Practice Transformation: Patient Centered Medical Home Overview

Size: px
Start display at page:

Download "Practice Transformation: Patient Centered Medical Home Overview"

Transcription

1 Practice Transformation: Patient Centered Medical Home Overview Megan A. Housley, MBA Business Development Director Kentucky Regional Extension Center

2 The Triple Aim Population Health TRIPLE AIM Per Capita Cost Experience of Care

3 Policy Framework For Achieving Triple Aim Quality & Efficiency Care Delivery & Innovation Provider Feedback & Measurement Payment Reform HIT Foundation: Meaningful Use of EHRs and HIE

4 A journey of a thousand miles begins with a single step Payment Innovation Meaningful Use Care Delivery Innovation (PCMH) Health IT & HIE + Quality Improvement

5 What is Patient-Centered Medical Home? What is Patient-Centered Medical Home? PCMH is a model that provides specific standards for transforming the organization and delivery of primary care to be more: Comprehensive Patient-Centered Coordinated Accessible Safe

6 Other Other Common Common PCMH PCMH Descriptors: Descriptors a vision of healthcare as it should be a framework for organizing systems of care at both the micro (practice) and macro (society) level a model to test, improve, and validate political construct that includes new ways of organizing and financing care, while attempting to remain true to the proven value of primary care part of the healthcare reform agenda

7 Patient PCMH: Centered Extreme Medical Makeover Home Extreme Makeover Uncoordinated care Over-loaded schedule Physician & practice-centric Arbitrary quality improvement projects Lack of clear leadership & support Team-based approach Open access Patient engagement & empanelment Data directed quality improvement efforts Engaged leadership

8 5 Functions of PCMH Five Functions of a PCMH 1. Comprehensive Care 2. Patient-Centered 3. Coordinated Care 4. Accessible Services 5. Quality and Safety

9 PCMH Benefits PCMH Benefits Long-term partnerships, not hurried visits Care that is coordinated among providers Better access Shared decision-making Lower costs Fewer EH visits/hospitalizations Practices get paid for doing the right things More satisfied providers and patients

10 Even Bigger Picture: Medical Neighborhood Primary Care Specialty Care Inpatient Care Emergency Care Urgent Care Laboratory Services Physical Therapy / Rehabilitation Mental Health Home Health Services Pharmacy Durable Medical Equipment Social Work Community Support Agencies

11 Patient-Centered Medical Neighborhood HIT Sub-Specialty PCMH/ Medical Home Neighbor HIT HIT Hospital HIT HIT Pharmacy HIT PCMH HIT Sub-Specialty Procedural Practice Lab

12 Meaningful Use So How Do We Get There? How Do We Get There? Primary Care-PCMH Recognition Care Coordination Agreements Define type of interaction Responsibility for elements of care Expectations for HIE Population Health Management focus (work with ACO/Medical System with this focus)

13 How To Achieve PCMH Recognition Many PCMH recognition programs National Committee for Quality Assurance (NCQA) Private, non-profit health care quality organization offering clinical & practice process programs Gold Standard for Primary Care Transformation By far the most widely used method for Medical Home Recognition (Each month 150+ practices apply) Partnering with Department of Defense, Department of Health & Human Services, state programs and insurance companies

14 NCQA PCMH Recognition NCQA PCMH Recognition For outpatient primary care Practice-site level NCQA defines practice as a clinician or clinicians practicing together at a single geographic location Recognizes PCPs at the site, including NPs and Pas who can be designated as a personal clinical with their own panel of patients 3-year Recognition period Practice may add/remove clinicians

15 Who Is Eligible? Who Is Eligible? Clinicians with intention of serving as the personal, primary care clinician Physicians, NPs and Pas who practice in Internal Medicine, Family Medicine, or Pediatrics Must have license as MD, DO, NP or PA

16 6 NCQA PCMH Standards Standard 1: Enhance Access and Continuity of Care Standard 2: Identify and Manage Patient Populations Standard 3: Plan and Manage Care Standard 4: Self-Care Support & Community Resources Standard 5: Track and Coordinate Care Standard 6: Measure and Improve Performance

17 NCQA PCSP Recognition For non-primary care specialists Practice-site level Recognizes clinicians at the site, including NPs and PAs with own/shared patient panel 3-year Recognition period May be multi-site and/or multi-specialty May add/remove clinicians

18 Who Is Eligible? Clinicians who typically receive referrals from PCPs and other nonprimary care specialists including : MDs, DOs, NPs/PAs with own/shared patient panel CNMs Behavioral health specialists: Psychologists, licensed clinical social workers, marriage and family counselors

19 6 NCQA PCSP Standards Standard 1: Track and Coordinate Referrals Standard 2: Provide Access and Communication Standard 3: Identify and Coordinate Patient Populations Standard 4: Plan and Manage Care Standard 5: Track and Coordinate Care Standard 6: Measure and Improve Performance

20 Meaningful Use Overlap PCMH reinforces the use of HIT through the involvement of an EHR, registries, and HIEs MU practices wellprepared for PCMH MU language embedded in PCMH Standards

21 Connect with Kentucky REC! Phone: (859) Follow us on Like us on Facebook: facebook.com/ehrresource Follow us on LinkedIn: linkedin.com/company/kentucky-rec Check out our website:

22 Andrew C. Bledsoe, MBA, CHPA, PCMH CCE Executive Director Northeast KY Regional Health Information Organization

23 NCQA Program Setup Standards Six Standards Outline Program Elements Six Must Pass Factors Must meet 50% AND ALL Critical Factors

24 2014 NCQA Standards PCMH 1 PCMH 2 PCMH 3 PCMH 4 PCMH 5 PCMH 6 Patient Centered Access Team Based Care Population Health Management Care Management and Support Care Coordination and Care Transition Performance Measurement and Quality Improvement

25

26 Sample Element P C M H 3 : P o p u l a t i o n H e a l t h M a n a g e m e n t Element D: Use Data for Population Management At least annually the practice proactively identifies populations of patients and reminds them, or their families/caregivers, of needed care based on patient information, clinical data, health assessments and evidence-based guidelines including: 1) At least two different preventive care services 2) At least two different immunizations 3) At least three different chronic or acute care services 4) Patient not recently seen by the practice 5) Medication monitoring or alert 100% The practice meets 4-5 factors 75% The practice meets 3 factors 50% The practice meets 2 factors 25% The practice meets 1 factor 0% The practice meets 0 factors 5 Points 3.75 Points 2.5 Points 0 Points 0 Points

27 Stage 2 Core MU Measures 1) CPOE 2) erx 3) Demographics 4) Vital Signs 5) Smoking Status 6) Clinical Decision Support 7) View, Download and Transmit 8) Clinical Summaries 9) Privacy and Security 10) Lab-test Results 11) List of Patients 12) Patient Reminders 13) Patient Education 14) Medication Reconciliation 15) Summary of Care/Transitions of Care 16) Immunization Registry 17) Secure Electronic Messaging

28 MU Core Measure 1 CPOE - 60% Medications - 30% Lab - 30% Radiology PCMH 4: Care Management and Support Element D: Use Electronic Prescribing 3.0 Points 1. More that 50% of eligible prescriptions written by the practice are compared to drug formularies and electronically sent to pharmacies 2. Enters electronic medication orders in the medical record for more that 60 percent of medications 3. Performs patient-specific checks for drug-drug and drug-allergy interactions 4. Alerts prescribers to generic alternatives PCMH 5: Care Coordination and Care Transitions Element A: Test Tracking and Follow-Up 6.0 Points 1. Tracks lab tests until results are available, flagging and following up on overdue results. (CRITICAL FACTOR) 2. Tracks imaging tests until results are available, flagging and following up on overdue results. (CRITICAL FACTOR) 3. Flags abnormal lab results, bringing them to the attention of the clinician. 4. Flags abnormal imaging results, bringing them to the attention of the clinician. 5. Notifies patients/families of normal and abnormal lab and imaging test results. 6. Follows up with the inpatient facility about newborn hearing and newborn blood-spot screening (N/A for adults). 7. More that 30% of laboratory orders are electronically recorded in the patient record 8. More that 30 %of the radiology orders are electronically recorded in the patient record 9. Electronically incorporates more than 55% of all clinical lab test results into structured fields in medical record. 10. More than 10% of scans and test that result in an image are accessible electronically.

