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Transforming Healthcare through Innovation EP2 (MU) and NYS PCMH Programs – 12/20/2018

Learn about the EP2/Meaningful Use Programs in New York State and how they are revolutionizing healthcare delivery through innovation and technology. Discover the benefits, eligibility, and objectives of these strategic healthcare initiatives.

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Transforming Healthcare through Innovation EP2 (MU) and NYS PCMH Programs – 12/20/2018

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  1. Transforming Healthcare through Innovation EP2 (MU) and NYS PCMH Programs – 12/20/2018 Presented by: Bill Lavoie, Grant Based Programs Manager

  2. Listening to Meeting From Your Home Office Today?

  3. Requested Meeting Procedure • Questions are welcome – at any time • Please mute your lines when listening • Unmute to speak

  4. Strategic Interests Overview • 8 Yr. Old Healthcare Advisory and Implementation Consulting Firm • Al Kinel - President • Awarded 2018 Top 100 Rochester Fastest Growing Businesses • Three Major Segments of Business: • Hospitals/Payers/DSRIP Programs • Strategy/Population Health/Interoperability/Telehealth/HIE/Grants • CMS/DOH/NYeC Grant Based Programs • Practice Transformation/BHIT/NYS PCMH/EP2 • Assist/Support Companies/Technologies • Patient Generated Data; At Home Monitoring; Medication Dispensing

  5. SI PTN Transformation Reach 2016-201925 Organizations, 73 Sites, 425 Clinicians9 Primary Care, 16 Specialty 13 Completed, Awaiting Graduation Approval

  6. New York State EP2/Meaningful Use

  7. SI Transformation Work - NYS EP2/MUEnrolled/In Progress - 16 Organizations – Rochester/Buffalo

  8. EP2 Overview • Medicaid Eligible Professional Program (EP2) • State funded grant program providing free consulting services to providers in NYS Medicaid EHR Incentive Program • Provides free outreach, assistance and support services for achieving Promoting Interoperability Program (formerly Meaningful Use) objectives: • Stage One – Data Capturing and Sharing • Stage Two – Advanced Clinical Processes • Stage Three – Improved Outcomes • CMS funded incentives – providers can earn up to $8500 per year for participation and successful attestation - total of $34,000

  9. Open to providers who participated in Medicaid EHR Incentive Program for 2016 Active Medicaid Fee For Service program status Medicaid Fee For Service Medicaid Managed Care Family Health Plus 30% Medicaid patient encounter volume threshold as determined by MEIPASS (20% for pediatricians) Provider Types: Physicians (MD/DO), including specialists Nurse Practitioners Certified Nurse Midwives Dentists PA’s who practice in a Federally Qualified Health Center (FQHC) Eligibility Requirements

  10. Promoting Interoperability (formerly Meaningful Use) Stage 3 Overview: 2019

  11. NY Medicaid EHR Incentive Program Introduction:CMS Promoting Interoperability Program • The NY Medicaid EHR Incentive Program is dedicated to improving interoperability and patients´ access to health information. • Participation in this program effectively lays the foundation for providers to become expert meaningful users of their CEHRT, paving the way towards value based care and successful Health Information Exchange (HIE) utilization.

  12. Participation in Medicaid Meaningful Use Modified Stage 2 Stage 3 Stage 2 2021 is the last year to receive MU incentive payment for EPs who have not yet reached the 6 year maximum participation cap. Stage 1

  13. Stages of Participation: First Participation in 2016 Maximum payment incentive over 6 participation years = $63,750

  14. What is Meaningful Use? • Meaningful Use sets specific objectives that eligible professionals (EPs) must achieve to qualify for Centers for Medicare & Medicaid Services (CMS) Incentive Programs. • To better reflect the CMS’s dedication to improving interoperability and patients’ access to health information, they have renamed the EHR Incentive Programs to the Promoting Interoperability (PI) Programs. • Meaningful Use is using certified electronic health record (EHR) technology to: • Improve quality, safety, efficiency, and reduce health disparities. • Engage patients and family. • Improve care coordination, and population and public health. • Maintain privacy and security of patient health information.

