The document discusses changes between the proposed rule and final rule for implementing the Medicare and Medicaid EHR Incentive Program under the HITECH Act. Key changes included lowering the thresholds for meaningful use measures, modifying clinical quality measures, and clarifying eligible provider and hospital definitions. The final rule aimed to ease burden and address concerns raised during public comment period.
This document provides an overview and summary of changes between the proposed rule and final rule for implementing the Medicare and Medicaid EHR Incentive Program under the HITECH Act. Some key changes included modifications to the meaningful use criteria and clinical quality measures, clarification of provider eligibility requirements, and adjustment of measure thresholds. The final rule aimed to address concerns raised in public comments to better achieve the goals of improved care, health outcomes, and interoperability.
HIT Standards Committee Trudel CMS RulesBrian Ahier
The document discusses changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program. Key changes included clarifying provider eligibility, modifying clinical quality measures, and lowering thresholds for some meaningful use objectives. The final rule kept the same statutory requirements and meaningful use goals as the proposed rule.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting requirements.
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.
Eligible professionals and hospitals have core and menu objectives they must meet to achieve Stage 1 Meaningful Use of electronic health records. Objectives include items like electronic prescribing, clinical decision support, and exchanging key clinical information. Professionals must complete 20 objectives total and hospitals must complete 19. Both must report on clinical quality measures to CMS or states. The document provides details on Stage 1 Meaningful Use requirements and measures.
The document discusses the objectives and requirements of Meaningful Use (MU), an incentive program that promotes the adoption and meaningful use of electronic health records (EHRs). It outlines the core objectives that eligible professionals and hospitals must meet, such as computerized provider order entry, maintaining active medication lists, and exchanging key clinical information. The document also details the measure thresholds associated with each objective that providers must meet to qualify for MU incentive payments.
This document provides an overview of the requirements for achieving Meaningful Use under the Medicare and Medicaid EHR Incentive Programs. It defines Meaningful Use as using certified EHR technology to improve quality, safety, efficiency and health outcomes. The three main components of Meaningful Use are use of EHRs in a meaningful manner, electronic exchange of health information, and submission of clinical quality measures. Stage 1 requirements include completing core and menu set objectives related to EHR usage, engaging patients, care coordination, and privacy/security. Eligible professionals must meet 15 core objectives and hospitals must meet 14.
The document provides guidance on the 2007 Physician Quality Reporting Initiative (PQRI) for eligible medical professionals. It describes the goals of the PQRI to focus on quality of care and reward reporting of quality measures with financial incentives. It outlines the eligible professionals, quality measures, reporting requirements, and bonus payments for successful reporting. It also provides details on understanding the quality measures, applicable codes, modifiers, and examples of successful reporting.
This document provides an overview and summary of changes between the proposed rule and final rule for implementing the Medicare and Medicaid EHR Incentive Program under the HITECH Act. Some key changes included modifications to the meaningful use criteria and clinical quality measures, clarification of provider eligibility requirements, and adjustment of measure thresholds. The final rule aimed to address concerns raised in public comments to better achieve the goals of improved care, health outcomes, and interoperability.
HIT Standards Committee Trudel CMS RulesBrian Ahier
The document discusses changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program. Key changes included clarifying provider eligibility, modifying clinical quality measures, and lowering thresholds for some meaningful use objectives. The final rule kept the same statutory requirements and meaningful use goals as the proposed rule.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting requirements.
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.
Eligible professionals and hospitals have core and menu objectives they must meet to achieve Stage 1 Meaningful Use of electronic health records. Objectives include items like electronic prescribing, clinical decision support, and exchanging key clinical information. Professionals must complete 20 objectives total and hospitals must complete 19. Both must report on clinical quality measures to CMS or states. The document provides details on Stage 1 Meaningful Use requirements and measures.
The document discusses the objectives and requirements of Meaningful Use (MU), an incentive program that promotes the adoption and meaningful use of electronic health records (EHRs). It outlines the core objectives that eligible professionals and hospitals must meet, such as computerized provider order entry, maintaining active medication lists, and exchanging key clinical information. The document also details the measure thresholds associated with each objective that providers must meet to qualify for MU incentive payments.
This document provides an overview of the requirements for achieving Meaningful Use under the Medicare and Medicaid EHR Incentive Programs. It defines Meaningful Use as using certified EHR technology to improve quality, safety, efficiency and health outcomes. The three main components of Meaningful Use are use of EHRs in a meaningful manner, electronic exchange of health information, and submission of clinical quality measures. Stage 1 requirements include completing core and menu set objectives related to EHR usage, engaging patients, care coordination, and privacy/security. Eligible professionals must meet 15 core objectives and hospitals must meet 14.
The document provides guidance on the 2007 Physician Quality Reporting Initiative (PQRI) for eligible medical professionals. It describes the goals of the PQRI to focus on quality of care and reward reporting of quality measures with financial incentives. It outlines the eligible professionals, quality measures, reporting requirements, and bonus payments for successful reporting. It also provides details on understanding the quality measures, applicable codes, modifiers, and examples of successful reporting.
Balancing post-market monitoring with pre-market requirementsTGA Australia
Dr Jane Cook discusses balancing pre-market requirements with post-market monitoring of new drugs. International trends show increased demand for early access to promising new therapies and different regulatory approaches between Europe and the US. This includes adaptive licensing in Europe and breakthrough therapy designation in the US. Ensuring benefits are realized requires effective post-market monitoring as initial trials may overstate benefits or overlook safety issues. Opportunities exist to learn from other regulators and focus on the drug lifecycle to confirm benefits, inform patients of limitations, and withdraw products if risks outweigh benefits.
The document outlines the proposed requirements for Stage 2 of Meaningful Use, including:
- Eligible professionals must meet or qualify for an exclusion to 17 core and 3 of 5 menu objectives, while hospitals must meet 16 core and 2 of 4 menu objectives. Both must report more clinical quality measures.
- Objectives involve increased percentages for items like CPOE, clinical decision support, recording patient data as structured data, and engaging patients online.
- It also discusses quality measure reporting requirements and considerations for both professionals and hospitals.
The document summarizes changes to the Meaningful Use Stage 2 rules for electronic health record incentive programs. Key changes include allowing a 90-day reporting period in 2017 for first-time participants and those choosing to implement Stage 3 in 2017. It modifies measures related to patient engagement, public health reporting, and thresholds for Stage 3 objectives like computerized provider order entry and electronic prescribing. The final rule also changes the 2015 reporting period to 90 days and aligns future periods with the calendar year. It streamlines programs by removing redundant measures and modifies several objectives and measures for Stages 1, 2 and 3.