29 MU Core Measure 2 erx - 50% Generate and transmit prescriptions electronically PCMH 4: Care Management and Support Element D: Use Electronic Prescribing 3.0 Points 1. More that 50% of eligible prescriptions written by the practice are compared to drug formularies and electronically sent to pharmacies 2. Enters electronic medication orders in the medical record for more that 60 percent of medications 3. Performs patient-specific checks for drug-drug and drug-allergy interactions 4. Alerts prescribers to generic alternatives 100% The practice meets 4 factors 75% The practice meets 3 factors 50% The practice meets 2 factors 25% The practice meets 1 factor 0% The practice meets 0 factors 3 Points 2.25 Points 1.5 Points.75 Points 0 Points

30 MU Core Measure 3 Record Demographics - 80% -Language -Sex -Race -Ethnicity -DoB PCMH 3: Population Health Management Element A: Patient Information 3.0 Points Practice records as structured data for more that 80% of patients the following: 1. Date of Birth 2. Sex 3. Race 4. Ethnicity 5. Preferred Language 6. Telephone numbers 7. address 8. Occupation 9. Dates of previous clinical visits 10. Legal guardian/health care proxy 11. Primary caregiver 12. Presence of advance directives 13. Health insurance information 14. Name and contact information of other health care professionals involved in patients care. 100% The practice meets factors 75% The practice meets 8-9 factors 50% The practice meets 5-7 factors 25% The practice meets 3-4 factor 0% The practice meets 0-2 factors 3 Points 2.25 Points 1.5 Points.75 Points 0 Points

31 MU Core Measure 4 Record Vitals - 80% -Height/length -Weight -Blood Pressure -BMI -Display growth chart PCMH 3: Population Health Management Element B: Clinical Data 4.0 Points The practice uses an electronic system with the functionality in factors 6 and 7 and records the information in factors 1-5 and 8-11 as structured data. 1. An up-to-date problem list with current and active diagnoses for 80% of patients 2. Allergies, including medication allergies and adverse reactions for more than 80% of patients 3. Blood pressure, with the date of update, for more than 80% of patients 3 and up. 4. Height/length for more than 80% of patients 5. Weight for more than 80% of patients 6. System calculates and displays BMI 7. System plots and displays growth charts 8. Status of tobacco use for patients 13 years and older for more than 80% of patients 9. List of prescription medications with date of updates for more than 80% of patients 10.More than 20% of patients have family history recorded as structured data 11.At least one electronic progress note created, edited and signed by an eligible professional for more than 30 % of patient with at least one office visit.

32 MU Core Measure 5 Record Smoking Status - 80% -Patients age 13 and up PCMH 3: Population Health Management Element B: Clinical Data 4.0 Points The practice uses an electronic system with the functionality in factors 6 and 7 and records the information in factors 1-5 and 8-11 as structured data. 1. An up-to-date problem list with current and active diagnoses for 80% of patients 2. Allergies, including medication allergies and adverse reactions for more than 80% of patients 3. Blood pressure, with the date of update, for more than 80% of patients 3 and up. 4. Height/length for more than 80% of patients 5. Weight for more than 80% of patients 6. System calculates and displays BMI 7. System plots and displays growth charts 8. Status of tobacco use for patients 13 years and older for more than 80% of patients 9. List of prescription medications with date of updates for more than 80% of patients 10.More than 20% of patients have family history recorded as structured data 11.At least one electronic progress note created, edited and signed by an eligible professional for more than 30 % of patient with at least one office visit.

33 MU Core Measure 6 -Implement 5 Clinical Decision Support Rules -Enable drug-drug and drug to allergy interaction checks PCMH 4: Care Management and Support Element D: Use Electronic Prescribing 3.0 Points 1. More that 50% of eligible prescriptions written by the practice are compared to drug formularies and electronically sent to pharmacies 2. Enters electronic medication orders in the medical record for more that 60 percent of medications 3. Performs patient-specific checks for drug-drug and drug-allergy interactions 4. Alerts prescribers to generic alternatives 100% 75% 50% 25% 0% The practice meets 4 factors The practice meets 3 factors The practice meets 2 factors The practice meets 1 factor The practice meets 0 factors 3 Points 2.25 Points 1.5 Points.75 Points 0 Points

34 MU Core Measure 7 Provide patients ability to View, Download and Transmit their ephi - 50% available - 5% viewed PCMH 1: Patient-Centered Access Element C: Electronic Access 2.0 Points The following information and services are provided to patients/families/caregivers, as specified, through a secure electronic system. 1. More than 50% of patients have online access to their health information within four business days of when the information is available to the practice. 2. More than 5% of patients view, and are provided the capability to download, their health information or transmit their health information to a third party. 3. Clinical summaries are provided within 1 business day for more than 50% of office visits. 4. A secure message was sent to more than 5% of patients. 5. Patients have two-way communication with the practice. 6. Patients can request appointments, prescription refills, referrals and test results.

35 MU Core Measure 8 Provide clinical summaries to patients for each office visit within one business day -50% PCMH 1: Patient-Centered Access Element C: Electronic Access 2.0 Points The following information and services are provided to patients/families/caregivers, as specified, through a secure electronic system. 1. More than 50% of patients have online access to their health information within four business days of when the information is available to the practice. 2. More than 5% of patients view, and are provided the capability to download, their health information or transmit their health information to a third party. 3. Clinical summaries are provided within 1 business day for more than 50% of office visits. 4. A secure message was sent to more than 5% of patients. 5. Patients have two-way communication with the practice. 6. Patients can request appointments, prescription refills, referrals and test results.

36 MU Core Measure 9 Protect electronic health information (Privacy and Security) PCMH 6: Performance Measurement and Quality Improvement Element G: Use Certified EHR Technology 0.0 Points 1. The practice uses an EHR system that has been certified and issued a CMS certification ID. 2. The practice conducts a security risk analysis and implement updates as necessary. 3. The practice demonstrates the capability to submit electronic syndromic surveillance data to public health agencies electronically. 4. The practice demonstrates the capability to identify and report cancer cases to a public health central cancer registry electronically. 5. The practice demonstrates the capability to identify and report specific cases to a specialized registry electronically. 6. The practice reports clinical quality measures to Medicare or Medicaid agency. 7. The practice demonstrates the capability to submit data to immunization registries or immunization information systems electronically. 8. The practice has access to a health information exchange. 9. The practice has bidirectional exchange with a health information exchange. 10.The practice generates lists of patients, and based on their preferred method of communication, proactively reminds more than 10% of patients/families/caregivers about needed preventive/follow-up care.

37 MU Core Measure 10 Incorporate clinical lab-test results into EHR as structured data. - 55% PCMH 5: Care Coordination and Care Transitions Element A: Test Tracking and Follow-Up 6.0 Points 1. Tracks lab tests until results are available, flagging and following up on overdue results. (CRITICAL FACTOR) 2. Tracks imaging tests until results are available, flagging and following up on overdue results. (CRITICAL FACTOR) 3. Flags abnormal lab results, bringing them to the attention of the clinician. 4. Flags abnormal imaging results, bringing them to the attention of the clinician. 5. Notifies patients/families of normal and abnormal lab and imaging test results. 6. Follows up with the inpatient facility about newborn hearing and newborn blood-spot screening (N/A for adults). 7. More that 30% of laboratory orders are electronically recorded in the patient record 8. More that 30 %of the radiology orders are electronically recorded in the patient record 9. Electronically incorporates more than 55% of all clinical lab test results into structured fields in medical record. 10. More than 10% of scans and test that result in an image are accessible electronically.

38 MU Core Measure 11 Generate lists of patients by specific condition PCMH 3: Population Health Management Element D: Use data for Population Management (MUST PASS) 5.0 Points At least annually the practice proactively identifies populations of patients and reminds them, or their families/caregivers of needed care based on patient information. 1. At least two different preventive care services 2. At least two different immunizations 3. At least three different chronic or acute care services 4. Patients not recently seen by the practice 5. Medication monitoring or alert.

39 MU Core Measure 12 Send reminders to patients for preventive/followup care - 10 % PCMH 6: Performance Measurement and Quality Improvement Element G: Use Certified EHR Technology 0.0 Points 1. The practice uses an EHR system that has been certified and issued a CMS certification ID. 2. The practice conducts a security risk analysis and implement updates as necessary. 3. The practice demonstrates the capability to submit electronic syndromic surveillance data to public health agencies electronically. 4. The practice demonstrates the capability to identify and report cancer cases to a public health central cancer registry electronically. 5. The practice demonstrates the capability to identify and report specific cases to a specialized registry electronically. 6. The practice reports clinical quality measures to Medicare or Medicaid agency. 7. The practice demonstrates the capability to submit data to immunization registries or immunization information systems electronically. 8. The practice has access to a health information exchange. 9. The practice has bidirectional exchange with a health information exchange. 10.The practice generates lists of patients, and based on their preferred method of communication, proactively reminds more than 10% of patients/families/caregivers about needed preventive/follow-up care.

