Meaningful Use: Introduction to Meaningful Use Eligible Providers

Transcription

1 Meaningful Use: Introduction to Meaningful Use Eligible Providers

2 Introduction to Meaningful Use: Webinar Overview Define Meaningful Use Review Meaningful Use Key Dates & Program Incentives Discuss the 4 Components Necessary to Achieve Meaningful Use Introduce Meaningful Use Core Requirements, Menu Measures, & Clinical Quality Measures Provider/Admin Q&A

3 What is Meaningful Use? American Recovery and Reinvestment Act of 2009/Health Information Technology for Economic and Clinical Health Information (ARRA/HITECH) Act, established programs under Medicare and Medicaid to provide incentive payments to eligible professionals that demonstrate meaningful use of certified electronic health record (EHR) technology. HITECH Act allocates 19 billion for the adoption, upgrade, and or implementation of EHR technology. These incentive programs (Medicare and Medicaid) are designed to support eligible professionals during health IT transition. Simply, "meaningful use" means providers must demonstrate that they're using certified EHR technology in ways that can be measured in quality and in quantity.

4 Meaningful Use-Objectives Meaningful Use is Using Certified EHR Technology to: Improve Quality, Safety, Efficiency and Reduce Health Disparities: Use of EHR Computerized order entry Electronic Prescribing/refill automation Record Problem list, medications, allergies, etc Engage patients and families: Patient portals and electronic copies of After Visit Summaries Educational material Improve Care Coordination Medication Reconciliation Exchange of Data with external Providers Improve Population and Public Health Electronic Reporting to Registries Maintain Patient Privacy and Security

5 Stages of Meaningful Use: Medicare & Medicaid Graduated Approach: Implemented in 3 Stages FOCUS OF: Stage 1 (2011) Data capture and sharing Stage 3 (2015) Stage 2 Improved (2013) outcomes Advanced clinical processes

6 Meaningful Use: Medicare Incentive Payment Structure Eligible providers can earn up to $44,000 if the provider receives at least $24,000 in Medicare payments and successfully meets all meaningful use requirements by Oct 1, The last year to begin participation in the Medicare EHR incentive program is 2014 to avoid penalties is First Payment Year Funding Year Incentive Totals Decrease in $ 18, $ 12,000 $ 18, $ 8,000 $ 12,000 $ 15, $ 4,000 $ 8,000 $ 12,000 $ 12, $ 2,000 $ 4,000 $ 8,000 $ 8, $ 2,000 $ 4,000 $ 4,000 Total $ 44,000 $ 44,000 $ 39,000 $ 24,000 Medicare payment reductions begin for providers who do not demonstrate meaningful use

7 Meaningful Use: Medicaid Incentive Payment Structure Eligible providers can earn up to $63,750 if the provider attests and successfully meets all meaningful use requirements. The last year to begin participation in the Medicaid EHR incentive program is Incentive payments do not decrease with time and there are no imposed penalties. Adoption Year Adoption Year Funding Year $ 21, $ 8,500 $ 21, $ 8,500 $ 8, $ 8,500 $ 8, $ 8,500 $ 8, $ 8,500 $ 8,500 No payment adjustments/ 2017 $ 8,500 no penalties Total $ 63,750 $ 63,750 $ 63,750

8 Medicare EHR Incentive Program Medicare EHR Incentive Program Managed by CMS Eligible Providers can receive a maximum incentive amount of $44,000 (over 5 consecutive years ( ) of program participation) Payment reductions begin in 2015 for providers who are eligible but choose not to participate In the first year and all remaining years providers have MU objectives and associated measures they must meet to get incentive payments

9 Medicaid EHR Incentive Program Medicaid EHR Incentive Program Each State Manages Its Own Program Eligible Providers can receive a maximum incentive amount is $63,750 (over 6 years ( ) of program participation) No Medicaid payment reductions if providers choose not to participate In the first year, providers can receive an incentive payment for adopting, implementing or upgrading a certified EHR In all remaining years, providers must meet the same MU objectives and associated measures as Medicare