Overview of Stage 2 Clinical Quality Measures for the Medicare and Medicaid E...Brian Ahier
Session provides in-depth overview of clinical quality measures included in the final rule for Stage 2 of Meaningful Use for the EHR Incentive Programs for eligible professionals. Details provided on the measures, the recommended core set for reporting purposes, and the upcoming release of the 2014 electronic specifications for the EHR Incentive Programs.
Health Technology Assessments in Indiashashi sinha
The document provides an overview of health technology assessment (HTA) in India. It discusses how HTA can help optimize resource allocation and ensure affordable access to essential healthcare as part of India's universal health coverage agenda. The HTAIn was established to conduct HTA studies to inform decision making. HTAIn's objectives include maximizing health outcomes while reducing costs and inequality. It has completed several studies that have informed policies on topics like safety engineered syringes, intraocular lenses for cataracts, and long acting contraceptives. Ongoing studies cover additional health technologies. HTAIn aims to support evidence-based policies to expand coverage and financial risk protection.
The document summarizes a proposed rule from the Centers for Medicare & Medicaid Services (CMS) to implement incentive programs for hospitals and healthcare providers to adopt electronic health records (EHRs) as authorized by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The proposed rule defines meaningful use criteria for EHRs, outlines incentive payment structures and eligibility over multiple stages and years, and solicits public comments on the proposals by March 15, 2010.
Please share this slideshow with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● A discussion on the Canadian public and private drug access environment
● A moderated panel on the broader access and innovation context, featuring an update on international access to innovative therapies, patient support programs, and innovative pathways for access to treatments
View the video:
Follow our social media accounts:
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This document discusses the importance of patient involvement in health technology assessment (HTA). It notes that HTA evaluates new drugs and medical technologies but typically does not incorporate patient perspectives on factors like quality of life. The document advocates that patients should play a role in HTA processes by providing input on treatment outcomes, tolerability, and other real-world considerations to ensure funding decisions align with patient values and needs. It provides examples of how patients could be engaged as representatives, through surveys or public input, and highlights the need for HTA to consider individual patient impacts rather than just average population effects.
CMS’ Final Rule expands Medicare reimbursement for chronic care management (CCM) services including telehealth. CCM requires at least 20 minutes per month of non-face-to-face care by a care team under a provider. It includes services like remote patient monitoring, medication management, and care coordination. Telehealth can help provide 24/7 access and monitor medical, functional, and psychosocial needs between in-person visits. Providers must meet documentation and patient consent requirements for reimbursement.
Measuring and Monitoring Clinical Quality Measures in Practice FusionKimberly Hilton
Clinical Quality Measures (CQMs) are used to measure and monitor the quality of care provided in practices. CQMs consist of numerators and denominators that are defined by measure specifications. Practice Fusion supports recording CQM data elements to report on over 25 CQMs across all six National Quality Strategy domains. Providers can record screening results, assessments, and follow-up plans in the patient chart to submit CQM data for quality reporting programs.
The document outlines a discussion on developing a universal pharmacare program in Canada, including reviewing different models proposed, lessons from international programs, and perspectives from mental health advocates. A vision and principles for a potential universal pharmacare plan are proposed that emphasize equitable access to necessary medications for all Canadians through a publicly-funded program. Next steps discussed include finalizing a report and seeking opportunities to promote the proposed approach.
Performance-based financing presentation to the Health Financing AcceleratorReBUILD for Resilience
1) The document reviews evidence on the effectiveness of performance-based financing (PBF) and direct facility financing (DFF) approaches.
2) The Cochrane review found that PBF generally improved utilization and quality of targeted health services, but results were mixed for non-targeted indicators. Impacts on health outcomes were also mixed.
3) Evidence on DFF was limited but other reviews found prospective payment mechanisms like capitation can reduce costs while maintaining service utilization and quality of care.
Using Patient Registries and Automated Patient Outreach to Qualify for NCQA L...Phytel
The document discusses using patient registries and automated patient outreach to help medical practices qualify for level 3 recognition as a patient-centered medical home according to NCQA standards. It describes how the Phytel system can mine practice data to identify patients for recommended care, contact patients via automated outreach scripts, and generate reports on quality measures and financial results to document improved performance. Using these tools helped one practice profiled achieve the highest level of NCQA medical home qualification.
AAPC Local chapter Presentation by Venkatesh Srinivas-Vee TechnologiesVee Technologies
The value of clinical documentation improvement in a value-based reimbursement model is discussed. Physicians play a critical role in supporting the transition to value-based care through improved documentation. Value-based care combined with CDI can help achieve the goal of improved population health. CDI ensures accurate reimbursement under various models like IPPS, OPPS, FFS, and risk-adjusted models by capturing the right codes. It also impacts quality reporting programs like MIPS and helps achieve better health outcomes and cost savings. Examples are provided showing the impact of CDI on reimbursement through correcting coding at the outpatient level under different models.
The Meaningful Use Stage 2 requirements include meeting or qualifying for exclusions to more objectives across core and menu sets compared to Stage 1. Eligible professionals must meet 17 core objectives and 5 menu objectives, while hospitals must meet 16 core and 2 menu objectives. Both must also report more clinical quality measures. The requirements focus on improving care coordination, patient engagement, population health, and privacy/security protections.
My presentation at Children's Hospital of LA regarding custom views that I have built over the past 4 years to assist physicians in their daily workflows.
This document discusses an overview of the Affordable Care Act (ACA) in 3 pages. It provides background on the ACA and its goals of making healthcare more affordable and accessible. Key points covered include expanding Medicaid eligibility, creating state-run health insurance exchanges, establishing essential health benefits, and implementing subsidies and penalties to increase insurance coverage. Frequently asked questions about the ACA are also addressed.
This document discusses innovations in patient care including electronic health records (EHR), practice management systems (PMS), health information exchange (HIE), and personal health records (PHR). It then provides a detailed 7-page digest on the benefits of the Affordable Care Act (ACA) and how it can be used to educate voters on why they should support the ACA. The digest has been used in community meetings and to educate over 1,500 individuals.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting requirements.