40 MU Core Measure 13 Identify and provide patient specific education resources to patient - 10% PCMH 4: Care Management and Support Element E: Support Self-Care and Shared Decision Making 5.0 Points The practice has, and demonstrates us of, materials to support patients and families/caregivers in self-management and shared decision making. 1. Uses an EHR to identify patient-specific education resources and provide them to more than 10% of patients. 2. Provides educational materials and resources to patients. 3. Provides self-management tools to record self-care results. 4. Adopts shared decision making aids. 5. Offers or refers patients to structured health education programs, such as group classes or peer support. 6. Maintains a current resource list of five topics or key community service areas of importance to the patient population including services offered outside the practice and its affiliates. 7. Assesses usefulness of identified community resources.

41 MU Core Measure 14 Perform Medication Reconciliation as relevant - 50% PCMH 4: Care Management and Support Element C: Medication Management 4.00 Points The practice has a process for managing medications, and systematically implements the process in the following ways. 1. Reviews and reconciles medications for more than 50% of patients received from care transitions. (CRITICAL FACTOR) 2. Reviews and reconciles medications with patients/families for more than 80% of care transitions. 3. Provides information about new prescriptions to more than 80% of patients/families/caregivers. 4. Assesses understanding of medications for more than 50% of patients/families/caregivers, and dates the assessment. 5. Assesses response to medications and barriers to adherence for more than 50% of patients, and dates the assessment. 6. Documents over-the-counter medications, herbal therapies and supplements for more than 50% of patients, and dates updates.

42 MU Core Measure 15 Provide Summary of Care record for transitions in care or referrals: a) Provide summary of care document 50% b) Provide summary of care document electronically 10% c) Provide summary of care document to another provider on different EHR - Once PCMH 5: Care Coordination and Care Transitions Element B: Coordinate Care Transitions (MUST PASS) 6.00 Points The practice: 1. Considers available performance information on consultants/specialists when making referral recommendations. 2. Maintains formal and information agreements with a subset of specialists based on established criteria 3. Maintains agreements with behavioral healthcare providers. 4. Integrates behavioral healthcare providers within the practice site. 5. Gives the consultant or specialist the clinical question, the required timing and the type of referral. 6. Gives the consultant or specialist pertinent demographic and clinical data, including test results and the current care plan. 7. Has the capacity for electronic exchange of key clinical information and provides an electronic summary of care record to another provider for more than 50% of referrals. 8. Tracks referrals until the consultant or specialist's report is available, flagging and following up on overdue reports. (CRITICAL FACTOR) 9. Documents co-management arrangements in the patients medical record 10. Asks patients/families about self-referrals and requesting reports from clinicians.

43 MU Core Measure 15 Provide Summary of Care record for transitions in care or referrals: a) Provide summary of care document 50% b) Provide summary of care document electronically 10% c) Provide summary of care document to another provider on different EHR - Once PCMH 5: Care Coordination and Care Transitions Element C: Coordinate Care Transitions 6.00 Points The practice: 1. Proactively identifies patients with unplanned hospital admissions and emergency department visits. 2. Shares clinical information with admitting hospitals and emergency departments. 3. Consistently obtains patient discharge summaries from the hospital and other facilities 4. Proactively contacts patients/families for appropriate follow-up care within an appropriate period following a hospital admission or emergency department visit. 5. Exchanges patient information with the hospital during a patient s hospitalization. 6. Obtains proper consent for release of information and has a process for secure exchange of information and for coordination of care with community partners. 7. Exchanges key clinical information with facilities and provides an electronic summary-of-care record to another care facility for more than 50 percent of patient transitions of care.

44 MU Core Measure 16 Submit electronic data to state Immunization Registry PCMH 6: Performance Measurement and Quality Improvement Element G: Use Certified EHR Technology 0.0 Points 1. The practice uses an EHR system that has been certified and issued a CMS certification ID. 2. The practice conducts a security risk analysis and implement updates as necessary. 3. The practice demonstrates the capability to submit electronic syndromic surveillance data to public health agencies electronically. 4. The practice demonstrates the capability to identify and report cancer cases to a public health central cancer registry electronically. 5. The practice demonstrates the capability to identify and report specific cases to a specialized registry electronically. 6. The practice reports clinical quality measures to Medicare or Medicaid agency. 7. The practice demonstrates the capability to submit data to immunization registries or immunization information systems electronically. 8. The practice has access to a health information exchange. 9. The practice has bidirectional exchange with a health information exchange. 10.The practice generates lists of patients, and based on their preferred method of communication, proactively reminds more than 10% of patients/families/caregivers about needed preventive/follow-up care.

45 MU Core Measure 17 Use Secure Electronic Messaging to communicate with Patients - 5% PCMH 1: Patient-Centered Access Element C: Electronic Access 2.0 Points The following information and services are provided to patients/families/caregivers, as specified, through a secure electronic system. 1. More than 50% of patients have online access to their health information within four business days of when the information is available to the practice. 2. More than 5% of patients view, and are provided the capability to download, their health information or transmit their health information to a third party. 3. Clinical summaries are provided within 1 business day for more than 50% of office visits. 4. A secure message was sent to more than 5% of patients. 5. Patients have two-way communication with the practice. 6. Patients can request appointments, prescription refills, referrals and test results.

46 Stage 2 Menu MU Measures 1) Syndromic Surveillance 2) Electronic Notes 3) Imaging Results 4) Family Health History 5) Cancer Registry 6) Specialized Registry

47 MU Menu Measure 1 Submit Syndromic Surveillance data to public health agency PCMH 6: Performance Measurement and Quality Improvement Element G: Use Certified EHR Technology 0.0 Points 1. The practice uses an EHR system that has been certified and issued a CMS certification ID. 2. The practice conducts a security risk analysis and implement updates as necessary. 3. The practice demonstrates the capability to submit electronic syndromic surveillance data to public health agencies electronically. 4. The practice demonstrates the capability to identify and report cancer cases to a public health central cancer registry electronically. 5. The practice demonstrates the capability to identify and report specific cases to a specialized registry electronically. 6. The practice reports clinical quality measures to Medicare or Medicaid agency. 7. The practice demonstrates the capability to submit data to immunization registries or immunization information systems electronically. 8. The practice has access to a health information exchange. 9. The practice has bidirectional exchange with a health information exchange. 10.The practice generates lists of patients, and based on their preferred method of communication, proactively reminds more than 10% of patients/families/caregivers about needed preventive/follow-up care.

48 MU Menu Measure 2 Record Electronic Notes in patient records - 30% PCMH 3: Population Health Management Element B: Clinical Data 4.0 Points The practice uses an electronic system with the functionality in factors 6 and 7 and records the information in factors 1-5 and 8-11 as structured data. 1. An up-to-date problem list with current and active diagnoses for 80% of patients 2. Allergies, including medication allergies and adverse reactions for more than 80% of patients 3. Blood pressure, with the date of update, for more than 80% of patients 3 and up. 4. Height/length for more than 80% of patients 5. Weight for more than 80% of patients 6. System calculates and displays BMI 7. System plots and displays growth charts 8. Status of tobacco use for patients 13 years and older for more than 80% of patients 9. List of prescription medications with date of updates for more than 80% of patients 10.More than 20% of patients have family history recorded as structured data 11.At least one electronic progress note created, edited and signed by an eligible professional for more than 30 % of patient with at least one office visit.

49 MU Menu Measure 3 Imaging Results are available in the EHR system - 10% PCMH 5: Care Coordination and Care Transitions Element A: Test Tracking and Follow-Up 6.0 Points 1. Tracks lab tests until results are available, flagging and following up on overdue results. (CRITICAL FACTOR) 2. Tracks imaging tests until results are available, flagging and following up on overdue results. (CRITICAL FACTOR) 3. Flags abnormal lab results, bringing them to the attention of the clinician. 4. Flags abnormal imaging results, bringing them to the attention of the clinician. 5. Notifies patients/families of normal and abnormal lab and imaging test results. 6. Follows up with the inpatient facility about newborn hearing and newborn blood-spot screening (N/A for adults). 7. More that 30% of laboratory orders are electronically recorded in the patient record 8. More that 30 %of the radiology orders are electronically recorded in the patient record 9. Electronically incorporates more than 55% of all clinical lab test results into structured fields in medical record. 10. More than 10% of scans and test that result in an image are accessible electronically.

