Meaningful Use Update: How to Prepare

1. Meaningful Use Update: How to Prepare Dr. Denise W. Hines, PMP, FHIMSS Director-Outreach & Education GA HIT Regional Extension Center

2. Overview • Resources to Assist with EHR Implementations • CMS EHR Incentive Programs • Regional Extension Centers (RECs) • Current & Future Requirements for EHR Adoption • Stages of Meaningful Use • Health Information Exchanges • New Models of Care Delivery • Questions

3. CMS EHR Incentive Programs • Over $27B Available • 260,000+ care providers registered • $6.7 Billion+ paid to eligible providers & hospitals • $176 Million+ paid to nurses& PA’s under Medicaid • 100,000+ hospitals and doctors received payment • EHR Adoption • % of U.S. Hospitals that adopted EHRs has doubled from 16 to 35% between 2009 and 2011 (AHA, 2011). • 55% of practices adopted an EHR last year (National center for Health Statistics, 2012) • 3 of 4 patients with paper records want their doctor to adopt an EHR (National Partnership for Women & Families, 2012) • Incentives are the #1 reason for EHR adoption growth

4. Medicare Incentive Program Eligible Professionals (EPs) • Doctor of Medicine or Osteopathy • Doctor of Dental Surgery or Dental Medicine • Doctor of Podiatric Medicine • Doctor of Optometry • Chiropractor • Total payout is $44K/4 years Eligible Hospitals • Acute Care, Critical Access Hospitals • Average payout for Care/Caid is $3-11M per facility Providers must Demonstrate MU • 90days then 1 year period • Penalties

5. Medicaid Incentive Program Eligible Professionals (EPs) • Physicians • Nurse Practitioners (NPs) • Certified Nurse-Midwives (CNMs) • Dentists • Physician Assistants • Total payout is $63,750/6years Eligible Hospitals • Acute Care, Critical Access, Children’s Hospitals • Average payout Care/Caid is $3-11M per facility Year 1-Provider must show proof of AIU EHR Starting Year 2-Provider must Demonstrate MU • No Penalties 5

6. Georgia Medicaid Incentive Program (MIP) • Administered by the Georgia DCH • A 10-year program • $480M to stimulate the Georgia economy • Opened on September 5, 2011 • Payments issued as of July 31, 2012 • 990 Eligible Professionals &Hospitals • TOTAL: $73,023,384.99 • Providers are now preparing for Year 2 of the Program- • Year 2 open for hospitals; EP’s will be open in Oct.

7. Regional Extension Centers • Purpose-Help 100,000 PCPs , Rural Health & CAHs nationally reach meaningful use • Services: • Assist in EHR selection process • Assess progress toward Meaningful Use • Support Practice through selection, implementation, training, go-live • Track Progress toward Meaningful Use • Meaningful Use Certification • HIT Education • Over 62 centers across the nation • ~140,000 enrolled providers to date • Year 2 of the 4 year program • Most RECs are ending provider enrollment and focused on meeting MU

8. GA-Health Information Technology Regional Extension Center (GA-HITREC) MSM-NCPC Awarded $20M to assist GA’s Providers Enrolled (to date) • 4200 individual providers • 51/56 Critical Access/Rural Hospitals Strategic Objectives • Outreach & Education • Technical Assistance • Business Development (Sustainability) Collaborative efforts with DCH & GA-HIE

9. GA-Health Information Technology Regional Extension Center (GA-HITREC) GAO report found that providers who partner with RECs are twice as likely to receive Medicare EHR Incentive Payments as those who don’t 80-85% of eligible providers who received Georgia Medicaid EHR incentive payments are GA-HITREC providers GA-HITREC Provider Enrollment Period Reopened: • ~80 provider spots • Providers who have an EHR, Reporting Quality & E-Prescribing

10. The Goals for Meaningful Use 2015-2016 2013-2014 2011-2012

11. Stage 1 Meaningful Use Requirements: • Use of a certified EHR in a meaningful way • Use of a certified EHR for electronic exchange • Use of a certified EHR to submit clinical quality data Eligible Professionals (EPs) • Must meet 15 core requirements + 5 menu requirements • Quality measures required for reporting for EPs – 3 core + 3 menu Eligible Hospitals and Critical Access Hospitals • Must meet 14 core requirements + 5 menu requirements • Quality measures required for reporting - 15 measures for hospitals Reporting Period • Any consecutive 90 days for first year • One year subsequently

12. Stages of Meaningful Use Meaningful Use Stage 1 Effective until 2014 • Hospitals & Providers can receive 3 payments under Stage 1 • 2011, 2012, 2013 Meaningful Use Stage 2 • Delayed to allow vendors time to implement new functionality • Final released August 23, 2012 • Attestation for Hospitals start Oct. 31,2013 • Attestation for Professionals start Jan. 1, 2014 • Builds on stage 1 with increased thresholds • Exchange of information required • Electronic access for patients • Updates to quality measures to align with other programs • Submission to registries • Record patient family health • Record imaging results inside EHR

13. Stages of Meaningful Use Meaningful Use Stage 3 • Ready by 2015 and required by 2016 • Builds upon Stages 1 and 2 with increased thresholds • Creation of collaborative care models with patients • Enhanced bi-directional exchange with public health agencies: • Immunization, lab, and syndromic surveillance data • Demonstrate improvement in patient outcomes • Patient access to self management tools, upload data • Bi-Directional communication among care team, patients, and family members

14. Health Information Exchange • Each designated agency will create a statewide HIE • Over $400M to states for planning & implementation • States required to submit a HIT strategic plan that includes technical, business, financing mechanisms over a 4 year period for the HIE • Required to use national standards • HIEs vary across the nation

15. GA’s HIE Progress • DCH is designated state agency for GA’s statewide HIE • Awarded $13M to support the planning of the HIE • Received approval for strategic plan in 2011 • Formed governance structure in 2011 • Developed phased approach late 2011: Using existing HIEs to test concepts: • Phase 1- Directed Exchange (2012) • Phase 2- Query-Based Exchange (Patient Search) (2013)

16. The Path Forward

17. Take Away Points • Purpose is to improve health care outcomes and improve our healthcare delivery system. • Take advantage of incentives and resources! • Providers must ADOPT and USE technology to participate in the healthcare models of the future.

18. Resources GA-HITREC 877-658-1990 www.ga-hitrec.org CMS Incentive Programs www.cms.gov/ehrincentiveprograms GA Medicaid Incentive Program www.dch.georgia.gov/ehr GA HIE Email: hitt@dch.ga.gov

19. QUESTIONS ????