10 How Do I Successfully Achieve Meaningful Use?

11 4 Components to Successfully Achieve Meaningful Use Determine eligibility to receive Medicare or Medicaid incentive Register for incentive program ELIGIBILITY/ REGISTRATION CERTIFIED EHR Ensure EHR is certified by ONC Approved Testing Body Epic is certified for MU For Medicare Year 1 report after demonstrating 90 consecutive days of meaningful use. For duration of program report after full year of demonstrating MU REPORTING/ ATTESTATION MEANINGFUL USE OF EHR Compliance with the MU Measures and Clinical Quality Reporting Report or Attest to 20 MU measures (15 core, 5 menu)

12 Meaningful Use: Eligible Providers Could be eligible for either Medicare or Medicaid (but not both in single year) Medicare-only Eligible Providers Doctor of Medicine Doctors of Osteopathy Doctors of Dental Medicine or Surgery Medicaid-only Eligible Providers Doctor of Optometry Doctors of Podiatric Medicine Chiropractor Nurse Practitioners Certified Nurse-Midwives Physician Assistants (PAs) when working at an FQHC or RHC that is so led by a PA

13 Additional Meaningful Use Eligibility Requirements Medicare Eligibility (must meet all of the following to qualify) If you are a physician that participates with Medicare and see patients in an office and outpatient setting Physicians who see Medicare patients must have Part B allowed charges Each eligible professional is only eligible for one incentive payment per year regardless of how many practices or locations at which he or she provide services. Hospital based professionals are not eligible for incentive payments An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital inpatient or emergency room setting. (POS 21 or POS 23)

14 Additional Meaningful Use Eligibility Requirements Medicaid Eligibility (must meet one of the following to qualify) If you are a physician that participates with Medicaid and see patients in an office and outpatient setting Physicians who have a minimum of 30% Medicaid patient volume (Medicaid or Medicaid Managed Care) Physicians must have a minimum of 20% Medicaid patient volume and is a pediatrician Hospital based professionals are not eligible for incentive payments An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital inpatient or emergency room setting. (POS 21 or POS 23) Practice predominately in a Federally Qualified Health Center or Rural Health Center and have a minimum of 30% patient volume attributable to need individuals

15 Meaningful Use: Registration Overview Registration is required to participate in the EHR incentive program As an eligible provider you are only required to register once for the duration of the incentive program. CMS offers third party registration. Required for third party registration Identity & Access Management Account (I&A) Association with the eligible providers NPI Eligible providers can register without having implementing certified EHR. Eligible Professionals cannot register for a Medicaid EHR Incentive Program until their state's program has launched and the state's site has opened. Providers eligible for both the Medicare and Medicaid EHR Incentive Programs must choose which incentive program they wish to participate in when they register. Before 2015, an eligible provider may switch programs only once after the first incentive payment is initiated..

16 Requirements for Registration National Provider Identifier (NPI) Provider Enrollment, Chain and Ownership System (PECOS) National Provider and Provider Enumeration System (NPPES) User ID and Password Payee Tax Identification Number (TIN) (benefits reassignment only) Payee National Provider Identifier (NPI) (benefits reassignment only)

17 Certified EHR Technology The Medicare and Medicaid EHR Incentive Programs require the use of certified EHR technology. Standards and certification criteria for EHR technology have been adopted by the Secretary of the Department of Health and Human Services. EHR technology must be tested and certified by an Office of the National Coordinator (ONC) Authorized Testing and Certification Body (ATCB) in order for a provider to qualify for EHR incentive payments. You do not need to have certified EHR technology in place to register for the EHR incentive programs. However before you can receive an EHR incentive payment you must successfully demonstrate meaningful use of a certified EHR For a list of certified EHRs go to the ONC website CERTIFIED EHR

18 Meaningful Use of EHR Stage 1 Meaningful Use Criteria: Criteria for stage 1 meaningful use is focused on electronically capturing health information in a coded format so information can be used for reporting and tracking purposes. To demonstrate meaningful use a provider must attest to successfully meeting required functional measures Functional Measures: 15 Core Objectives 5 Menu Measures from a menu list of 10 6 total Clinical Quality Measures (3 core or alternate core and 3 out of 38 from an additional set) MEANINGFUL USE OF EHR