50 MU Menu Measure 4 Record Family Health History as structured data - 20% PCMH 3: Population Health Management Element B: Clinical Data 4.0 Points The practice uses an electronic system with the functionality in factors 6 and 7 and records the information in factors 1-5 and 8-11 as structured data. 1. An up-to-date problem list with current and active diagnoses for 80% of patients 2. Allergies, including medication allergies and adverse reactions for more than 80% of patients 3. Blood pressure, with the date of update, for more than 80% of patients 3 and up. 4. Height/length for more than 80% of patients 5. Weight for more than 80% of patients 6. System calculates and displays BMI 7. System plots and displays growth charts 8. Status of tobacco use for patients 13 years and older for more than 80% of patients 9. List of prescription medications with date of updates for more than 80% of patients 10.More than 20% of patients have family history recorded as structured data 11.At least one electronic progress note created, edited and signed by an eligible professional for more than 30 % of patient with at least one office visit.

51 MU Menu Measure 5 Capability to identify and report cancer cases to public health cancer registry MU Menu Measure 6 Capability to identify and report specific cases to public health specialized registry PCMH 6: Performance Measurement and Quality Improvement Element G: Use Certified EHR Technology 0.0 Points 1. The practice uses an EHR system that has been certified and issued a CMS certification ID. 2. The practice conducts a security risk analysis and implement updates as necessary. 3. The practice demonstrates the capability to submit electronic syndromic surveillance data to public health agencies electronically. 4. The practice demonstrates the capability to identify and report cancer cases to a public health central cancer registry electronically. 5. The practice demonstrates the capability to identify and report specific cases to a specialized registry electronically. 6. The practice reports clinical quality measures to Medicare or Medicaid agency. 7. The practice demonstrates the capability to submit data to immunization registries or immunization information systems electronically. 8. The practice has access to a health information exchange. 9. The practice has bidirectional exchange with a health information exchange. 10.The practice generates lists of patients, and based on their preferred method of communication, proactively reminds more than 10% of patients/families/caregivers about needed preventive/follow-up care.

52 Care Coordination Within a Patient Centered Medical Home Practice Angie Ross, RnCC Catholic Health Partners

53 Planned and Purposeful Care Between visits Riskbased out reach post visit Pre-visit visit Identify high risk population Pre-visit planning During patient s office visit Following patient s office visit or specialty appointment Between visits

54 Identifying Patients for Care Coordination Practice Risk Report Produced quarterly or monthly, pulls from claims data on our population health patients in our physician practices that are based on historical claims history Daily Census Produced daily, pulls from Meditech and lists all patients in our physician practices who have been admitted, are in observation or are at the ER by hospital A1C greater than 8 Report Input from Physician and Physician Staff Produced real time, from Explorys and lists all patients by practice who have A1C greater than 8 as well as patient s next visit to the practice During office visit, recognizing patient in need of further clinical support and management of care beyond the physician s office

55 Initial Assessment Initial Evaluation Living situation Type of support Mental status Self care deficits Durable medical equipment Financial assessment Health literacy Anticipated needs Fall risk assessment Develop Care Plan Patient input Physician input Assist with goal setting

56 Ongoing Workflow Follow up monthly calls/visits, or can be as often as several times a week based on patient needs such as: Active medication adjustments-weekly calls for 3-4 weeks, then decreased to biweekly Post hospitalization initial call within hours follow up weekly for 4 weeks New referrals or tests ordered facilitate scheduling; follow up post appointment to facilitate getting consult or results in patient chart

57 Care Coordination: Pre Visit Pre-visit Review needs prior to visit; ie are labs, retinal exam, podiatrist visit ect. due Communicate to physician what is due. Make sure patient knows if need to be fasting Was patient referred to another provider since last visit-if so, was appointment made and are visit results in the chart

58 Care Coordination: Office Visit Update physician on patient goals, progress toward goals, barriers, social issues effecting treatment plan, compliance issues, patient concerns Participate in setting and explaining plan/orders/goals Let patient know when to expect next follow up

59 Care Coordination: Post Visit Follow up calls-frequency based on individual needs Face to face visits either in office or at patient s home Continued education/support

60 Care Coordination: Patient Outcome Goals set during initial visit: Weight less than 400 lbs. HgbA1C less than 7 Will walk 3 times a week for 3-5 minute increments Initial Current WEIGHT 432 lbs 408 lbs A1C LDL TG S CHOL

61 Key Takeaways Care coordination is a key part of our success in a value-based delivery system and will help ensure an overall better experience and outcome for our patients Care coordination is a vital asset to our practices to ensure our eyes are on the patient during, after, and between visits with PCP and specialty Care coordination is vital within our practices to support and implement patient centered medical home standards

62 THANK YOU

PCMH 2014 Recognition Checklist

PCMH 2014 Recognition Checklist 1 PCMH1: Patient Centered Access 10.00 points Element A - Patient-Centered Appointment Access ~~ MUST PASS 4.50 points 1 Providing same-day appointments for routine and urgent care (Critical Factor) Policy

More information

Appendix 5. PCSP PCMH 2014 Crosswalk

Appendix 5. PCSP PCMH 2014 Crosswalk Appendix 5 Crosswalk NCQA Patient-Centered Medical Home 2014 July 28, 2014 Appendix 5 Crosswalk 5-1 APPENDIX 5 Crosswalk The table compares NCQA s Patient-Centered Specialty Practice () standards with

More information

APPENDIX 2 NCQA PCMH 2011 AND CMS STAGE 1 MEANINGFUL USE REQUIREMENTS

APPENDIX 2 NCQA PCMH 2011 AND CMS STAGE 1 MEANINGFUL USE REQUIREMENTS Appendix 2 NCQA PCMH 2011 and CMS Stage 1 Meaningful Use Requirements 2-1 APPENDIX 2 NCQA PCMH 2011 AND CMS STAGE 1 MEANINGFUL USE REQUIREMENTS CMS Meaningful Use Requirements* All Providers Must Meet

More information

PCSP 2016 PCMH 2014 Crosswalk

PCSP 2016 PCMH 2014 Crosswalk - Crosswalk 1 Crosswalk The table compares NCQA s Patient-Centered Specialty Practice (PCSP) 2016 standards with NCQA s Patient-Centered Medical Home (PCMH) 2014 standards. The column on the right identifies

More information

Appendix 4 CMS Stage 1 Meaningful Use Requirements Summary Tables 4-1 APPENDIX 4 CMS STAGE 1 MEANINGFUL USE REQUIREMENTS SUMMARY

Appendix 4 CMS Stage 1 Meaningful Use Requirements Summary Tables 4-1 APPENDIX 4 CMS STAGE 1 MEANINGFUL USE REQUIREMENTS SUMMARY Appendix 4 CMS Stage 1 Meaningful Use Requirements Summary Tables 4-1 APPENDIX 4 CMS STAGE 1 MEANINGFUL USE REQUIREMENTS SUMMARY 1. Use CPOE (computerized physician order entry) for medication orders directly

More information

CROSSWALK: CHANGE CONCEPTS FOR PRACTICE TRANSFORMATION AND 2014 NCQA PCMH TM RECOGNITION STANDARDS

CROSSWALK: CHANGE CONCEPTS FOR PRACTICE TRANSFORMATION AND 2014 NCQA PCMH TM RECOGNITION STANDARDS CROSSWALK: CHANGE CONCEPTS FOR PRACTICE TRANSFORMATION AND 2014 NCQA PCMH TM RECOGNITION STANDARDS 1a. Provide visible and sustained leadership to lead overall cultural change as well as specific strategies

More information

Patient-Centered Specialty Practice (PCSP) Recognition Program

Patient-Centered Specialty Practice (PCSP) Recognition Program Patient-Centered Specialty Practice (PCSP) Recognition Program Standards Workshop Part 2 2013 All materials 2013, National Committee for Quality Assurance Agenda Part 1 Content of PCSP Standards and Guidelines

More information

Stage 2 Meaningful Use Objectives and Measures

Stage 2 Meaningful Use Objectives and Measures Stage 2 Meaningful Use Objectives and Measures Author: Mia Evans About Technosoft Solutions: Technosoft Solutions is a healthcare technology consulting, dedicated to providing software development services