  15. Meaningful Use Overview AIU Promote the acquisition of an Electronic Health Record

  16. Stage 3 Provider Eligibility Returning Participant • Must have initiated participation in Meaningful Use in 2016 or year prior • Must not exceed 6 years attesting Medicaid Patient Volume • 30% of encounters are Medicaid patients • 20% for pediatricians • MPV reporting period is 90 days • In previous calendar year • In 12 months preceding attestation • Can’t use same reporting period twice Eligible Provider Type • Physician (MD or DO) • Nurse Practitioner • Certified Nurse-Midwife • Dentist • Physician Assistant (PA) who furnishes services in a FQHC or Rural Health Clinic that is led by a PA

  17. What is Stage 3? • Stage 3 is final stage of Meaningful Use • Single set of 8 objectives • Required beginning in 2019 • Aligns CQM reporting with Merit-based Incentive Payment System (MIPS) • 2015 edition Certified Electronic Health Record Technology (CEHRT) required MU STAGE 3

  18. 2015 CEHRT Health IT Goals Improve Interoperability Ensure Privacy & Security Facilitate Data Access/Exchange Improve Patient Safety Support the EHR Incentive Program

  19. Promoting Interoperability Reporting Timeframes: 2019 Full calendar year 90 days

  20. Stage 3 Reporting Requirements Summary Clinical Quality Measures (eCQMs) • 6 eCQMs • EPs choose from list of 53 total eCQMs • eCQMs align with MIPS • EPs report on any eCQMs relevant to scope of practice, regardless of NQS domain Meaningful Use Objectives • 8 objectives • Providers must attest to all 8 • Thresholds increased moderately • Greater emphasis on patient engagement & electronic exchange of information

  21. Meaningful Use Stage 3 (MU3): 2019

  22. Meaningful Use Stage 3 (MU3): 2019

  23. 2019 Stage 3 Promoting Interoperability Objectives • Objective 1: Protect Patient Health Information • Objective 2: Electronic Prescribing (eRx) • Objective 3: Clinical Decision Support (CDS) • Objective 4: Computer Provider Order Entry • Objective 5: Patient Electronic Access • Objective 6: Coordinate Care/Pt. Engagement • Objective 7: Health Information Exchange • Objective 8: Public Health Reporting

  24. NYS EP2 – Transformation Assistance • SI Working with New York eHealth Collaborative • Currently Enrolling Eligible Providers in Eight County Buffalo Area • Erie, Niagara, Orleans, Genesee, Wyoming, Allegany, Chautauqua, Cattaraugus • Note: Must have attested previously and have payments confirmed.

  25. Readiness Assessment Ensuring practice has certified EHR/meets program qualifications Project/Program Support Direct/remote assistance/services to support successful attestation Staff training and education Project Management, administrative support Workflow analysis and redesign Audit Readiness and Preparation Ensure practice has documentation needed in case of audit HIE Connectivity Assistance in facilitating HIE enrollment in local Qualified Entity (QE)(RHIO) Consulting Services Offered

  26. Bill Lavoie – Program Manager 2017-2019 Transformation Consultant Program mgmt., financials, recruitment, team management, NYeC liaison Current program management/implementation of NYS EP2 (MU), NYS Practice Transformation Network (PTN) and NYS PCMH programs Steve Russell – MU Consultant 2015-2019 Transformation Consultant Program mgmt. assistance, previous program guidance, recruitment, NYeC liasion Previous implementation of MU program – esp. dental schools and practices Deb Blanchard - MU Consultant 2015-2019 Transformation Consultant Current program implementation of NYS PCMH program Marla Cybul, RNC– Clinical Transformation Consultant 2016-2019 Transformation Consultant Current program management/implementation of NYS EP2 (MU), NYS Practice Transformation Network (PTN) and NYS PCMH programs All Consultants Plan, coordinate and deliver transformation services to assigned practices Help manage and speak at events, presentations, communications Account set up and administration SI EP2 Team – Strategic Interests