Balancing post-market monitoring with pre-market requirementsTGA Australia
Dr Jane Cook discusses balancing pre-market requirements with post-market monitoring of new drugs. International trends show increased demand for early access to promising new therapies and different regulatory approaches between Europe and the US. This includes adaptive licensing in Europe and breakthrough therapy designation in the US. Ensuring benefits are realized requires effective post-market monitoring as initial trials may overstate benefits or overlook safety issues. Opportunities exist to learn from other regulators and focus on the drug lifecycle to confirm benefits, inform patients of limitations, and withdraw products if risks outweigh benefits.
The document outlines the proposed requirements for Stage 2 of Meaningful Use, including:
- Eligible professionals must meet or qualify for an exclusion to 17 core and 3 of 5 menu objectives, while hospitals must meet 16 core and 2 of 4 menu objectives. Both must report more clinical quality measures.
- Objectives involve increased percentages for items like CPOE, clinical decision support, recording patient data as structured data, and engaging patients online.
- It also discusses quality measure reporting requirements and considerations for both professionals and hospitals.
The document summarizes changes to the Meaningful Use Stage 2 rules for electronic health record incentive programs. Key changes include allowing a 90-day reporting period in 2017 for first-time participants and those choosing to implement Stage 3 in 2017. It modifies measures related to patient engagement, public health reporting, and thresholds for Stage 3 objectives like computerized provider order entry and electronic prescribing. The final rule also changes the 2015 reporting period to 90 days and aligns future periods with the calendar year. It streamlines programs by removing redundant measures and modifies several objectives and measures for Stages 1, 2 and 3.
Overview of Stage 2 Clinical Quality Measures for the Medicare and Medicaid E...Brian Ahier
Session provides in-depth overview of clinical quality measures included in the final rule for Stage 2 of Meaningful Use for the EHR Incentive Programs for eligible professionals. Details provided on the measures, the recommended core set for reporting purposes, and the upcoming release of the 2014 electronic specifications for the EHR Incentive Programs.
Health Technology Assessments in Indiashashi sinha
The document provides an overview of health technology assessment (HTA) in India. It discusses how HTA can help optimize resource allocation and ensure affordable access to essential healthcare as part of India's universal health coverage agenda. The HTAIn was established to conduct HTA studies to inform decision making. HTAIn's objectives include maximizing health outcomes while reducing costs and inequality. It has completed several studies that have informed policies on topics like safety engineered syringes, intraocular lenses for cataracts, and long acting contraceptives. Ongoing studies cover additional health technologies. HTAIn aims to support evidence-based policies to expand coverage and financial risk protection.
The document summarizes a proposed rule from the Centers for Medicare & Medicaid Services (CMS) to implement incentive programs for hospitals and healthcare providers to adopt electronic health records (EHRs) as authorized by the Health Information Technology for Economic and Clinical Health (HITECH) Act. The proposed rule defines meaningful use criteria for EHRs, outlines incentive payment structures and eligibility over multiple stages and years, and solicits public comments on the proposals by March 15, 2010.
Please share this slideshow with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● A discussion on the Canadian public and private drug access environment
● A moderated panel on the broader access and innovation context, featuring an update on international access to innovative therapies, patient support programs, and innovative pathways for access to treatments
View the video:
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
This document discusses the importance of patient involvement in health technology assessment (HTA). It notes that HTA evaluates new drugs and medical technologies but typically does not incorporate patient perspectives on factors like quality of life. The document advocates that patients should play a role in HTA processes by providing input on treatment outcomes, tolerability, and other real-world considerations to ensure funding decisions align with patient values and needs. It provides examples of how patients could be engaged as representatives, through surveys or public input, and highlights the need for HTA to consider individual patient impacts rather than just average population effects.
CMS’ Final Rule expands Medicare reimbursement for chronic care management (CCM) services including telehealth. CCM requires at least 20 minutes per month of non-face-to-face care by a care team under a provider. It includes services like remote patient monitoring, medication management, and care coordination. Telehealth can help provide 24/7 access and monitor medical, functional, and psychosocial needs between in-person visits. Providers must meet documentation and patient consent requirements for reimbursement.
Measuring and Monitoring Clinical Quality Measures in Practice FusionKimberly Hilton
Clinical Quality Measures (CQMs) are used to measure and monitor the quality of care provided in practices. CQMs consist of numerators and denominators that are defined by measure specifications. Practice Fusion supports recording CQM data elements to report on over 25 CQMs across all six National Quality Strategy domains. Providers can record screening results, assessments, and follow-up plans in the patient chart to submit CQM data for quality reporting programs.
The document outlines a discussion on developing a universal pharmacare program in Canada, including reviewing different models proposed, lessons from international programs, and perspectives from mental health advocates. A vision and principles for a potential universal pharmacare plan are proposed that emphasize equitable access to necessary medications for all Canadians through a publicly-funded program. Next steps discussed include finalizing a report and seeking opportunities to promote the proposed approach.
Performance-based financing presentation to the Health Financing AcceleratorReBUILD for Resilience
1) The document reviews evidence on the effectiveness of performance-based financing (PBF) and direct facility financing (DFF) approaches.
2) The Cochrane review found that PBF generally improved utilization and quality of targeted health services, but results were mixed for non-targeted indicators. Impacts on health outcomes were also mixed.
3) Evidence on DFF was limited but other reviews found prospective payment mechanisms like capitation can reduce costs while maintaining service utilization and quality of care.
Using Patient Registries and Automated Patient Outreach to Qualify for NCQA L...Phytel
The document discusses using patient registries and automated patient outreach to help medical practices qualify for level 3 recognition as a patient-centered medical home according to NCQA standards. It describes how the Phytel system can mine practice data to identify patients for recommended care, contact patients via automated outreach scripts, and generate reports on quality measures and financial results to document improved performance. Using these tools helped one practice profiled achieve the highest level of NCQA medical home qualification.
AAPC Local chapter Presentation by Venkatesh Srinivas-Vee TechnologiesVee Technologies
The value of clinical documentation improvement in a value-based reimbursement model is discussed. Physicians play a critical role in supporting the transition to value-based care through improved documentation. Value-based care combined with CDI can help achieve the goal of improved population health. CDI ensures accurate reimbursement under various models like IPPS, OPPS, FFS, and risk-adjusted models by capturing the right codes. It also impacts quality reporting programs like MIPS and helps achieve better health outcomes and cost savings. Examples are provided showing the impact of CDI on reimbursement through correcting coding at the outpatient level under different models.
The Meaningful Use Stage 2 requirements include meeting or qualifying for exclusions to more objectives across core and menu sets compared to Stage 1. Eligible professionals must meet 17 core objectives and 5 menu objectives, while hospitals must meet 16 core and 2 menu objectives. Both must also report more clinical quality measures. The requirements focus on improving care coordination, patient engagement, population health, and privacy/security protections.