More information

Part 3: NCQA PCMH 2014 Standards

Part 3: NCQA PCMH 2014 Standards Part 3: NCQA PCMH 2014 Standards Heather Russo, CCE PCMH Consultant September 15, 2015 Advancing Healthcare Improving Health PCMH Standard 4: Care What s New? Management and Support Combined 2011 Standards

More information

STAGE 2 PROPOSED REQUIREMENTS FOR MEETING MEANINGFUL USE OF EHRs 1

STAGE 2 PROPOSED REQUIREMENTS FOR MEETING MEANINGFUL USE OF EHRs 1 STAGE 2 PROPOSED REQUIREMENTS FOR MEETING MEANINGFUL USE OF EHRs 1 Requirement CPOE Use CPOE for medication orders directly entered by any licensed health care professional who can enter orders into the

More information

Patient Centered Medical Home 2011

Patient Centered Medical Home 2011 Patient Centered Medical Home 2011 NCQA Standards Rand David, MD, FACP Associate Professor of Medicine Director, Dept. of Ambulatory Care Mount Sinai School of Medicine Elmhurst Hospital Center I have

More information

MEANINGFUL USE STAGE 2

MEANINGFUL USE STAGE 2 MEANINGFUL USE STAGE 2 PHASED-IN IMPLEMENTATION PROCESS DECEMBER 2014 - PREPARATION MONTH Start this process as early as possible WATCH VIDEO TRAINING SESSIONS: (Sessions available starting December 1,

More information

Medicare and Medicaid EHR Incentive Program. Stage 3 and Modifications to Meaningful Use in 2015 through 2017 Final Rule with Comment

Medicare and Medicaid EHR Incentive Program. Stage 3 and Modifications to Meaningful Use in 2015 through 2017 Final Rule with Comment Medicare and Medicaid EHR Incentive Program Stage 3 and Modifications to Meaningful Use in 2015 through 2017 Final Rule with Comment Measures, and Proposed Alternative Measures with Select Proposed 1 Protect

More information

2015 MEANINGFUL USE STAGE 2 FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY

2015 MEANINGFUL USE STAGE 2 FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY 2015 MEANINGFUL USE STAGE 2 FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY STAGE 2 REQUIREMENTS EPs must meet or qualify for an exclusion to 17 core objectives EPs must meet 3 of the 6 menu measures.

More information

Meaningful Use: Review of Changes to Objectives and Measures in Final Rule

Meaningful Use: Review of Changes to Objectives and Measures in Final Rule Meaningful Use: Review of Changes to Objectives and Measures in Final Rule The proposed rule on meaningful use established 27 objectives that participants would meet in stage 1 of the program. The final

More information

Computer Provider Order Entry (CPOE)

Computer Provider Order Entry (CPOE) Computer Provider Order Entry (CPOE) Use computerized provider order entry (CPOE) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record

More information

Harnessing the Power of MHS Information Systems to Achieve Meaningful Use of Health Information

Harnessing the Power of MHS Information Systems to Achieve Meaningful Use of Health Information 2011 Military Health System Conference Harnessing the Power of MHS Information Systems to Achieve Meaningful Use of Health Information The Quadruple Aim: Working Together, Achieving Success Forum Moderator:

More information

Stage 1 Meaningful Use Objectives and Measures

Stage 1 Meaningful Use Objectives and Measures Stage 1 Meaningful Use Objectives and Measures Author: Mia Evans About Technosoft Solutions: Technosoft Solutions is a healthcare technology consulting, dedicated to providing software development services

More information

PROPOSED MEANINGFUL USE STAGE 2 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY

PROPOSED MEANINGFUL USE STAGE 2 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY PROPOSED MEANINGFUL USE STAGE 2 REQUIREMENTS FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY On February 23, the Centers for Medicare & Medicaid Services (CMS) posted the much anticipated proposed

More information

MEANINGFUL USE STAGE FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY

MEANINGFUL USE STAGE FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY MEANINGFUL USE STAGE 2 2014 FOR ELIGIBLE PROVIDERS USING CERTIFIED EMR TECHNOLOGY STAGE 2 REQUIREMENTS EPs must meet or qualify for an exclusion to 17 core objectives. EPs must meet 3 of the 6 menu measures.

More information

Webinar #5 Meaningful Use: Looking Ahead to Stage 2 and CPS 12

Webinar #5 Meaningful Use: Looking Ahead to Stage 2 and CPS 12 New York State-Health Centered Controlled Network (NYS HCCN) Webinar #5 Meaningful Use: Looking Ahead to Stage 2 and CPS 12 December 10, 2013 Ekem Merchant-Bleiberg, Director of Implementation Services

More information

WHAT IT FEELS LIKE

WHAT IT FEELS LIKE PCMH and PCSP WHAT IT FEELS LIKE Presentation Outline Goals of the Patient Centered Medical Home and the Patient Centered Specialty Practice Identifying the Joint Principles Recognition Programs Standards

More information

Meaningful Use Stage 2

Meaningful Use Stage 2 Meaningful Use Stage 2 Presented by: Deb Anderson, HTS Consultant HTS, a division of Mountain Pacific Quality Health Foundation 1 HTS Who We Are Stage 2 MU Overview Learning Objectives 2014 CEHRT Certification

More information

Transforming Health Care with Health IT

Transforming Health Care with Health IT Transforming Health Care with Health IT Meaningful Use Stage 2 and Beyond Mat Kendall, Director of the Office of Provider Adoption Support (OPAS) March 19 th 2014 The Big Picture Better Healthcare Better

More information

during the EHR reporting period.

during the EHR reporting period. CMS Stage 2 MU Proposed Objectives and Measures for EPs Objective Measure Notes and Queries PUT YOUR COMMENTS HERE CORE SET (EP must meet all 17 Core Set objectives) Exclusion: Any EP who writes fewer

More information

THE MEANING OF MEANINGFUL USE CHANGES IN THE STAGE 2 MU FINAL RULE. Angel L. Moore, MAEd, RHIA Eastern AHEC REC

THE MEANING OF MEANINGFUL USE CHANGES IN THE STAGE 2 MU FINAL RULE. Angel L. Moore, MAEd, RHIA Eastern AHEC REC THE MEANING OF MEANINGFUL USE CHANGES IN THE STAGE 2 MU FINAL RULE Angel L. Moore, MAEd, RHIA Eastern AHEC REC WE WILL BRIEFLY DISCUSS Meaningful Use (MU) Incentive Programs, Eligibility & Timelines WE

More information

Version 11.5 Patient-Centered Medical Home (PCMH) 2014 Reference Guide for Sevocity Users

Version 11.5 Patient-Centered Medical Home (PCMH) 2014 Reference Guide for Sevocity Users Version 11.5 Reference Guide for Sevocity Users Table of Contents Product Support Services... 3 Introduction to PCMH 2014... 4 PCMH 2014 Scoring... 5 PCMH 2014 Meaningful Use Alignment... 7 PCMH 2014 Summary

More information

Measures Reporting for Eligible Providers

Measures Reporting for Eligible Providers Meaningful Use White Paper Series Paper no. 5a: Measures Reporting for Eligible Providers Published September 4, 2010 Measures Reporting for Eligible Providers The fourth paper in this series reviewed

More information

Measures Reporting for Eligible Hospitals

Measures Reporting for Eligible Hospitals Meaningful Use White Paper Series Paper no. 5b: Measures Reporting for Eligible Hospitals Published September 5, 2010 Measures Reporting for Eligible Hospitals The fourth paper in this series reviewed

More information

2014 PCMH Standards: How CPCI Can Help with Transformation. CHCANYS Quality Improvement Program November 20, 2014

2014 PCMH Standards: How CPCI Can Help with Transformation. CHCANYS Quality Improvement Program November 20, 2014 2014 PCMH Standards: How CPCI Can Help with Transformation CHCANYS Quality Improvement Program November 20, 2014 Agenda Review of PCMH 2014 Standards and Stage II MU Crosswalk PCMH Transformation and the

More information

CHIME Concordance Analysis of Stage 2 Meaningful Use Final Rule - Objectives & Measures

CHIME Concordance Analysis of Stage 2 Meaningful Use Final Rule - Objectives & Measures CHIME Concordance Analysis of Stage 2 Meaningful Use Final Rule - Objectives & Measures Stage 2 MU Objectives and Measures for EHs - Core More than 60 percent of medication, 1. Use CPOE for medication,

More information

Eligible Professionals (EP) Meaningful Use Final Objectives and Measures for Stage 1, 2011

Eligible Professionals (EP) Meaningful Use Final Objectives and Measures for Stage 1, 2011 Eligible Professionals (EP) Meaningful Use Final Objectives and Measures for Stage 1, 2011 1 On demand webinars are best heard through a headset or earphones (ipod for example) that can be plugged into

More information

ENGAGED LEADERSHIP. TC-02 (Core): Defines practice organizations structure and staff responsibilities/skills to support key PCMH functions.

