GE Healthcare Meaningful Use and Economic Stimulus Update Centricity Customer Webinar February 16, 2010
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Today s Agenda ARRA HITECH Regulation Overview Preparing for Meaningful Use with Centricity Mike Friguletto Vice President and General Manager Mark J. Segal, PhD Director, Government and Industry Affairs Ken Edwards General Manager, Account Management & Organizational Readiness Matt Wojcik Senior Account Manager
GE Healthcare ARRA HITECH Regulation Overview Mark Segal, PhD Director, Government and Industry Affairs GE Healthcare IT
The HITECH Act and Meaningful Use HITECH Act Part of American Recovery and Reinvestment Act of 2009 (ARRA) February 2009 $36+B for HIT Infrastructure and EHR Adoption/Use Meaningful Use Eligible Professionals (EP) and Hospitals demonstrate Meaningful Use of Certified EHR to receive Medicare and Medicaid EHR incentives 6/
Major Policy Issues Certification & Standards Meaningful Use Quality Reporting HIT Policy/ Standards Committees HIT Policy/ Standards Committees GE, EHRA, ehi, HIMSS, Customers
Briefing on the ONC Agenda David Blumenthal, MD, MPP National Coordinator for Health Information 8/ Technology, December 15, 2009
Two Regulations Released: 12/30/2009 CMS: Meaningful Use and Payment Policies Notice of Proposed Rulemaking (NPRM) 60-day comment period from January 13, 2010: March 15, 2010 Final Rule in 2010 (after March, effective 60 days after publication) ONC: Standards and Certification Interim Final Rule (IFR) Effective 30 days after publication date (January 13 +30) 60-day comment period from January 13, 2010: March 15, 2010 Final Rule in 2010 ONC: Testing and Certification Program IFR expected early 2010 Multiple certifying bodies under ONC rules and certification criteria CCHIT role to change 9/
Meaningful Use and Other Medicare and Medicaid Incentive Policies: NPRM
Evolution of Meaningful Use 11 /
Meaningful Use Criteria and Reporting Objectives/Measures Overall Few changes from Policy Committee Each objective has a measure Must meet all objectives & measures Eligible Professionals (EP) 25 Objectives/Measures By NPI and TIN EHR Use EP MU: 50%+ encounters in period must be at location(s) w/ certified EHR Reporting 2011 Attestation 2012 Attestation Quality: Direct submit via EHR technology to CMS/state directly or via HIE/registry Medicare and Medicaid Common definition Minimum for Medicaid but criteria for HHS to accept state requirements Additional state requirement cannot require additional EHR functionality 12 /
Meaningful Use Grid Page 1 Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Proposed Rule, January `3, 2010, Federal Register, pp. 1844-2011
Clinical Quality Measure Reporting HHS not ready to accept quality data electronically 2011: One time attestation to CMS CMS portal or claims as for MU generally Submit summary calculated measures Attest EHR used to capture data elements and calculate results 2012: Submit quality measures electronically Whether 2012 is first or second payment year If HHS cannot accept in 2012, stay with attestation Quality measures for Medicare apply to Medicaid Alternative Medicaid measures for hospitals 14 /
Clinical Quality Measure Reporting: EP HHS proposes extensive list (90) of EP core and specialty-specific measures for 2011-12 Many from PQRI Only some have electronic specifications Challenge to support so many measures Numbers likely to be reduced 15 /
Clinical Quality Measure Reporting: EP 2011-12: each EP submits two groups Core measures group Specialty group: subset of clinical measures Some specialties exempt from non-core reporting with attestation 16 /
Clinical Quality Measure Reporting: EP Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Proposed Rule, January `3, 2010, Federal Register, pp. 1844-2011 17 /
Demonstrating Meaningful Use Common for Medicare and Medicaid States can apply to add to base definition Stage 1: Attestation One-time secure attestation per reporting period Via claims submission or CMS portal Specifics TBD Indicate certified EHR technology used Use same method for quality for 2011 CMS/States to pilot EHR-based submission 18 /
When Can/Must 2011 MU be Shown to Receive Full Medicare Payment? For First Payment Year (2011+) in which MU shown, reporting period is 90 continuous days in payment year 2011 First Start Last Start Eligible Professionals 1/1/2011 10/1/2011 Hospitals 10/1/2010 7/1/2011 Note: Above monthly timing applies to all post-2011 first payment years to get full payment for that year 19 /
The Path to 2015: Stages by Start Year Stage Timing Compressed for Post-2011 Starts First Payment Year 2011 2012 2013 2014 2015 and later** 2011 Stage 1 Stage 1 Stage 2 Stage 2 Stage 3 2012 Stage 1 Stage 1 Stage 2 Stage 3 2013 Stage 1 Stage 2 Stage 3 2014 Stage 1 Stage 3 2015 and later* Stage 3 *Avoids payment adjustments only for EPs in Medicare EHR Incentive Program **Stage 3 criteria of meaningful use or a subsequent update to criteria if one is established Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Proposed Rule, January `3, 2010, Federal Register, pp. 1844-2011 20 /
Medicare Incentive Policies: EP Calendar Year 2011 $18,000 First CY in which the EP Receives an Incentive Payment 2011 2012 2013 2014 2015 and subsequent years 2012 $12,000 $18,000 2013 $8,000 $12,000 $15,000 2014 $4,000 $8,000 $12,000 $12,000 2015 $2,000 $4,000 $8,000 $8,000 $0 2016 $2,000 $4,000 $4,000 $0 TOTAL $44,000 $44,000 $39,000 $24,000 $0 Medicare Penalties: % of allowed charges: 2015 (1%), 2016 (2%), 2017+ (3%) Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Proposed Rule, January `3, 2010, Federal Register, pp. 1844-2011
