Issues and Challenges for Medicaid Eligible Providers: From AIU to Stage 1 Meaningful Use

1. Issues and Challenges for Medicaid Eligible Providers: From AIU to Stage 1 Meaningful Use Clint Kuntz, CEO Fairfield Community Health Center ckuntz@fairfieldchc.org

2. What is “Meaningful Use”? • The American Recovery and Reinvestment Act of 2009 specifies three main components of Meaningful Use: • The use of a certified EHR in a meaningful manner, such as e-prescribing. • The use of certified EHR technology for electronic exchange of health information to improve quality of health care. • The use of certified EHR technology to submit clinical quality and other measures. • Simply put, "meaningful use" means providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity.

3. Who is Eligible? • An eligible professional, not hospital-based, with at least 30% of patient volume attributable to Medicaid • A pediatrician, not hospital-based, with at least 20% of patient volume attributable to Medicaid • These physicians will be eligible for only 2/3 of the indicated payments • Providers practicing predominantly in a FQHC or RHC with at least 30% of patient volume attributable to needy individuals* • *Needy individual • receiving Medicaid • receiving assistance under Title XXI (SCHIP) • being furnished uncompensated care by the provider • being charged a reduced rate based on ability to pay

4. How Do I Meet Meaningful Use Requirements? • Medicaid EHR Incentive Program—Eligible professionals and eligible hospitals may qualify for incentive payments if they adopt, implement, upgrade or demonstrate meaningful use in their first year of participation. They must successfully demonstrate meaningful use for subsequent participation years. • Adopted:  Acquired and installed certified EHR technology. (For example, can show evidence of installation.) • Implemented: Began using certified EHR technology. (For example, provide staff training or data entry of patient demographic information into EHR.) • Upgraded: Expanded existing technology to meet certification requirements. (For example, upgrade to certified EHR technology or add new functionality to meet the definition of certified EHR technology.)

5. What is Stage 1 Meaningful Use? • Stage 1 Objectives and Measures Reporting • Eligible Professionals must complete: • 15 core objectives • 5 objectives out of 10 from menu set • 6 total Clinical Quality Measures (3 core or alternate core, and 3 out of 38 from alternate set)

6. Challenges Facing Providers Financial • Uncertainty around return on investment (ROI) • Provider and staff productivity • Uncertainty about financial incentives

7. Challenges Facing Providers Technical • Concerns about technically supporting a system • Lack of necessary computer skills • Finding the right EHR to suit practice needs (“usability”) • Having the right IT staff in place • Possibility of information overload

8. Challenges Facing Providers Organizational Change • Disruption of workflow and productivity • Privacy and security concerns • Maintaining patient centeredness and satisfaction