ENGAGED LEADERSHIP. TC-02 (Core): Defines practice organizations structure and staff responsibilities/skills to support key PCMH functions. Change Concepts for Practice Transformation AND 2014 NCQA PCMH Standards Crosswalk to 2017 NCQA Standards Change Concept Element 2014 NCQA PCMH Standards 2014 --> 2017 2017 NCQA Standards ENGAGED LEADERSHIP

More information

PCMH 2014 NCQA Standards and Guidelines

PCMH 2014 NCQA Standards and Guidelines PCMH 2014 NCQA Standards and Guidelines Training Objectives Overview of process and timeline including new Renewal Option Overview of 2014 Standards Review updates and new concepts with focus on Must Pass

More information

Patient-Centered Connected Care 2015 Recognition Program Overview. All materials 2016, National Committee for Quality Assurance

Patient-Centered Connected Care 2015 Recognition Program Overview. All materials 2016, National Committee for Quality Assurance Patient-Centered Connected Care 2015 Recognition Program Overview All materials 2016, National Committee for Quality Assurance Learning Objectives Introduction to Patient-Centered Connected Care and Eligibility

More information

Meaningful Use Hello Health v7 Guide for Eligible Professionals. Stage 2

Meaningful Use Hello Health v7 Guide for Eligible Professionals. Stage 2 Meaningful Use Hello Health v7 Guide for Eligible Professionals Stage 2 Table of Contents Introduction 3 Meaningful Use 3 Terminology 4 Computerized Provider Order Entry (CPOE) for Medication, Laboratory

More information

Part 2: PCMH 2014 Standards

Part 2: PCMH 2014 Standards Part 2: PCMH 2014 Standards Heather Russo, CCE PCMH Consultant September 15, 2015 Advancing Healthcare Improving Health For Practices Recognized at Level 2 or Level 3 under the 2011 Standards Your Guide

More information

PCC Resources For PCMH

PCC Resources For PCMH PCC Resources For PCMH Tim Proctor Users Conference 2015 Goals and Takeaways Introduction to NCQA's 2014 PCMH. What is it? Why get recognition? Show how PCC functionality and reports can be used for PCMH

More information

Tips for PCMH Application Submission

Tips for PCMH Application Submission Tips for PCMH Application Submission Remain calm. The certification process is not as complicated as it looks. You will probably find you are already doing many of the required processes, and these are

More information

Agenda 2. EHR Incentive Programs 3/5/2015. Overview EHR incentive programs Meaningful Use Differences between Stage 1 and Stage 2

Agenda 2. EHR Incentive Programs 3/5/2015. Overview EHR incentive programs Meaningful Use Differences between Stage 1 and Stage 2 Meaningful Use and the Electronic Health Record Presented by: Susan Reehill CPC, CEMC, CHONC, CPMA Certified Professional Medical Auditor AHIMA Approved ICD-10 CM/PCS Trainer Overview EHR incentive programs

More information

Meaningful Use Hello Health v7 Guide for Eligible Professionals. Stage 1

Meaningful Use Hello Health v7 Guide for Eligible Professionals. Stage 1 Meaningful Use Hello Health v7 Guide for Eligible Professionals Stage 1 Table of Contents Introduction 3 Meaningful Use 3 Terminology 5 Computerized Provider Order Entry (CPOE) for Medication Orders [Core]

More information

Meaningful Use Modified Stage 2 Roadmap Eligible Hospitals

Meaningful Use Modified Stage 2 Roadmap Eligible Hospitals Evident is dedicated to making your transition to Meaningful Use as seamless as possible. In an effort to assist our customers with implementation of the software conducive to meeting Meaningful Use requirements,

More information

Meaningful Use Stages 1 & 2

Meaningful Use Stages 1 & 2 Meaningful Use Stages 1 & 2 Making Sure You Get the Most Out of Your EHR Tracy McDonald Medicaid EHR Incentive Program Coordinator Agenda Meaningful Use Stages & Incentive Program Timing 2014 Changes to

More information

Putting PCMH into Practice: A Transformation Series Care Coordination & Care Transitions (CC) September 12, 2018

Putting PCMH into Practice: A Transformation Series Care Coordination & Care Transitions (CC) September 12, 2018 Putting PCMH into Practice: A Transformation Series Care Coordination & Care Transitions (CC) September 12, 2018 WEBINAR FACILITATOR Hannah Stanfield NCQA PCMH CCE Practice Transformation Coordinator WACMHC

More information

Care Management Policies

Care Management Policies POLICY: Category: Care Management Policies Care Management 2.1 Patient Tracking and Registry Functions Effective Date: Est. 12/1/2010 Revised Date: Purpose: To ensure management and monitoring of patient

More information

HIE Implications in Meaningful Use Stage 1 Requirements

HIE Implications in Meaningful Use Stage 1 Requirements s in Meaningful Use Stage 1 Requirements HIMSS Health Information Exchange Steering Committee March 2010 2010 Healthcare Information and Management Systems Society (HIMSS). 1 An HIE Overview Health Information

More information

HITECH* Update Meaningful Use Regulations Eligible Professionals

HITECH* Update Meaningful Use Regulations Eligible Professionals HITECH* Update Meaningful Use Regulations Eligible Professionals October 2010 * Health Information Technology for Economic and Clinical Health, a component of the ARRA of 2009 McDowell Lecture December

More information

Patient-Centered Medical Home (PCMH) All materials 2015, National Committee for Quality Assurance

Patient-Centered Medical Home (PCMH) All materials 2015, National Committee for Quality Assurance Patient-Centered Medical Home (PCMH) 2014 1 All materials 2015, National Committee for Quality Assurance Learning Objectives Introduction to PCMH and Eligibility Overview of the 6 PCMH Standards Highlight

More information

Meaningful Use Stage 2 For Eligible and Critical Access Hospitals

Meaningful Use Stage 2 For Eligible and Critical Access Hospitals Meaningful Use Stage 2 For Eligible and Critical Access Hospitals Eileen Colen This material was prepared by HealthInsight, the Medicare Quality Improvement Organization for Nevada and Utah, under contract

More information

Meaningful Use and PCC EHR. Tim Proctor Users Conference 2017

Meaningful Use and PCC EHR. Tim Proctor Users Conference 2017 Meaningful Use and PCC EHR Tim Proctor (tim@pcc.com) Users Conference 2017 Agenda MU basics and eligibility How to participate in MU What s Next for MU? Meeting MU measures in PCC EHR Takeaways An understanding

More information

HIE Implications in Meaningful Use Stage 1 Requirements

HIE Implications in Meaningful Use Stage 1 Requirements HIE Implications in Meaningful Use Stage 1 Requirements HIMSS 2010-2011 Health Information Exchange Committee November 2010 The inclusion of an organization name, product or service in this publication

More information

MEANINGFUL USE 2015 PROPOSED 2015 MEANINGFUL USE FLEXIBILITY RULE

MEANINGFUL USE 2015 PROPOSED 2015 MEANINGFUL USE FLEXIBILITY RULE MEANINGFUL USE 2015 PROPOSED 2015 MEANINGFUL USE FLEXIBILITY RULE *Please note, the below guidelines are currently proposed. ASCRS will let you know if and when they are finalized through regulatory alerts

More information

Medicaid Provider Incentive Program

Medicaid Provider Incentive Program Medicaid Provider Incentive Program The Road to Meaningful Use Ohio Association of Community Health Centers 2013 Spring Conference March 6, 2013 Presenters: Elbony McIntyre, Project Manager Emma Esmont,

More information

Introduction to PCMH 2017

Introduction to PCMH 2017 Introduction to PCMH 2017 PCMH 2017 Eligibility Requirements Eligibility Requirements Outpatient primary care practices Practice defined: a clinician or clinicians practicing together at a single geographic

More information

9/28/2011. Learning Agenda. Meaningful Use and why it s here. Meaningful Use Rules of Participation. Categories, Objectives and Thresholds

9/28/2011. Learning Agenda. Meaningful Use and why it s here. Meaningful Use Rules of Participation. Categories, Objectives and Thresholds Coding on the River 10/01/2011 Christina Catalano University of Florida Jacksonville Healthcare Inc. Director, EHR Compliance and Meaningful Use Learning Agenda Meaningful Use and why it s here Meaningful