  27. SI’s Advantage • Previous experience working with NYeC on MU program implementation/EHR Reporting • Specific expertise with MU implementation for dentist schools and practices statewide, including knowledge of dental EHR’s. SI consultant Steve Russell is Co-Chair of the NYS Oral Health Coalition and maintains high level contacts. • Understanding of MU: eligibility, objectives, measures, thresholds, and attestation • Experience with MU for QPP/MIPS submission (Advancing Care Info) • Knowledge of the attestation process/MEIPASS navigation • Help with required integration: registries, public health; RHIO • Experience in planning the project to achieve the full set of measures • Workflow assistance/guidance to improve the numbers (e.g. increase % patient portal usage) • Simplification/assistance with administration of program documents

  28. Enrollment/Tasks Required of Practices • Enrollment is open to eligible providers! • Two Easy Steps!: • Complete, with SI’s help, a spreadsheet based roster of practice demographics and eligible clinicians • Complete, with single signing authority, electronic Practice Participation Agreement/Business Associate Agreement. This will be done through Docu-Sign. One person can sign for an organization. • Next Steps: • Enroll practice/eligible clinicians in MEIPASS (SI can help) • Verify Provider Status/CMS Registration (SI can help) • Confirm the next phase of MU based on previous MU submission (MU Modified Stage 2, Stage 2, Stage 3) • Complete and attest to 2018/2019 in MEIPASS (SI can help)

  29. Questions?

  30. Key Contacts/Info For EP2 Program Services • Bill Lavoie, Program Lead, Strategic Interests • Email: blavoie@strategicinterests.com • Phone: 585-261-5625 • SI Website: http://strategicinterests.com/ • Marla Cybul, Consultant, Strategic Interests • Email: mcybul@strategicinterests.com • Odin Erickson, Senior Manager of Healthcare Advisory Professional Services (HAPS), New York eHealth Collaborative • Email: oerickson@nyehealth.org • Phone: 646-619-6420 • NYeC Website: https://www.nyehealth.org/

  31. New York State PCMH

  32. SI Transformation Work 2018-2020 – NYS PCMHCurrently 16 Organizations, 43 Sites* * Project 80 – 100 by Q2 2019

  33. NYS PCMH – Overview • Built Upon NCQA PCMH Model – Integrated in 2018 • Supports State Initiative for Achieving Triple Aim: • Better Health, Lower Costs, Better Patient Experience • Benefits • NYSDOH paid year one recognition fee or annual review fee • No Cost Transformation Assistance Available – Strategic Interests • Enhanced Reimbursement Opportunities • Medicaid PCMH Incentive Program - $6.00 per member per month • Medicaid Fee For Service Per Visit Add Ons – $29.00 Professional Claims; $25.25 Institutional Claims for PCMH 2014 Level 3 or PCMH 2017

  34. NYS PCMH – Renewal/Review Requirements • Current 2014 Level 3 – “Annual Review” Process • Meet 12 NYS PCMH Core Criteria and Additional Reporting Requirements during next Annual Review • Additional Reporting Requirements: Attest/provide documentation continuing activities from PCMH 2014 • Nine months of transformation services; submit evidence to NCQA • Current 2011/2014 Level 1 or 2 - “Accelerated Renewal” Process • 15 Months to achieve 52 Core Criteria and 7-9 Elective Credits • Three virtual check-ins (#1 – 21 Core; #2 – 52 Core; #3 – 7-9 Electives) • Includes 12 NYS PCMH Core Criteria • Can enroll early for NYS PCMH, will receive an earlier expiration date • Recommendation for Grant Based Svcs: Expiration Date Minus Ten Months

