Presentation Transcript

1. Medicare & Medicaid EHR Incentive Program Meaningful Use:Stage 1 Changes & Stage 2 Quality Measures

   Yvonne Sanchez, MPA Program Manager CentrEast Regional Extension Center June 6, 2013
2. EHR Incentive Program Basics Stage 1 Changes Stage 2 of Meaningful Use Presentation Overview
3. Medicare and Medicaid EHR Incentive Program Basics
4. Choosing an Incentive Program: Medicare or Medicaid
5. EHR Incentive Programs: Who is Eligible Medicare Eligible Providers: Doctor of Medicine or Osteopathy Doctor of Dental Surgery or Dental Medicine Doctor of Podiatric Medicine Doctor of Optometry Chiropractor Medicaid Eligible Providers: Physicians Nurse Practitioners Certified Nurse-Midwives Dentists Physician Assistants (PAs) working in Federally Qualified Health Center (FQHC) or rural health clinic (RHC) that is so led by a PA Eligible Hospitals : Acute Care Hospitals including Critical Access Hospitals Eligible for Medicare and Medicaid Children’s Hospitals
6. Medicare EHR Incentive: Be a Medicare Eligible Professional (EP) Use certified electronic health record (EHR) technology Show that you are “meaningfully using” your EHR by meeting thresholds for meaningful use and clinical quality measures Medicaid EHR Incentive: Be a Medicaid EP Meet a minimum of 30% patient volume or 20% if a Pediatrician Use certified EHR technology Show that you are “meaningfully using” your EHR by meeting thresholds for meaningful use and clinical quality measures If you work at an FQHC or RHC: 30% patient volume attributable to needy individuals Practice predominantly: over 50% of the EP’s total encounters for 6 months in the most recent calendar year. . Qualifying for an Incentive
7. CMS EHR Incentive Program Registration and Attestation Portal Medicare and Medicaid Incentive participants both register with CMShttps://ehrincentives.cms.gov/hitech/login.action
8. Texas Medicaid EHR Incentive Program Attestation Portal Medicaid participants continue their enrollment through HHSC/TMHP http://www.tmhp.com/Pages/HealthIT/HIT_EHR_GettingStarted.aspx
9. Meaningful Use Timeline: Medicare EP The amount of your payment depends on when you begin, which is 75% of your allowed charges up to a maximum annual cap.
10. Meaningful Use Timeline: Medicaid EP
11. Meaningful Use Timeline Eligible Hospitals Medicare Hospitals: Payment calculations are hospital specific and depend on Medicare and Medicaid share of patients Hospitals are eligible for both the Medicare and Medicaid incentive
12. Changes to Stage 1
13. Changes to Stage 1 Measures in 2013
14. Policy Changes to Stage 1 in 2013
15. Texas-specific Policy Changes Limited enrollment form is only for use by FQHC and RHC providers – all others now required to complete full enrollment application Physician Assistants required to complete an attestation form FQHC and RHC providers are required to upload their supporting documentation for patient volume A board-certified pediatric dentist is allowed to use the 20% patient volume as part of their eligibility
16. Meaningful Use: Changes from Stage 1 to Stage 2
17. Clinical Quality Measures: Changes from Stage 1 to Stage 2
18. 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 HHH National Quality Strategy Domains
19. Meaningful Use: Changes from Stage 1 to Stage 2
20. EHRs Meeting ONC 2014 Standards – starting in 2014, all EHR Incentive Programs participants will have to adopt certified EHR technology that meets ONC’s Standards & Certification Criteria 2014 Final Rule Reporting Period Reduced to Three Months – to allow providers time to adopt 2014 certified EHR technology and prepare for Stage 2, all participants will have a three-month reporting period in 2014. 2014 Specific Changes
21. Medicare EPs: Stage 2 rule allows for batch reporting of meaningful use measures -- starting in 2014, groups will be allowed to submit attestation information for all of their individual EPs in one file for upload to the Attestation System, rather than having each EP individually enter data Batch Reporting
22. Overview of Stage 2
23. Stage 2 EP Core Objectives EPs must meet all 17 core objectives:
24. Stage 2 EP Core Objective
25. Stage 2 EP Menu Objectives EPs must select 3 out of the 6:
26. Stage 2 Hospital Core Objectives EPs must meet all 16 core objectives:
27. Stage 2 Hospital Core Objectives
28. Stage 2 Hospital Menu Objectives Eligible hospitals must select 3 out of the 6:
29. Patient Engagement: More than 5% of patients must send secure messages to their EP More than 5% of patients must access their health information online Electronic Information Exchange: Stage 2 requires that a provider send a summary of care record for more than 50% of transitions of care and referrals. Requires that a provider electronically transmit a summary of care for more than 10% of transitions of care and referrals At least one summary of care document sent electronically to recipient with different EHR vendor or to CMS test EHR Stage 2 MU Focus
30. Your certified EHR does all the work—it calculates the measures and gives you the numbers to report to CMS If your EHR reports zeros on one of the core CQMs, replace it with one from the alternate core list There are no minimum values that you must achieve for CQMs; you only have to report on them, not achieve a benchmark Chose three measures from the additional list that are relevant to your scope of practice. Things to Remember about CQMs
31. CMS EHR Incentive Program:www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms/ Texas Medicaid EHR Incentive Program:www.tmhp.com/Pages/HealthIT/HIT_EHR.aspx EHR Incentive Program References