Medicaid Meaningful Use Incentive Program and Statewide Providers HIT Survey

1. Medicaid Meaningful Use Incentive Program and Statewide Providers HIT Survey By James Phelps Actuarial SpecialistReimbursement UnitUtah Medicaid and Health Financing

2. State HIT Vision “Utah is a place where Secure and efficient use and exchange of electronic health information will Result in improved health care, Better health care, Lower cost and healthier communities”

3. Steps to “Meaningful Use” and Incentive Payments • Must demonstrate qualification for incentive Payment First year must demonstrate that they are engaged in efforts to adopt, implement, or upgrade to certified EHR technology. Attest to meeting the Medicaid volumes for the Incentive payment program. Second – Sixth year demonstrate “Meaningful Use” and meet the Medicaid volume level each year.

4. “Meaningful Use” • American Recovery and Reinvestment Act of 2009 (ARRA) • provide incentive payments for the meaningful use of certified EHR technology • Stage 1 • “The criteria for meaningful use focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information.”

5. “Meaningful Use” • Stage 2 • “ Would expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management, support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies.”

6. “Meaningful Use” • Stage 3 • “Would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.”

7. Eligible Provider Medicaid Incentives Qualifications

8. Payment For Eligible Providers(EP’S)

9. Eligible Hospitals Payments • 2 Million Dollar Base • Plus $200 for Discharges 1,150 - 23,000 Note: CMS is finalizing a formula/definition of eligible hospitals for this calculation.

10. Payments for Eligible Providers & Hospitals • 100% FFP for Medicaid Incentive Payments • Hospitals FFY 2011 • Individual Physicians CY 2011

11. Where are we today? • Survey • Part One: General Respondent and Practice Information • Part Two: Provider Organizational Information • Part Three: Provider Incentive Eligibility • Part Four: Health information Technology • Part Five: Requirements Concerns

12. Current HIT Infrastructure • Estimated 55% EHR Penetration as of 1/1/10 for Outpatient • UHIN • 15 yrs Experience providing administrative exchange services • Currently includes 95% of state’s providers • State’s cHIE • Providers’ Use • 826 independent physicians connect to Intermountain Healthcare • Mountain Star/HCA interface with three of the largest practices in the area. Source: HealthInsight

13. Questions ?