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Indiana Primary Health Care Association. June 6 th , 2011. Medicaid Incentive Program. Eligible Providers per Federal Regulation Physicians Nurse Practitioners Certified Nurse Midwives Dentists Physician Assistants practicing at a PA-lead FQHC Patient Volume Thresholds
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Indiana Primary Health Care Association June 6th, 2011
Medicaid Incentive Program • Eligible Providers per Federal Regulation • Physicians • Nurse Practitioners • Certified Nurse Midwives • Dentists • Physician Assistants practicing at a PA-lead FQHC • Patient Volume Thresholds • 30% Medicaid visit volume • 30% needy individual volume at a FQHC or RHC • 20% for Pediatricians
Eligibility: Practices Predominantly & Needy Individuals • EP is also eligible when practicing predominantly in FQHC/RHC providing care to needy individuals • Practicing predominantly is when FQHC/RHC is the clinical location for over 50% of total encounters over a period of 6 months in the most recent calendar year • Needy individuals (specified in statute) include: –Medicaid or CHIP enrollees; –Patients furnished uncompensated care by the provider; or –furnished services at either no cost or on a sliding scale.
Payments: EP Adoption Timeline 2011 2012 2013 2014 2015 2016 2011 $21,250 2012 $8,500 $21,250 2013 $8,500 $8,500 $21,250 2014 $8,500 $8,500 $8,500 $21,250 2015 $8,500 $8,500 $8,500 $8,500 $21,250 2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250 2017 $8,500 $8,500 $8,500 $8,500 $8,500 2018 $8,500 $8,500 $8,500 $8,500 2019 $8,500 $8,500 $8,500 2020 $8,500 $8,500 2021 $8,500 TOTAL $63,750 $63,750 $63,750 $63,750 $63,750 $63,750
Provider Preparedness • Verify eligibility with CMS • Make sure you have a certified EMR system • Update your NPPES Information • Update or verify your PECOS Information • Sign up for Indiana’s Web interChange Provider Portal: • (317) 488-5160 or 1-877-877-5182 • INXIXElectronicSolution@hp.com
Medicaid Guidance • Program details and FAQs at: http://provider.indianamedicaid.com/general-provider-services/ehr-incentive-program.aspx
HIT Puzzle Pieces Regional Extension Centers Workforce Training ADOPTION Improved Individual & Population Health Outcomes Increased Transparency & Efficiency Improved Ability to Study & Improve Care Delivery Medicare and Medicaid Incentives and Penalties MEANINGFUL USE State Grants forHealth Information Exchange Standards & Certification Framework Privacy & Security Framework EXCHANGE Health IT Practice Research
Indiana HIE Participants • Health Information Organizations • Michiana Health Information Network (MHIN) • HealthBridge • HealthLINC • Med-Web • Indiana Health Information Exchange (IHIE) • Regional Extension Centers • I-HITECH (Purdue) • Tri-State REC (HealthBridge) • Indiana Medicaid • Beacon - Indiana Health Information Exchange & Healthbridge • SHIE-CAP – IHIT, Inc.
What is IHIT? • Indiana Health Information Technology, Inc. • State Designated Entity (SDE) • Received $10.3 million in April 2010 • Responsible to further HIE activities within the state
IHIT Governance • IHIT Board of Directors • IHIT CEO/State HIT Director • Advisory Councils • Policy/Technical • Data Provision and Use • Patient Advocacy • Research and Education
Role of the State HIT Director • Develop and advocate for HIT Policy • Coordinate efforts with Medicaid, public health, and other federally funded programs • Serve as a liaison between the private and public sectors • Serve as a resource for all HIT stakeholders
IHIT Environmental Scan • 66% of Acute Care Hospitals have connections to a HIO • Only 29% of CAH are connect to a HIO • 89% of hospital beds are connected • <10% of FQHC and RHC have interface connections with HIO’s • Approximately 40% of hospitals are using the HIO connection in a “meaningful” manner
IHIT Environmental Scan Findings • Low Penetration of HIE Services in Rural Areas • Limited bi-directional Interfaces between Providers and HIO’s • High Level HIE Activities being Provided by HIO’s • Limited Information Flow between HIO’s • Limited Data Standards
IHIT Strategic Pillars As proposed in Indiana’s Strategic/Operational Plan Submission
Strategic Pillars Description • Connecting Data Sources • Development of interfaces or access infrastructure to allow providers to link to existing HIO’s. • Interoperability • Development of standards and/or infrastructure to allow health information to flow freely between providers. • Improved Outcomes • Timely use of health information exchange to improve clinical decisions from the provider, payer, and patient perspective. • Federal State Initiatives • The use of HIE to meet other federal/state initiatives.
IHIT Funded Projects • Connectivity Matching Grant Program ($2.65 M) • 30 additional Rural/Critical Access Hospitals • 100 FQHC and Rural Health Clinics • 50 stand-alone lab and radiology entities • Data Mapping and Normalization ($750K) • Preferred Standards for Data Elements • Patient ID • Radiology Results • Lab Results • Clinical Documents • Privacy and Security Policy Development ($200K) • Indiana Policy Environmental Scan • External State/Federal Scan • Gap Analysis • Roadmap for addressing gaps
IHIT Funded Projects, cont. • HIO Connectivity ($5 M) • HIO to HIO message routing • CCD/CCR routing • Message Extraction to Data Repository • Consolidated Care Summaries by push and query methodologies • Web Communication Tool ($100K) • Blogging • Discussion Forums • Statewide HIT Calendar • Immunization Registry Integration ($1 M) • HIO and EMR bi-direction interfacing with CHIRP • Increased access to immunization data
State Challenge Projects • Approximately $3 million in Supplemental Funds awarded by ONC • Consumer Mediated Exchange • ~$1.268 million • Data Liquidity • Patient identification and authentication • Secure Messaging • NoMoreClipboards partnership • Enabling Advanced Query for Patient Care • ~$1.718 million • Capture additional discrete data with tags • Patient Preference Controls • Browser based search and filtering capabilities • Ethics framework for fair information practices • Regenstrief Institute partnership
HIE Connectivity Project • Up to $10K incentive per certified location to connect to an Indiana HIO • Defined Interface Specifications • Inbound Lab Results and Outbound Immunizations or • Bi-directional CCD documents
HIE Connectivity Project Steps • Required to sign a letter of intent to complete project in 2011 or 2012 • Live Interfaces with Indiana HIO • Documentation of Expenses • Interface Verification • IHIT Payment to Provider
Contact Information Andrew VanZee Statewide Health IT Director andrew.vanzee@fssa.in.gov 317-232-1165 www.indianahealthit.com Jared Linder Medicaid HIT Coordinator jared.linder@fssa.in.gov 317-234-4856