Mel Borkan June 18, 2010

1. Meaningful Use and Ohio Medicaid Mel Borkan June 18, 2010

2. Meaningful Use As Opposed To??? ARRA (American Recovery and Reinvestment Act) …Stimulus $$, recall? Provided incentive $ for eligible professionals and hospitals who become meaningful users of certified electronic health record technology. Medicare’s got a program Medicaid’s got a program. Cleverly named: the Medicaid Incentive Pmt Pgm: MPIP

3. What’s This All About? Free Money? SHOCKINGLY NO! Actually the meaningful use of certified EHR technology is one part of a broader Health Information Technology infrastructure needed to improve health care quality, efficiency and patient safety.

4. So, This Goes with a Bigger Plan? Of course it does! So, Ohio, like every other state, has to come up with a vision and plan to get there for Health Information Technology (HIT) and the meaningful use of Electronic Health Record Technology

5. So, This Goes with a Bigger Plan? Yep, but only if we want the money…and we don’t want to break the law…and there is that improve the quality of health care aspect…. As Is (where we are now) To Be (vision) Road Map for getting there SMHP I-APD

6. So Meaningful Use Goes with the big HIT/EHR work and I’ve got to do what to get MPIP $? Per ARRA (American Recovery and Reinvestment Act) …You have to be an eligible professional or a hospital who is a meaningful user of certified electronic health record technology.

7. MPIP EPs Eligible professionals (EPs): physicians, dentists, certified nurse-midwives, nurse practitioners, physician assistants who are practicing in FQHC or RHC led by a physician assistant Meet min M’d patient volume percentages Waive rights to M’care EHR incentive pmts Can get up to 85% of net average allowable cost for certified EHR tech, trning Up to max level, for no more than 6 yrs

8. MPIP Acute Care Hospitals Acute Care Hospitals with at least 10% Medicaid patient volume Children’s Hospitals of any Medicaid patient volume.

9. Meaningful Use Means?? . A phased approach with reasonable criteria for meaningful use of certified EHR technology based on currently available technology capabilities and provider practice experience, and builds up to a more robust definition of meaningful use, based on anticipated technology and capabilities development according to the proposed rule

10. Initial Year Meaningful Use The HITECH Act requires that to receive a Medicaid incentive payment in the initial year of payment, an EP or eligible hospital may demonstrate that they have engaged in efforts to adopt, implement, or upgrade certified EHR technology

11. Meaningful Use Means? Stage 1 meaningful use criteria focuses on electronically capturing health information in a coded format, using that information to track key clinical conditions and communicating that information for care coordination purposes. It also calls for implementing clinical decision support tools to facilitate disease and medication management and reporting clinical quality measures and public health information. For MPIP it means Attestations

12. Meaningful Use Means? CMS officials are recommending that  Stage 2 criteria be proposed by the end of 2011 and the Stage 3 definition be proposed by the end of 2013. Yes, requirements to meet Meaningful Use get more rigorous over time

13. What Does Ohio Have To Do To Participate? Demonstrate compliance with three criteria: • Use the funds for the purposes of administering the incentive payments, including the tracking of meaningful use of certified EHR technology by Medicaid providers • Conduct adequate oversight of the incentive program, including routine tracking of meaningful use attestations and reporting mechanisms • Pursue initiatives to encourage the adoption of certified EHR technology to promote health care quality & the exchange of health care information under Medicaid, while ensuring privacy & security of data

14. Is My Check in the Mail? • First, CMS has to approve our plan to define: • Today’s As Is about HIT and EHR • The Vision for Ohio’s To Be (including defined by not just bureaucrats but Ohioans!) • The Road Map for Getting to the Vision *Our SMHP *Ohio’s I-APD Plan submitted last Tuesday

15. Is My Check in the Mail? Then we have to actually do the work outlined in the plan, including building the MPIP Infrastructure And we have to hook up our infrastructure with CMS’ Did I mention there is no final CMS rule yet, including no rule on what a certified system is?

16. So When Already?? Confirmation of Federal Approval Begin Work on As Is; To Be Vision; Road Map Creation of SMHP and IAPD Submit to CMS CMS approval State Oks EPs and Hospitals to submit State Payment

17. What Do You Need from Me and How Can I Keep Track of What You’re Doing? • We’ll be looking for feedback • Calculation of Medicaid patient percentages • What influences choice of M’d or Mcare? • Attestations • Monitoring/fraud • We’ll have website info available

18. Keep In Touch Mark Vidmar, Project Manager Mark.Vidmar@jfs.ohio.gov Mel Borkan, Chief Strategy Officer Mel.Borkan@jfs.ohio.gov Ohio Department of Job and Family Services, Ohio Health Plans, 614-752-3086