My presentation at Children's Hospital of LA regarding custom views that I have built over the past 4 years to assist physicians in their daily workflows.
This document discusses an overview of the Affordable Care Act (ACA) in 3 pages. It provides background on the ACA and its goals of making healthcare more affordable and accessible. Key points covered include expanding Medicaid eligibility, creating state-run health insurance exchanges, establishing essential health benefits, and implementing subsidies and penalties to increase insurance coverage. Frequently asked questions about the ACA are also addressed.
This document discusses innovations in patient care including electronic health records (EHR), practice management systems (PMS), health information exchange (HIE), and personal health records (PHR). It then provides a detailed 7-page digest on the benefits of the Affordable Care Act (ACA) and how it can be used to educate voters on why they should support the ACA. The digest has been used in community meetings and to educate over 1,500 individuals.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting requirements.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures requirements for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting policies to fully implement the program in 2011.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting requirements.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting requirements.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures requirements for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting policies.
This document summarizes changes from the proposed rule to the final rule for Stage 1 of the Medicare and Medicaid EHR Incentive Program's meaningful use criteria. Key changes included lowering thresholds for some objectives, removing administrative transactions, adding new objectives, and modifying clinical quality measures for eligible professionals. The final rule provided more flexibility for states and clarified various eligibility and reporting requirements.
The document summarizes the specifics of the Medicare and Medicaid EHR Incentive Program for hospitals. It outlines who is eligible to participate in the program, how incentive payment amounts are calculated under Medicare and Medicaid, and what the requirements are for hospitals to qualify for incentive payments, including adopting/implementing certified EHR technology and demonstrating meaningful use of EHRs through meeting objectives and clinical quality measures.
This document provides an overview of the Medicare and Medicaid EHR Incentive Program for hospitals. It discusses who is eligible, how incentive payments are calculated, the meaningful use requirements including core and menu objectives, and clinical quality measures. Key details include that hospitals can receive incentives from both Medicare and Medicaid by meeting meaningful use through CMS, incentive payments are based on Medicaid and Medicare patient volumes and discharged and range from $2 million to multi-year payments, and Stage 1 meaningful use involves completing 14 core objectives and 5 out of 10 menu objectives.
Working with Regulators: A Focus on CMS | June 24, 2014 | All SlidesCancerSupportComm
CMS is seeking input from patient advocacy groups like the Cancer Support Community on developing quality measures that focus on issues that matter most to patients and caregivers. CMS measures quality of cancer care across different settings and aims to align measures across public and private payers to reduce reporting burden and consistently focus on important patient issues. CMS oversees large healthcare programs that impact over 100 million Americans and seeks to transform the healthcare system to make it more patient-centered, outcomes-focused, coordinated, and sustainable.
Stage 2 Meaningful Use brings more stringent requirements for the Stage 1 measures, a host of new measures, and a greater focus on clinical quality measures. In this instructive session, our expert faculty members review:
*The requirements and timeline for implementation of Stage 2 Meaningful Use
*The top five questions you need to ask to determine if your organization is ready for Stage 2
*The steps you can take to prepare your organization to successfully meet the Stage 2 requirements and get the most out of your EHR system
The document outlines the 15 core requirements that must be met under Meaningful Use Stage 1, which include objectives like computerized provider order entry, drug interaction checks, maintaining problem lists and medication lists, recording vital signs and smoking status, implementing clinical decision support rules, and conducting security risk analyses to protect electronic health information. Eligible providers must meet thresholds for each objective through the use of certified electronic health records in order to qualify for financial incentives.
An Insider's Guide to Working with CMS - Shari LingCancerSupportComm
This document summarizes a presentation given by Shari Ling, Deputy Chief Medical Officer at CMS, to the Cancer Policy Institute at the Cancer Support Community. Some key points:
- CMS is focused on developing more patient-centered quality measures that assess outcomes important to patients and caregivers. They welcome input from patient advocacy groups.
- CMS aims to align quality measures across different healthcare settings to reduce reporting burden and focus measurement on the issues that matter most to patients.
- CMS is responsible for administering Medicare, Medicaid, and other large healthcare programs, and uses quality measurement to incentivize higher quality, more coordinated care, and payment reform efforts like value-based purchasing.
The document summarizes the opportunity and need for healthcare providers to adopt electronic medical records (EMRs) to qualify for incentive payments under the HITECH Act. It outlines how adopting EMRs can help providers meet meaningful use standards and notes the large costs savings estimated from greater healthcare efficiencies and automation. It also highlights the growing requirements over the next few years that make it important for providers not to wait to implement an EMR system.
Michigan Hospital Association Governance meetingMary Beth Bolton
Patient centered medical home activities in MI and Nationally and the opportunity to improve quality outcomes by increased access to primary care doctors who outreach members who are missing preventive and chronic care services.
How to Define Effective and Efficient Real World TrialsTodd Berner MD
This document discusses strategies for designing effective and efficient real-world clinical trials. It covers topics such as using real-world evidence to inform clinical trial design, the differences between efficacy and effectiveness, challenges around representativeness in trial populations, and the value of pragmatic clinical trials. It also discusses leveraging electronic health records for condition-specific prompts and clinical decision support to improve performance and quality of care.
How to design effective and efficient real world trials TB Evidence 2014 10.2...Todd Berner MD
This document discusses strategies for designing effective and efficient real-world clinical trials. It covers topics such as using real-world evidence to inform clinical trial design, the differences between efficacy and effectiveness, challenges in defining quality metrics, and strategies for improving performance within healthcare systems. The document provides information on pragmatic clinical trials and how real-world evidence could reduce costs compared to traditional clinical trials.
Meaningful Use Stage 1 establishes the basic concepts and requirements for using electronic health records to qualify for incentive payments, including: establishing core measures of meaningful use; requiring the use of certified EHR systems; and outlining the stages of meaningful use that focus on data capture, clinical processes, and improved outcomes. It also describes the eligible providers, certified EHR criteria, Medicare and Medicaid program differences, and recommendations to familiarize oneself with the requirements to receive incentive payments.
> Why HEOR?
> Costs, Consequences and Perspectives
> Key Stakeholders in HEOR
> What is Health Economics and Pharmaco-economic Research?