19 Stage 1: Requirements Overview The table below outlines the core set of meaningful use objectives. All core set measures are required and must be reported. Core Set Measures Attestation Type 1. Use CPOE (Exclusion Available) Numerator/Denominator 2. Implement drug-drug and drug-allergy interaction checks (No Exclusion) Yes/No 3. Generate and transmit prescriptions electronically (Exclusion Available) 4. Record Patient Demographics (No Exclusion) Numerator/Denominator Numerator/Denominator 5. Maintain up-to-date problem list (No Exclusion) Numerator/Denominator 6. Maintain active medication list (No Exclusion) Numerator/Denominator 7. Maintain active medication allergy list (No Exclusion) Numerator/Denominator 8. Report vital signs and chart changes (Exclusion Available) Numerator/Denominator 9. Record smoking status for patients 13 years or older (Exclusion Available) Numerator/Denominator 10. Implement one clinical decision support rule (No Exclusion) Yes/No 11. Report clinical quality measures to CMS or States (No Exclusion) Numerator/Denominator 12. Electronically exchange key clinical information among providers and authorized entities (No Exclusion) Yes/No 13. Provide patients with electronic copy of their health information (No Exclusion) Numerator/Denominator 14. Provide patients with visit clinical summaries (Exclusion Available) Numerator/Denominator 15. Protect electronic health information created or maintained by certified EHR Yes/No

20 Stage 1: Requirements Overview The table below outlines the menu set of meaningful use objectives. EPs must select 5 of the10 options to report. One menu measure must be a public health. Menu Set Measures 1. Implement drug-formulary checks 2. Incorporate clinical laboratory test results into EHRs 3. Generate lists of patients by specific conditions for quality improvement purposes 4. Use EHR to identify patient-specific education resources 5. Perform medication reconciliation between care settings 6. Provide summary of care record for patients referred/transitioned to another provider 7. Submit electronic immunization data to registries or information systems 8. Submit electronic syndromic surveillance data to public health agencies 9. Send reminders to patients for preventive and follow-up care (EP) 10. Provide patients with timely electronic access to their health information (EP) Attestation Type Yes/No Numerator/Denominator Yes/No Numerator/Denominator Numerator/Denominator Numerator/Denominator Yes/No Yes/No Numerator/Denominator Numerator/Denominator

21 Stage 1: Requirements Overview An Eligible Provider Must Report on 6 total Clinical Quality Measures (CQMs) Core set An EP must report on these three core set measures, unless they are not appropriate to their patient population. NQF 0013: Hypertension: Blood Pressure Management NQF 0028: Preventative Care and Screening Measure Pair: a. Tobacco Use Assessment b. Tobacco Cessation Intervention; and NQF 0421/PQRI 128: Adult Weight Screening and Follow-up Alternate core set If an EP can not report on core set measures, they must report on three alternate core measures: NQF 0041/PQRI 110: Preventative Care and Screening: Influenza Immunization for Patients 50 Years Old NQF 0024: Weight Assessment and Counseling for Children and Adolescents NQF 0038: Childhood Immunization Status Additional set Plus an EP must select three additional measures from a set of 38 quality measures that was included in the original proposed rule. 3 Core Set or Alternate Core Set + 3 Additional Set = 6 CQMs

22 Reporting and Attestation Eligible providers must report on identified functional measures: 15 Core Objectives 5 Menu Measures from a menu list of 10 6 total Clinical Quality Measures (3 core or alternate core and 3 from an additional set) Reporting and attestation is done at the INDIVIDUAL eligible professional level For the Medicare Program, Reporting period is after 90 consecutive days of Meaningful Use for the first adoption year and yearly every subsequent year of participation in the incentive program For Medicaid Program, providers do not need to attest to demonstrate Meaningful Use in the first year of program participation but during the second year have to report their 90 day data. REPORTING & ATTESTATION

23 Introduction to Meaningful Use: Webinar Recap Define Meaningful Use Review Meaningful Use Key Dates & Program Incentives Discuss the 4 Components Necessary to Achieve Meaningful Use Introduced Meaningful Use Core Requirements, Menu Measures, & Clinical Quality Measures

24 Upcoming Webinars: MU Webinar : Meaningful Use Registration and Attestation November 3 rd and 15 th MU Webinar : Guide to Clinical Quality Measures November 10 th and 17 th Dec 1st MU Webinar : Workflow Changes for MU Measures TBA MU Webinar: Epic Reporting and Attestation TBA

25 QUESTIONS?