardship exceptions only
if they determine that providers have demonstrated that those
circumstances pose a significant barrier to them achieving
meaningful use
Deadlines: Applications need to be submitted no later than
July 1 for EPs of the year before the payment adjustment
year, but CMS recommends earlier submission
For More Information: Details on how to apply will be available
in the future at www.cms.gov/EHRIncentivePrograms
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43. Medicaid Eligibility Expansion
Patient Encounters
Definition of patient encounter has changed
The rule includes encounters for anyone enrolled in the
Medicaid program, including Medicaid expansion encounters
(except stand-alone Title 21) and those with zero-pay claims
The rule adds flexibility in the look-back period for overall
patient volume
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44. Provider Eligibility:
Patient Volume Calculation
Medicaid Encounters
Previously under Stage 1 rule:
– Service rendered on any one day where Medicaid paid for all or part of
the service or Medicaid paid the co-pays, cost-sharing or premiums
Changes in Stage 2 rule (applicable to all stages):
– Service rendered on any one day to a Medicaid-enrolled individual,
regardless of payment liability
– Includes zero-pay claims and encounters with patients in Title-21
funded Medicaid expansions (but not separate CHIPs)
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45. Provider Eligibility:
Patient Volume Calculation
90 Day Period for Medicaid Patient Volume
Calculation
Under Stage 1 rule, Medicaid patient volume for providers
calculated across 90-day period in last calendar year
Under Stage 2 rule (applicable to all stages), States also have the
option to allow providers to calculate Medicaid patient volume
across 90-day period in last 12 months preceding provider’s
attestation
Also applies to needy individual patient volume
Applies to patient panel methodology:
– With at least one Medicaid encounter taking place in the last 24 months
prior to the 90-day period (expanded from 12 months prior)
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47. Stage 2 Resources
CMS Stage 2 Website
http://www.cms.gov/Regulations-and
Guidance/Legislation/EHRIncentivePrograms/Stage_2.html
Links to the Federal Register
Tip Sheets:
– Stage 1 Changes
– 2014 Clinical Quality Measures
– Payment Adjustments & Hardship Exceptions
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48. Contact Us
Michelle Brunsen
Sr. Health IT Advisor
mbrunsen@telligen.org
(515) 453-8180
www.telligenhitrec.org
@TelligenHITREC
In Partnership with: The Office of the National Coordinator for Health Information Technology (ONC) U.S. Department of
Health and Human Services grant 90RC0004/01.
IA-HITREC-05/13-794
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