> Economic Evaluations
> Incremental Cost Effectiveness Ratio (ICER)
> Concept of HRQoL
> Comparative Effectiveness Research (CER)
> Pragmatic Clinical Trials
> Observational Studies
> Systematic Reviews and Meta-Analysis
> Application of CER
> Health Technology Assessment (HTA)
> Real World Evidence (RWE)
> Patient Reported Outcomes (PROs)
> Patient Focused Drug Development (PFDD)
> Application of Health Economic Evaluations
> Challenges and Barriers
The document provides an overview of meaningful use and the EHR incentive programs. It discusses the stages of meaningful use, eligibility requirements, incentive payment schedules, requirements for evidencing meaningful use such as objectives and measures, the EHR certification process, and next steps for providers in registering for incentive programs in 2011. The presentation was given by Scott Rogerson of consulting firm The Hill Group to prepare attendees for meaningful use.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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1. Medicare & Medicaid EHR
Incentive Program Final Rule
Implementing the American
Recovery & Reinvestment Act of 2009
2. The Journey to Meaningful Use
Faith is the bird that sings when the dawn is still
dark. Rabindranath Tagore
2
3. Overview
• American Recovery & Reinvestment Act
(Recovery Act) – February 17, 2009
• Medicare & Medicaid Electronic Health Record
(EHR) Incentive Program Notice of Proposed
Rulemaking (NPRM)
• Display – December 30, 2009
• Publication – January 13, 2010
• Final Rule on Display – July 13, 2010
• Final Rule Published – July 28, 2010
3
4. What did not change
in the final rule
• Adopted statutory provider eligibility and payment
requirements
• Meaningful Use matrix goals remained the same.
• Hospital definition did not change.
• EPs will still be required to demonstrate MU
individually
• Clinical quality measures reporting timeline will stay
the same
• MU reporting period of 90 days for first year and one
year thereafter. 4
5. What Changed from the NPRM
to the Final Rule?
• Meaningful Use Criteria
• Clinical Quality Measures
• Hospital-based EPs
• Medicaid acute care hospitals
• Medicaid patient volume
• Removed reporting period for adopt, implement
or upgrade (Medicaid)
• All programs will start in 2011
• More clarification throughout
5
6. Changes to Provider Eligibility
• Due to recent legislation, hospital-based EPs are only
those who see more than 90% of their patients in a
hospital in-patient or ER setting
• Medicaid included critical access hospitals in its
definition of “acute care hospital” (but incentive is like
other acute care hospitals, not following the Medicare
CAH formula)
6
7. Medicaid Patient Volume
Medicaid EP participation hinges on patient volume
requirements.
• Medicaid patient volume was significantly clarified
• Expanded definition of “encounter” to include any
encounter for which Medicaid had any payment liability
e.g. premiums, co-pays, waivers
• Allows States to define patient volume as just
encounters or encounters plus patient panel (managed
care), both or propose a new methodology
7
8. Meaningful Use: Process of Defining
• National Committee on Vital and Health Statistics
(NCVHS) hearings
• HIT Policy Committee (HITPC) recommendations
• Listening Sessions with providers/organizations
• Public comments on HITPC recommendations
• Comments received from the Department and the
Office of Management and Budget (OMB)
• Revised based on public comments on the NPRM
8
9. Meaningful Use Stage 1 –
Health Outcome Priorities*
• Improve quality, safety, efficiency, and reduce
health disparities
• Engage patients and families in their health care
• Improve care coordination
• Improve population and public health
• Ensure adequate privacy and security protections
for personal health information
*Adapted from National Priorities Partnership. National Priorities and Goals: Aligning Our Efforts to Transform America’s
Healthcare. Washington, DC: National Quality Forum; 2008.
9
10. Meaningful Use: Changes from
the NPRM to the Final Rule
NPRM Final Rule
Meet all MU reporting objectives Must meet “core set”/can defer 5 from
optional “menu set”
25 measures for EPs/23 measures for 25 measures for EPs/24 for eligible
eligible hospitals hospitals
Measure thresholds range from 10% to Measure thresholds range from 10% to
80% of patients or orders (most at higher 80% of patients or orders (most at lower
range) to middle range)
Denominators – To calculate the Denominators – No measures require
threshold, some measures required manual chart review to calculate
manual chart review threshold
Administrative transactions (claims and Administrative transactions removed
eligibility) included
Measures for Patient-Specific Education Measures for Patient-Specific Education
Resources and Advanced Directives Resources and Advanced Directives (for
discussed but not proposed hospitals) included
10
11. Meaningful Use: Changes from
the NPRM to the Final Rule, cont’d
NPRM Final Rule
States could propose requirements States’ flexibility with Stage 1 MU is
above/beyond MU floor, but not with limited to seeking CMS approval to
additional EHR functionality require 4 public health-related
objectives to be core instead of menu
Core clinical quality measures (CQM) Modified Core CQM and removed
and specialty measure groups for EPs specialty measure groups for EPs
90 CQM total for EPs 44 CQM total for EPs – must report
total of 6
35 CQM total for eligible hospitals and 15 CQM total for eligible hospitals
8 alternate Medicaid CQM
5 CQM overlap with CHIPRA initial core 4 CQM overlap with CHIPRA initial core
set set
11
12. How were MU Core Objectives
Selected?
• Overarching considerations
• Statutory requirements-e.g.- e-prescribing, CQM, health information
exchange
• Foundational objectives-e.g. privacy and security and those that provide
foundational data needed for other measures, like demographics,
medication lists, etc.
• Patient-centered
• Patient access- e.g. clinical summaries
• Patient safety-e.g.-drug-drug and drug-allergy features)
• Part of providers’ “normal” practice
• Looked at how the objectives aligned
• Feedback received from HIT Policy Committee and commenters
12
13. Meaningful Use: Denominators
• Two types of percentage based measures are
included to address the burden of demonstrating
MU
1. Denominator is all patients seen or admitted during
the EHR reporting period
• The denominator is all patients regardless of whether their
records are kept using certified EHR technology
1. Denominator is actions or subsets of patients seen or
admitted during the EHR reporting period
13
14. Meaningful Use: Applicability of
Objectives and Measures
• Some MU objectives are not applicable to every
provider’s clinical practice, thus they would not
have any eligible patients or actions for the
measure denominator.
• In these cases, the EP, eligible hospital or CAH
would be excluded from having to meet that
measure
• Ex: Dentists who do not perform immunizations;
Chiropractors do not e-prescribe
• The denominator only includes patients, or actions taken on
behalf of those patients, whose records are kept using
certified EHR technology
14
15. How were the Thresholds Selected
• 80%-Objective part of standard practice-e.g.-
maintain active medication list
• Others-defined on a case-by-case basis based on
commenter or clearance feedback
• Example-e-prescribing set at 40% lowered from
75% to address concerns by commenters
regarding non-participation by pharmacies and
patient preference.