Medicare Incentive Policies: EP EP: MD/DO, DDS/M, DPM, DO, DC authorized for state practice Payment year: calendar year (CY) Incentives for up to five years, starting CY 2011 Payment schedule per start year (not actual year) Medicare maximum: $44,000 (HPSA = $48,000) Incentive: 75% Medicare allowable charges in payment year Subject to annual caps (e.g, $18K in first payment year: 2011-12) Qualifying EP: Show MU for EHR reporting period First Payment Year: Reporting period for full incentive is continuous 90 days during payment year; later years: full calendar year 22 /
Medicare Incentive Policies: EP Must meet all objectives & measures Hospital-based EPs ineligible EP furnishing 90%+ Medicare covered services in hospital inpatient, outpatient, and ED settings (place of service 21, 22, or 23) 27% of EPs Single annual incentive payment for EPs - electronic Payments by Medicare Carrier to TIN given by EP Payments on rolling basis When EP demonstrates MU for reporting period (90 days for first year or CY for later years) & hits allowed charge level for maximum payment Can reassign entire incentive to one employer/entity 23 /
Medicare Incentive Policies: EP Other Medicare Payment Programs Medicare incentive recipients ineligible for erx incentives EPs eligible for Medicare and Medicaid incentives must choose one to participate in Can change selection once for 2012 2014 Incentives for Medicare Advantage (MA) plans 24 /
Medicaid Incentive Policies: EPs State Medicaid programs administers Must select between Medicare or Medicaid Enroll via single provider election repository Medicaid EPs in multiple states must choose 1 One TIN for EP incentive payments per EP MU demonstrated by State method (HHS to ok) 25 /
Medicaid Incentive Policies: EPs EPs Physicians, dentists, NP, CNMs PAs practicing predominantly in PA-directed FQHC/RHC Cannot be hospital-based (FQHC/RHC exempt) Medicaid managed care EPs eligible for Medicaid incentives Must annually meet patient volume thresholds 30% of encounters for 90 days in prior year 20% for pediatricians 26 /
Medicaid Incentive Policies: EPs Up to $63,750 over six years and must start by 2016 Pediatricians with Medicaid volume of 20-29% -$42,500 Maximum of $21,250 in first payment year Adopt, implement or upgrade certified EHR or MU In later years, annual max of $8,500 for most EPs Up to $29K from others as initial contribution to EHR Up to $10.6K per year in later years Without incentive reduction No cap for State or local government contributions Can assign to employers or state-designated entities 27 /
Standards and Certification Criteria: Interim Final Rule
Standards and Certification Criteria Interim Final Rule (IFR) effective 2/12/2010 60-day comment period Final Rule to be issued sometime in 2010 Certification criteria: minimum capabilities and standards for certified EHRs to support Stage 1 MU Standards, certification criteria basis for testing and certification of complete EHRs and EHR Modules Process TBD ONC testing/certification IFR: early 2010 Multiple certifying organizations likely Note: Modules address 1+ certification criteria NIST: ONC to consult on certification program 29 /
Certification Criteria Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Proposed Rule, January `3, 2010, Federal Register, pp. 1844-2011 30 /
For More Information HHS Office of the National Coordinator for Health Information Technology www.hhs.gov/healthit/ 31 /
GE Healthcare Preparing for Meaningful Use with Centricity Ken Edwards General Manager, Account Management and Organizational Readiness Matt Wojcik Senior Account Manager
The Road to Meaningful Use Final ONC/CMS criteria for certification and measures (Q2) GE will test for CCHIT 2011 comprehensive certification (Q2) ARRA certification of EMR products expected (Q2/Q3 2010) Customer implementations & upgrades (beginning 2 nd half of 2010) Centricity EMR 9.5 Centricity Practice Solution 9.5 33 /
Planning Considerations Leverage your partnership with GE to prepare for meaningful use Prepare to implement functionality available today work with your Account Manager to plan Upgrade to the ARRA-certified version once available EMR 9.5 and Centricity Practice Solution 9.5 Engage in meaningful use for reporting period utilize MQIC (Medical Quality Improvement Consortium) Submit measures to CMS (and states for Medicaid) to receive incentive payments 34 /
Meaningful Use of your Account Manager Advanced eprescribing? Patient Portal? Secure Messaging? Health Information Exchange? Centricity EMR 9.5 or Centricity Practice Solution 9.5 Current Version Hardware (32 vs 64 bit)? Virtualization? Terminal Servers? Orders Module? MQIC? 35 /
Five Overarching Meaningful Use Themes: Centricity EMR Meets the Challenge Requirements Improve quality, safety, efficiency and reduce health disparities Engage patients and families Improve care coordination Improve population and public health Ensure adequate privacy and security protections for PHI GE Capabilities 36 /
For More Information HHS Office of the National Coordinator for Health Information Technology: www.hhs.gov/healthit/ Customer support sites: www.gehealthcare.com/usen/security/cis EMR@ge.com Thank you for joining us today 37 /