More information

INTERGY MEANINGFUL USE 2014 STAGE 1 USER GUIDE Spring 2014

INTERGY MEANINGFUL USE 2014 STAGE 1 USER GUIDE Spring 2014 INTERGY MEANINGFUL USE 2014 STAGE 1 USER GUIDE Spring 2014 Intergy Meaningful Use 2014 User Guide 2 Copyright 2014 Greenway Health, LLC. All rights reserved. This document and the information it contains

More information

Core Measure Set. Status. MU1 Increase from 30% New. Computerized Physician Order Entry Use computerized provider order. NextGen EHR Medication Module

Core Measure Set. Status. MU1 Increase from 30% New. Computerized Physician Order Entry Use computerized provider order. NextGen EHR Medication Module Bridge to Meaningful Use: Stage 2 Our Bridge to Meaningful Use connects the various measurements of the EHR Incentives to their respective counterparts in the EHR system. By utilizing the software and

More information

NCQA s Patient-Centered Medical Home (PCMH) 2011 Standards 11/21/11

NCQA s Patient-Centered Medical Home (PCMH) 2011 Standards 11/21/11 NCQA s Patient-Centered Medical Home (PCMH) 2011 Standards 11/21/11 28 PCMH 1: Enhance Access and Continuity PCMH 1: Enhance Access and Continuity 20 points provides access to culturally and linguistically

More information

PCMH 1A Patient Centered Access

PCMH 1A Patient Centered Access PCMH 1A Patient Centered Access The practice has a written process and defined standards for providing access to appointments, and regularly assesses its performance on: Providing same day appointments

More information

Meaningful Use Measures: Quick Reference Guide Stage 2 (2014 and Beyond)

Meaningful Use Measures: Quick Reference Guide Stage 2 (2014 and Beyond) Meaningful Use Measures: Quick Reference Guide Stage 2 (2014 and Beyond) Core Measures Required: All 17 objectives Objective: Requirement: Exclusions: Accomplish in Clinical 1. Computerized - Documenting

More information

Meaningful Use Participation Basics for the Small Provider

Meaningful Use Participation Basics for the Small Provider Meaningful Use Participation Basics for the Small Provider Vidya Sellappan Centers for Medicare & Medicaid Services Office of E-Health Standards and Services HIT Initiatives Group July 30, 2014 EHR INCENTIVE

More information

GE Healthcare. Meaningful Use 2014 Prep: Core Part 1. Ramsey Antoun, Training Operations Coordinator December 12, 2013

GE Healthcare. Meaningful Use 2014 Prep: Core Part 1. Ramsey Antoun, Training Operations Coordinator December 12, 2013 GE Healthcare Meaningful Use 2014 Prep: Core Part 1 Ramsey Antoun, Training Operations Coordinator December 12, 2013 2013 General Electric Company All rights reserved. This does not constitute a representation

More information

The HITECH EHR "Meaningful Use" Requirements for Hospitals and Eligible Professionals

The HITECH EHR Meaningful Use Requirements for Hospitals and Eligible Professionals The HITECH EHR "Meaningful Use" Requirements for Hospitals and Eligible Professionals The HITECH EHR "Meaningful Use" Requirements for Hospitals and Eligible Professionals September 1, 2010 Presented and

More information

About the National Standards for CYSHCN

About the National Standards for CYSHCN National Standards for Systems of Care for Children and Youth with Special Health Care Needs: Crosswalk to National Committee for Quality Assurance Primary Care Medical Home Recognition Standards Kate

More information

PBSI-EHR Off the Charts Meaningful Use in 2016 The Patient Engagement Stage

PBSI-EHR Off the Charts Meaningful Use in 2016 The Patient Engagement Stage PBSI-EHR Off the Charts Meaningful Use in 2016 The Patient Engagement Stage Please note that this document is intended to supplement the information available on the CMS website for Meaningful Use for

More information

ARRA New Opportunities for Community Mental Health

ARRA New Opportunities for Community Mental Health ARRA New Opportunities for Community Mental Health Presented to: The Indiana Council of Community Behavioral Health Kevin Scalia Executive Vice-President, Corporate Development February 11, 2010 Overview

More information

of 23 Meaningful Use 2015 PER THE CMS REVISION TO THE FINAL RULE RELEASED OCTOBER 6, 2015 CHARTMAKER MEDICAL SUITE

of 23 Meaningful Use 2015 PER THE CMS REVISION TO THE FINAL RULE RELEASED OCTOBER 6, 2015 CHARTMAKER MEDICAL SUITE 1 Meaningful Use 2015 PER THE CMS REVISION TO THE FINAL RULE RELEASED OCTOBER 6, 2015 CHARTMAKER MEDICAL SUITE WHEN WE ARE FINISHED TODAY YOU SHOULD KNOW THE FOLLOWING. 2 EHR reporting periods Amended

More information

The History of Meaningful Use

The History of Meaningful Use A Guide to Modified Meaningful Use Stage 2 for Wound Care Practitioners for 2015 The History of Meaningful Use During the first term of the Obama administration in 2009, Congress passed the Health Information

More information

REQUIREMENTS GUIDE: How to Qualify for EHR Stimulus Funds under ARRA

REQUIREMENTS GUIDE: How to Qualify for EHR Stimulus Funds under ARRA REQUIREMENTS GUIDE: How to Qualify for EHR Stimulus Funds under ARRA Meaningful Use & Certified EHR Technology The American Recovery and Reinvestment Act (ARRA) set aside nearly $20 billion in incentive

More information

Russell B Leftwich, MD

Russell B Leftwich, MD Russell B Leftwich, MD Chief Medical Informatics Officer Office of ehealth Initiatives, State of Tennessee 1 Eligible providers and hospitals can receive incentives for meaningful use of certified EHR

More information

Medicare & Medicaid EHR Incentive Programs. Stage 2 Final Rule Travis Broome AMIA

Medicare & Medicaid EHR Incentive Programs. Stage 2 Final Rule Travis Broome AMIA Medicare & Medicaid EHR Incentive Programs Stage 2 Final Rule Travis Broome AMIA 9-20-2012 What is in the Rule Changes to Stage 1 of meaningful use Stage 2 of meaningful use New clinical quality measures

More information

Medicare & Medicaid EHR Incentive Programs HIT Policy Committee May 6, 2014

Medicare & Medicaid EHR Incentive Programs HIT Policy Committee May 6, 2014 Medicare & Medicaid EHR Incentive Programs HIT Policy Committee May 6, 2014 Registration and Payment Data 2 Active Registrations March 2014 March-14 Program-to-Date Medicare Eligible Professionals 8,361

More information

HIE/HIO Organizations Supporting Meaningful Use (MU) Stage 2 Goals Q Update from 2013 HIE Survey Participants

HIE/HIO Organizations Supporting Meaningful Use (MU) Stage 2 Goals Q Update from 2013 HIE Survey Participants HIE/HIO Organizations Supporting Meaningful Use (MU) Stage 2 Goals Q4 Update from HIE Survey Participants January 9, 2015 Purpose of HIE Survey Update The purpose of the HIE Survey was two-fold: To recognize

More information

Stage 2 Eligible Professional Meaningful Use Core and Menu Measures. User Manual/Guide for Attestation using encompass 3.0

Stage 2 Eligible Professional Meaningful Use Core and Menu Measures. User Manual/Guide for Attestation using encompass 3.0 Stage 2 Eligible Professional Meaningful Use Core and Menu Measures User Manual/Guide for Attestation using encompass 3.0 Prepared By: Arête Healthcare Services, LLC Document Version: V1.0 9/02/2015 Eligible

More information

Moving HIT and Meaningful Use

Moving HIT and Meaningful Use Moving HIT and Meaningful Use Tim Gutshall, MD March 30, 2011 EHR Adoption in Iowa Less than 50 percent of Iowa physicians have adopted EHRs As late as 2009, 89 percent of Iowa s hospitals still used some

More information

Qualifying for Medicare Incentive Payments with Crystal Practice Management. Version 1.0

Qualifying for Medicare Incentive Payments with Crystal Practice Management. Version 1.0 Qualifying for Medicare Incentive Payments with Crystal Practice Management Version 1.0 July 18, Table of Contents Qualifying for Medicare Incentive Payments with... 1 General Information... 3 Links to