15
16. Meaningful Use – Stage 1 Core Set
Health Stage 1 Objective Stage 1 Measure
Outcomes
Policy
Priority
Improving Use CPOE for medication orders directly entered by More than 30% of unique patients with at least one
quality, any licensed healthcare professional who can enter medication in their medication list seen by the EP or
safety, orders into the medical record per state, local, and admitted to the eligible hospital or CAH have at least
efficiency, professional guidelines one medication entered using CPOE
and Implement drug-drug and drug-allergy interaction The EP/eligible hospital/CAH has enabled this
reducing checks functionality for the entire EHR reporting period
health
disparities EP Only: Generate and transmit permissible More than 40% of all permissible prescriptions written
prescriptions electronically (eRx) by the EP are transmitted electronically using certified
EHR technology
Record demographics: preferred language, gender, More than 50% of all unique patients seen by the EP or
race, ethnicity, date of birth, and date and admitted to the eligible hospital or CAH have
preliminary cause of death in the event of mortality demographics as recorded structured data
in the eligible hospital or CAH
Maintain up-to-date problem list of current and More than 80% of all unique patients seen by the EP or
active diagnoses admitted to the eligible hospital or CAH have at least
one entry or an indication that no problems are known
for the patient recorded as structured data
17. Meaningful Use – Stage 1 Core Set, cont’d
Health Stage 1 Objective Stage 1 Measure
Outcomes
Policy
Priority
Improving Maintain active medication list More than 80% of all unique patents seen by the EP or
quality, admitted to the eligible hospital or CAH have at least
safety, one entry (or an indication that the patient is not
efficiency, currently prescribed any medication) recorded as
and structured data
reducing Maintain active medication allergy list More than 80% of all unique patents seen by the EP or
health admitted to the eligible hospital or CAH have at least
disparities one entry (or an indication that the patient has no
known medication allergies) recorded as structured data
Record and chart vital signs: height, weight, blood For more than 50% of all unique patients age 2 and over
pressure, calculate and display BMI, plot and display seen by the EP or admitted to the eligible hospital or
growth charts for children 2-20 years, including BMI CAH, height, weight, and blood pressure are recorded as
structured data
Record smoking status for patients 13 years old or More than 50% of all unique patients 13 years or older
older seen by the EP or admitted to the eligible hospital or
CAH have smoking status recorded as structured data
Implement one clinical decision support rule and the Implement one clinical decision support rule
ability to track compliance with the rule
Report clinical quality measures to CMS or the States For 2011, provide aggregate numerator, denominator,
and exclusions through attestation; For 2012,
electronically submit clinical quality measures
18. Meaningful Use – Stage 1 Core Set, cont’d
Health Stage 1 Objective Stage 1 Measure
Outcomes
Policy
Priority
Engage Provide patients with an electronic copy of their More than 50% of all unique patients of the EP, eligible
patients and health information (including diagnostic test results, hospital or CAH who request an electronic copy of their
families in problem list, medication lists, medication allergies, health information are provided it within 3 business
their discharge summary, procedures), upon request days
healthcare Hospitals Only: Provide patients with an electronic More than 50% of all patients who are discharged from
copy of their discharge instructions at time of an eligible hospital or CAH who request an electronic
discharge, upon request copy of their discharge instructions are provided it
EPs Only: Provide clinical summaries for each office Clinical summaries provided to patients for more than
visit 50% of all office visits within 3 business days
Improve care Capability to exchange key clinical information (ex: Performed at least one test of the certified EHR
coordination problem list, medication list, medication allergies, technology’s capacity to electronically exchange key
diagnostic test results), among providers of care and clinical information
patient authorized entities electronically
Ensure Protect electronic health information created or Conduct or review a security risk analysis per 45 CFR
adequate maintained by certified EHR technology through the 164.308(a)(1) and implement updates as necessary and
privacy and implementation of appropriate technical capabilities correct identified security deficiencies as part of the
security EP’s, eligible hospital’s or CAH’s risk management
protections process
for personal
health
information
19. Meaningful Use – Stage 1 Menu Set
Health Stage 1 Objective Stage 1 Measure
Outcomes
Policy
Priority
Improving Implement drug-formulary checks The EP/eligible hospital/CAH has enabled this
quality, functionality and has access to at least one internal or
safety, external drug formulary for the entire EHR reporting
efficiency, period
and reducing Hospitals Only: Record advance directives for More than 50% of all unique patients 65 years old or
health patients 65 years old or older older admitted to the eligible hospital or CAH have an
disparities indication of an advance directive status recorded
Incorporate clinical lab-test results into certified EHR More than 40% of all clinical lab test results ordered by
technology as structured data the EP, or an authorized provider of the eligible hospital
or CAH, for patients admitted during the EHR reporting
period whose results are either in a positive/negative or
numerical format are incorporated in certified EHR
technology as structured data
Generate lists of patients by specific conditions to Generate at least one report listing patients of the EP,
use for quality improvement, reduction of disparities, eligible hospital or CAH with a specific condition
research or outreach
EPs Only: Send reminders to patients per patient More than 20% of all unique patients 65 years or older
preference for preventive/follow-up care or 5 years old or younger were sent an appropriate
reminder during the EHR reporting period
20. Meaningful Use – Stage 1 Menu Set, cont’d
Health Stage 1 Objective Stage 1 Measure
Outcomes
Policy
Priority
Engage EPs Only: Provide patients with timely electronic More than 10% of all unique patients seen by the EP are
patients and access to their health information (including lab provided timely (available to the patient within 4
families in results, problem list, medication lists, medication business days of being updated in the certified EHR
their health allergies) within 4 business days of the information technology) electronic access to their health
care being available to the EP information subject to the EP’s discretion to withhold
certain information
Use certified EHR technology to identify patient- More than 10% of all unique patients seen by the EP or
specific education resources and provide those admitted to the eligible hospital or CAH are provided
resources to the patient, if appropriate patient-specific education resources
Improve care The EP, eligible hospital or CAH who receives a The EP, eligible hospital or CAH performs medication
coordination patient from another setting of care or provider of reconciliation for more than 50% of transitions of care in
care or believes an encounter is relevant should which the patient is transitioned into the care of the EP
perform medication reconciliation or admitted to the eligible hospital or CAH
The EP, eligible hospital or CAH who receives a The EP, eligible hospital or CAH who transitions or refers
patient from another setting of care or provider of their patient to another setting of care or provider of
care or refers their patient to another provider of care provides a summary of care record for more than
care should provide a summary of care record for 50% of transitions of care and referrals
each transition of care or referral
21. Meaningful Use – Stage 1 Menu Set, cont’d
Health Stage 1 Objective Stage 1 Measure
Outcomes
Policy
Priority
Improve Capability to submit electronic data to immunization Performed at least one test of the certified EHR
population registries or Immunization Information Systems and technology’s capacity to submit electronic data to
and public actual submission in accordance with applicable law immunization registries and follow-up submission if the
health1 and practice test is successful (unless none of the immunization
registries to which the EP, eligible hospital or CAH
submits such information have the capacity to receive
such information electronically)
Hospitals Only: Capability to submit electronic data Performed at least one test of certified EHR
on reportable (as required by state or local law) lab technology’s capacity to provide submission of
results to public health agencies and actual reportable lab results to public health agencies and
submission in accordance with applicable law and follow-up submission if the test is successful (unless
practice none of the public health agencies to which the EP,
eligible hospital or CAH submits such information have
the capacity to receive such information electronically)
Capability to submit electronic syndromic Performed at least one test of certified EHR
surveillance data to public health agencies and actual technology’s capacity to provide electronic syndromic
submission in accordance with applicable law and surveillance data to public health agencies and follow-
practice up submission if the test is successful (unless none of
the public health agencies to which the EP, eligible
hospital or CAH submits such information have the
capacity to receive such information electronically)
1
Unless an EP, eligible hospital or CAH has an exception for all of these objectives and measures they must complete at least one as part of their
demonstration of the menu set in order to be a meaningful EHR user.