  35. 12 PCMH electives are now “core”criteria for NYS PCMH Code Criteria Team-Based Care TC5 The practice uses an EHR system (or modules) that has been certified and issued an ONC Certification ID, conducts asecurityrisk analysis, and implements security updates as necessary correcting identified securitydeficiencies Knowing and Managing Patients KM4 Conducts BH screenings and/or assessments using a standardized tool. (implement two or more) A. Anxiety B.AlcoholUse Disorder C. Substance Use Disorder D. Pediatric Behavioral Health Screening E. PTSD F. ADHD G. PostpartumDepression Patient-Centered Access and Continuity AC08 Has a secure electronic system for two-way communication to provide timely clinicaladvice AC12 Provides continuity of medical record information for care and advice when the office isclosed Care Management and Support KM11 Identifies and addresses population-level needs based on the diversity of the practice and the community (Demonstrate at least2) A. Target pop. health mgmt. on disparities in care B. Address health literacy of the practice C. Educate staff in culturalcompetence CM3 Applies a comprehensive risk - stratification process to entire patient panel in order to identify and direct resourcesappropriately CM9 Care plan is integrated and accessible across settings ofcare CC08 Works with non-behavioral healthcare specialists to whom the practice frequently refers to set expectations forinformationsharing and patientcare Care Coordination and Care Transitions CC09Works with behavioral healthcare specialists to whom the practice frequently refers to set expectations forinformationsharing and patientcare CC19 Implements process to consistently obtain patient discharge summaries from the hospital and otherfacilities CC21 Demonstrates electronic exchange of information with external entities, agencies and registries (may select 1 or more): RHIO, Immunization Registry, Summary of care record to other providers or care facilities for caretransitions The practice is engaged in Value-Based Contract Agreement.Practice engages in up-side riskcontract Practice engages in two-sided risk contract1 QI19 Quality Improvement 1 A value-based program where the clinician/practice receives an incentive for meeting performance expectations but do not share losses if costs exceed targets. Source: 2017 NCQAPCMH 35

  36. NYS PCMH – Transformation Assistance • SI Working with New York eHealth Collaborative • Currently Enrolling Practices in Eight County Buffalo Area • Erie, Niagara, Orleans, Genesee, Wyoming, Allegany, Chautauqua, Cattaraugus • Eligible Primary Care: • Internal Medicine, Family Medicine, Pediatrics, FQHC’s • NEW 12/2018: CPC + Practices (75) – Eligible for NYS PCMH Assistance • Length of Transformation: • 2014 Level 3: Nine Months • Practices not previously PCMH Recognized: 15 months • 2011 or 2014 Level 1 or Level 2: 15 months

  37. NYS PCMH – SI Transformation Assistance • Assistance with Q-PASS Enrollment and a Q-PASS Registration Fee Waiver • Practice needs assessment and evaluation to identify gaps • Customized curriculum, training, and delivery of skilled coaching and guidance to successfully implement workflow changes and achieve program milestones • Work plan designed to get practices prepared for value-based care (VBC) • Implementation of new team-based care, care coordination, and care management methodologies and workflows • Assistance with NYS PCMH Annual Reporting Requirements to renew your 2014 PCMH status to meet 2017 PCMH recognition

  38. Bill Lavoie – Program Manager Program mgmt., financials, recruitment, team management, NYeC liaison Current program management/implementation of NYS EP2 (MU), NYS Practice Transformation Network (PTN) and NYS PCMH programs, Val Migliore – NYS PCMH Consultant 2017-2019 Transformation Consultant Previous implementation of NYS Practice Transformation Network (PTN) NCQA Certified Content Expert (CCE) In Training Deb Blanchard – NYS PCMH Consultant 2015-2019 Transformation Consultant Current program implementation of EP2 MU Program NCQA Certified Content Expert (CCE) and NCQA Reviewer/Trainer Marla Cybul, RNC– NYS PCMH Consultant 2017-2019 Transformation Consultant Current program implementation - NYS Practice Transformation Network (PTN) All Consultants Plan, coordinate and deliver transformation services to assigned practices Help manage and speak at events, presentations, communications Account set up and administration SI NYS PCMH Team – Strategic Interests

  39. Enrollment • Enrollment is open now to receive grant based assistance! • Two initial steps to enrollment and enabling SI free consulting/support services: • Practice enrolls/indicates in QPASS they will work with Transformation Agent, sets Annual Review • Put in code for annual fee waiver; assign SI and NYeC team as reviewers for documentation • Complete, with single signing authority, electronic Practice Participation Agreement/Business Associate Agreement. This will be done through Docu-Sign. One person can sign for an organization.

  40. Questions?

  41. Key Contacts/Info For PCMH Program Services • Bill Lavoie, Program Lead, Strategic Interests • Email: blavoie@strategicinterests.com • Phone: 585-261-5625 • SI Website: http://strategicinterests.com/ • Odin Erickson, Senior Manager of Healthcare Advisory Professional Services (HAPS), New York eHealth Collaborative • Email: oerickson@nyehealth.org • Phone: 646-619-6420 • NYeC Website: https://www.nyehealth.org/

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