More information

PCC Resources For PCMH. Tim Proctor Users Conference 2017

PCC Resources For PCMH. Tim Proctor Users Conference 2017 PCC Resources For PCMH Tim Proctor (tim@pcc.com) Users Conference 2017 Agenda Current state of PCMH and what s coming Exploration of how PCC functionality applies to new 2017 PCMH factors PCC Resources

More information

Iatric Systems Supports the Achievement of Meaningful Use

Iatric Systems Supports the Achievement of Meaningful Use Iatric Systems Supports the Achievement of Meaningful Use Iatric Systems offers a wide variety of solutions to assist with today s business challenges and support hospitals in providing superior patient

More information

Eligibility. Program Structure and Process for Receiving Incentives

Eligibility. Program Structure and Process for Receiving Incentives Overview of Medicare Incentives in the Centers for Medicare & Medicaid Services (CMS) Final Rule on Meaningful Use of Certified Electronic Health Records 1 Eligibility Medicare Eligibility: For Medicare

More information

Meaningful Use Stage 2

Meaningful Use Stage 2 Meaningful Use Stage 2 Objectives Gain understanding of the changes Focus on Transitions in Care and Patient Engagement Recognize the increasing HIE role Who Are You? What is YOUR Need Today? A. Office

More information

NCQA PCMH 2017 Standard Two 4/11/18. 6 PCMH Concepts within the standards

NCQA PCMH 2017 Standard Two 4/11/18. 6 PCMH Concepts within the standards Candace Chitty RN, MBA, CPHQ, PCMH-CCE 1 6 PCMH Concepts within the standards 1. Team-Based Care and Practice Organization (TC). 2. Knowing and Managing Your Patients (KM). 3. Patient-Centered Access and

More information

INTERGY MEANINGFUL USE 2014 STAGE 2 USER GUIDE Spring 2014

INTERGY MEANINGFUL USE 2014 STAGE 2 USER GUIDE Spring 2014 INTERGY MEANINGFUL USE 2014 STAGE 2 USER GUIDE Spring 2014 Intergy Meaningful Use 2014 User Guide 2 Copyright 2014 Greenway Health, LLC. All rights reserved. This document and the information it contains

More information

EHR Incentive Programs for Eligible Professionals: What You Need to Know for 2016 Tipsheet

EHR Incentive Programs for Eligible Professionals: What You Need to Know for 2016 Tipsheet EHR Incentive Programs for Eligible Professionals: What You Need to Know for 2016 Tipsheet CMS published a final rule that specifies criteria that eligible professionals (EPs), eligible hospitals, and

More information

EHR Incentive Programs: 2015 through 2017 (Modified Stage 2) Overview

EHR Incentive Programs: 2015 through 2017 (Modified Stage 2) Overview EHR Incentive Programs: 2015 through (Modified Stage 2) Overview CMS recently released a final rule that specifies criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals

More information

Meaningful Use - Modified Stage 2. Brett Paepke, OD David Wolfson Marni Anderson

Meaningful Use - Modified Stage 2. Brett Paepke, OD David Wolfson Marni Anderson Meaningful Use - Modified Stage 2 Brett Paepke, OD David Wolfson Marni Anderson Wait! Where did Stage 1 and Stage 2 go? Traditional stages eliminated in late 2015 in order to: 1. reduce reporting requirements

More information

Roll Out of the HIT Meaningful Use Standards and Certification Criteria

Roll Out of the HIT Meaningful Use Standards and Certification Criteria Roll Out of the HIT Meaningful Use Standards and Certification Criteria Chuck Ingoglia, Vice President, Public Policy National Council for Community Behavioral Healthcare February 19, 2010 Purpose of Today

More information

Meaningful Use Stage 2. Physician Office October, 2012

Meaningful Use Stage 2. Physician Office October, 2012 Meaningful Use Stage 2 Physician Office October, 2012 Why are we here? Meaningful Use overview NOT Stage 1 requirements NOT Interesting facts Stage 1 - The Moving Target Stage 2 Final Rule Penalties Audits

More information

Meaningful Use Basics and Attestation Process Guide for Medicare and Medi-Cal. Lori Hack & Val Tuerk, Object Health

Meaningful Use Basics and Attestation Process Guide for Medicare and Medi-Cal. Lori Hack & Val Tuerk, Object Health Meaningful Use Basics and Attestation Process Guide for Medicare and Medi-Cal Lori Hack & Val Tuerk, Object Health 2 3 Agenda Who Qualifies for the EHR Incentive Funds? EHR Incentive Registration Process

More information

American Recovery & Reinvestment Act

American Recovery & Reinvestment Act American Recovery & Reinvestment Act Meaningful Use Dawn Ross, Clinical Informatics Director Linda Wilson, Meaningful Use Coordinator 10/26/2015 Overview American Recovery and Reinvestment Act of 2009

More information

A complete step by step guide on how to achieve Meaningful Use Core Set Measures in Medgen EHR.

A complete step by step guide on how to achieve Meaningful Use Core Set Measures in Medgen EHR. Medgen EHR A complete step by step guide on how to achieve Meaningful Use Core Set Measures in Medgen EHR. Contents Important information regarding Meaningful Use... 2 How to generate your measure report

More information

Go! Knowledge Activity: Meaningful Use and the Hospital EHR

Go! Knowledge Activity: Meaningful Use and the Hospital EHR Go! Knowledge Activity: Meaningful Use and the Hospital EHR Discipline applications This activity has been developed as an introduction to Meaningful Use and its application in the electronic health record.

More information

Meaningful Use and Care Transitions: Managing Change and Improving Quality of Care

Meaningful Use and Care Transitions: Managing Change and Improving Quality of Care Small Rural Hospital Transition (SRHT) Project HELP Webinar Meaningful Use and Care Transitions: Managing Change and Improving Quality of Care Paul Kleeberg, MD, FAAFP, FHIMSS Aledade Medical Director

More information

FINAL Meaningful Use Objectives for

FINAL Meaningful Use Objectives for Meaningful Use s All Eligible Professionals (EP) and Eligible Hospitals (EH) must attest to all objectives using a 2014 Edition CEHRT. Protect Electronic Health Information Protect electronic health information

More information

Meaningful Use May, 2012

Meaningful Use May, 2012 Meaningful Use May, 2012 Shehnaz Scheyer New Jersey Institute of Technology 211 Warren Street, Newark, NJ 07103 Phone: 973-557-4571 x716 Fax: 973-846-4634 Email: sscheyer@csicorp.net www.njhitec.org Eligible

More information

AHA Survey on Hospitals Ability to Meet Meaningful Use Requirements of the Medicare and Medicaid Electronic Health Records Incentive Programs

AHA Survey on Hospitals Ability to Meet Meaningful Use Requirements of the Medicare and Medicaid Electronic Health Records Incentive Programs AHA Survey on Hospitals Ability to Meet Meaningful Use Requirements of the Medicare and Medicaid Electronic Health Records Incentive Programs February 7, 2011 Executive Summary The vast majority of hospitals

More information

Stage 1 Changes Tipsheet Last Updated: August, 2012

Stage 1 Changes Tipsheet Last Updated: August, 2012 Stage 1 Changes Tipsheet Last Updated: August, 2012 Overview CMS recently announced some changes to the Stage 1 meaningful use objectives, measures, and exclusions for eligible professionals (EPs), eligible

More information

ecw and NextGen MEETING MU REQUIREMENTS

ecw and NextGen MEETING MU REQUIREMENTS ecw and NextGen MEETING MU REQUIREMENTS ecw version 9.0 is Meaningful Use certified and will be upgraded in Munson hosted practices. Anticipated to be released the end of February. NextGen application

More information

CMS EHR Incentive Programs Overview

CMS EHR Incentive Programs Overview CMS EHR Incentive Programs Overview Elizabeth Holland and Robert Anthony Session 20, Room 320 Monday, February 24 at 11:30 AM DISCLAIMER: The views and opinions expressed in this presentation are those

More information

Ophthalmology Meaningful Use Attestation Guide 2016 Edition Updated July 2016

Ophthalmology Meaningful Use Attestation Guide 2016 Edition Updated July 2016 Ophthalmology Meaningful Use Attestation Guide 2016 Edition Updated July 2016 Provided by the American Academy of Ophthalmology and the American Academy of Ophthalmic Executives (AAOE), the Academy's practice

More information

PCMH 2014 Record Review Workbook (RRWB)

PCMH 2014 Record Review Workbook (RRWB) PCMH 2014 Record Review Workbook (RRWB) Purpose of the Record Review Workbook (RRWB) There are three elements in PCMH 2014 that require an accurate estimate of the percentage of patients for whom practices

More information