22. Future Stages
• Intend to propose 2 additional Stages through
future rulemaking. Future Stages will expand upon
Stage 1 criteria.
• Stage 1 menu set will be transitioned into core
set for Stage 2
• Administrative transactions will be added
• CPOE measurement will go to 60%
• Will reevaluate other measures – possibly higher
thresholds
• Stage 3 will be further defined in next rulemaking
22
23. States’ Flexibility to Revise
Meaningful Use
• States can seek CMS prior approval to require 4
MU objectives be core for their Medicaid
providers:
• Generate lists of patients by specific conditions for
quality improvement, reduction of disparities, research
or outreach (can specify particular conditions)
• Reporting to immunization registries, reportable lab
results and syndromic surveillance (can specify for
their providers how to test the data submission and to
which specific destination)
23
24. MU for Hospitals that Qualify for
Both Medicare & Medicaid Payments
• Applies to sub-section (d) and acute care
hospitals
• Attest/Report on Meaningful Use to CMS for the
Medicare EHR Incentive Program
• Will be deemed meaningful users for Medicaid
(even if the State has CMS approval for the MU
flexibility around public health objectives)
24
25. Clinical Quality Measures (CQM)
Overview
• 2011 – EPs, eligible hospitals and CAHs seeking
to demonstrate Meaningful Use are required to
submit aggregate CQM numerator, denominator,
and exclusion data to CMS or the States by
attestation.
25
26. Meaningful Use for EPs who Work at
Multiple Sites
• An EP who works at multiple locations, but does
not have certified EHR technology available at all
of them would:
• Have to have 50% of their total patient encounters at
locations where certified EHR technology is available
• Would base all meaningful use measures only on
encounters that occurred at locations where certified
EHR technology is available
• 2012 – EPs, eligible hospitals and CAHs seeking to demonstrate
Meaningful Use are required to electronically submit aggregate CQM
numerator, denominator, and exclusion data to CMS or the States.
26
27. CQM: Eligible Professionals
• Core, Alternate Core, and Additional CQM sets for
EPs
• EPs must report on 3 required core CQM, and if the
denominator of 1or more of the required core measures is
0, then EPs are required to report results for up to 3
alternate core measures
• EPs also must select 3 additional CQM from a set of 38
CQM (other than the core/alternate core measures)
• In sum, EPs must report on 6 total measures: 3 required
core measures (substituting alternate core measures where
necessary) and 3 additional measures
27
28. CQM: Core Set for EPs
NQF Measure Number & PQRI Clinical Quality Measure Title
Implementation Number
NQF 0013 Hypertension: Blood Pressure
Measurement
NQF 0028 Preventive Care and Screening
Measure Pair: a) Tobacco Use
Assessment b) Tobacco Cessation
Intervention
NQF 0421 Adult Weight Screening and Follow-up
PQRI 128
28
29. CQM: Alternate Core Set for EPs
NQF Measure Number & PQRI Clinical Quality Measure Title
Implementation Number
NQF 0024 Weight Assessment and Counseling for
Children and Adolescents
NQF 0041 Preventive Care and Screening:
PQRI 110 Influenza Immunization for Patients 50
Years Old or Older
NQF 0038 Childhood Immunization Status
29
30. CQM: Additional Set for EPs
1. Diabetes: Hemoglobin A1c Poor Control
2. Diabetes: Low Density Lipoprotein (LDL) Management and Control
3. Diabetes: Blood Pressure Management
4. Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB)
Therapy for Left Ventricular Systolic Dysfunction (LVSD)
5. Coronary Artery Disease (CAD): Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI)
6. Pneumonia Vaccination Status for Older Adults
7. Breast Cancer Screening
8. Colorectal Cancer Screening
9. Coronary Artery Disease (CAD): Oral Antiplatelet Therapy Prescribed for Patients with CAD
10. Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
11. Anti-depressant medication management: (a) Effective Acute Phase Treatment,(b)Effective Continuation Phase
Treatment
12. Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation
13. Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of
Retinopathy
14. Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care
15. Asthma Pharmacologic Therapy
16. Asthma Assessment
17. Appropriate Testing for Children with Pharyngitis
18. Oncology Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR)
Positive Breast Cancer
19. Oncology Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients
30
31. CQM: Additional Set for EPs, cont’d
20. Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients
21. Smoking and Tobacco Use Cessation, Medical assistance: a) Advising Smokers and Tobacco Users to
Quit, b) Discussing Smoking and Tobacco Use Cessation Medications, c) Discussing Smoking and
Tobacco Use Cessation Strategies
22. Diabetes: Eye Exam
23. Diabetes: Urine Screening
24. Diabetes: Foot Exam
25. Coronary Artery Disease (CAD): Drug Therapy for Lowering LDL-Cholesterol
26. Heart Failure (HF): Warfarin Therapy Patients with Atrial Fibrillation
27. Ischemic Vascular Disease (IVD): Blood Pressure Management
28. Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic
29. Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: a) Initiation, b)
Engagement
30. Prenatal Care: Screening for Human Immunodeficiency Virus (HIV)
31. Prenatal Care: Anti-D Immune Globulin
32. Controlling High Blood Pressure
33. Cervical Cancer Screening
34. Chlamydia Screening for Women
35. Use of Appropriate Medications for Asthma
36. Low Back Pain: Use of Imaging Studies
37. Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control
38. Diabetes: Hemoglobin A1c Control (<8.0%)
31
32. CQM: Eligible Hospitals and CAHs
1. Emergency Department Throughput – admitted patients Median time from ED arrival to
ED departure for admitted patients
2. Emergency Department Throughput – admitted patients – Admission decision time to ED
departure time for admitted patients
3. Ischemic stroke – Discharge on anti-thrombotics
4. Ischemic stroke – Anticoagulation for A-fib/flutter
5. Ischemic stroke – Thrombolytic therapy for patients arriving within 2 hours of symptom
onset
6. Ischemic or hemorrhagic stroke – Antithrombotic therapy by day 2
7. Ischemic stroke – Discharge on statins
8. Ischemic or hemorrhagic stroke – Stroke education
9. Ischemic or hemorrhagic stroke – Rehabilitation assessment
10. VTE prophylaxis within 24 hours of arrival
11. Intensive Care Unit VTE prophylaxis
12. Anticoagulation overlap therapy
13. Platelet monitoring on unfractionated heparin
14. VTE discharge instructions
15. Incidence of potentially preventable VTE
32
33. Participation in HITECH and other
Medicare Incentive Programs for EPs
Other Medicare Incentive Eligible for HITECH EHR Incentive Program?
Program
Medicare Physician Quality Yes, if the EP is eligible.
Reporting Initiative (PQRI)
Medicare Electronic Health Yes, if the EP is eligible.
Record Demonstration (EHR
Demo)
Medicare Care Management Yes, if the practice is eligible. The MCMP demo will end
Performance Demonstration before EHR incentive payments are available.
(MCMP)
Electronic Prescribing (eRx) If the EP chooses to practice in the Medicare EHR Incentive
Incentive Program Program, they cannot participate in the Medicare eRx
Incentive Program simultaneously in the same program
year. If the EP chooses to participate in the Medicaid EHR
Incentive Program, they can participate in the Medicare
eRx Incentive Program simultaneously.
33
34. EHR Incentive Program Timeline
• Registration for the EHR Incentive Programs will begin in January 2011
• For Medicare providers, attestation for the EHR Incentive Programs will begin in
April 2011
• EHR incentive payments will be made 11 months after the rule is published*
• For Medicaid providers, States may launch their programs in January 2011 and
thereafter
• November 30, 2011 – Last day for eligible hospitals and CAHs to register and
attest to receive an incentive payment for FFY 2011 (Medicare providers)
• February 29, 2012 – Last day for EPs to register and attest to receive an incentive
payment for CY 2011 (Medicare providers)
• 2015 – Medicare payment adjustments begin for EPs and eligible hospitals that are
not meaningful users of EHR technology**
• 2016 – Last year to receive a Medicare EHR incentive payment; Last year to
initiate participation in Medicaid EHR Incentive Program**
• 2021 – Last year to receive Medicaid EHR incentive payment**
**Statutory
34
Logo: EHR Incentive Programs (Tagline: Connecting America for Better Health) Logo: CMS – Centers for Medicare and Medicaid Services
NPRM vs. Final Rule Meet all MU reporting objectives vs. Must meet “core set”/can defer 5 from optional “menu set” 25 measures for EPs/23 for eligible hospitals vs. 25 measures for EPs/24 for eligible hospitals Measure thresholds range from 10% to 80% of patients or orders (most at higher range) vs. Measure thresholds range from 10% to 80% of patients or orders (most at lower to middle range) Denominators – To calculate the threshold, some measures required manual chart review vs. Denominators – No measures require manual chart review to calculate threshold (Speaker Note: Manual chart review including the counting of orders. For the final rule, the only counting that would be required would be to know the number of patients seen or admitted during the EHR reporting period. All other denominators can be obtained automatically using certified EHR technology. ) Administrative transactions (claims and eligibility) included vs. Administrative transactions removed Measures for Patient-Specific Education Resources and Advanced Directives discussed but not proposed vs. Measures for Patient-Specific Education Resources and Advanced Directives (for hospitals) included
NPRM vs. Final Rule, continued States could propose above/beyond MU floor, but not with additional EHR functionality vs. States’ flexibility with Stage 1 MU is limited to seeking CMS approval to require 4 public health-related objectives to be core instead of menu Core CQM and specialty measure groups for EPs vs. Modified Core CQM and removed specialty measure groups for EPs 90 CQM total for EPs vs. 44 CQM total for EPs – must report total of 6 35 CQM total for eligible hospitals and 8 alternate Medicaid CQM vs. 15 CQM total for eligible hospitals 5 CQM overlap with CHIPRA initial core set vs. 4 CQM overlap with CHIPRA initial core set
Core Set CQM for EPs Hypertension: Blood Pressure Measurement (NQF 0013) Preventive Care and Screening Measure Pair: a) Tobacco Use Assessment b) Tobacco Cessation Intervention (NQF 0028) Adult Weight Screening and Follow-up (NQF 0421, PQRI 128)
Alternate Core CQM Set for EPs Weight Assessment and Counseling for Children and Adolescents (NQF 0024) Preventive Care and Screening: Influenza Immunization for Patients > 50 Years old (NQF 0041, PQRI 110) Childhood Immunization Status (NQF 0038)
Other Medicare Incentive Program -- Eligible for HITECH? Medicare Physician Quality Reporting Initiative (PQRI) -- Yes, if the EP is eligible. Medicare Electronic Health Records Demonstration (EHR Demo) -- Yes, if the EP is eligible. Medicare Care Management Performance Demonstration (MCMP) -- Yes, if the practice is eligible. The MCMP demo will end before EHR incentive payments are available. Electronic Prescribing (eRx) Incentive Program -- If the EP chooses to practice in the Medicare EHR Incentive Program, they cannot participate in the Medicare eRx Incentive Program simultaneously in the same program year. If the EP chooses to participate in the Medicaid EHR Incentive Program, they can participate in the Medicare eRx Incentive Program simultaneously.