Performance Progress CoP
Medicaid EHR Incentive Program June 9, 2015
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This is an advanced copy of the Performance
Progress presentation for your review only. This
presentation is subject to change and should not
be reproduced. The final version of the presentation
will be posted to the Medicaid HITECH TA Web site
at a later date.
Agenda
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Snapshot of the Medicaid EHR Incentive Program
• Sam Schaffzin, CMS/CMCHO
Medicaid EHR Incentive Program Analytics
State Spotlight: Wisconsin
• Denise Webb, Director and State Health IT Coordinator
Implementation Advance Planning Document (IAPD) Submission:
Process, Tips and Q&A
• Robert McCarthy, CMS/CMCHO
Wrap Up and Next Steps
• Melissa Corrado, MeT
Snapshot of the Medicaid EHR
Incentive Program:
June 2015
Sam Schaffzin, CMS/CMCHO
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By the Numbers
• Total Medicaid EHR incentive payments through June 3,
2015: 250,295 payments to providers totaling
$9,752,734,790.
• 155,882 unique participating providers.
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Disbursed Payment
Adopt,
Implement,
Upgrade
(AIU)
50 States plus Puerto Rico, D.C., and N.M.I.
Meaningful
Use (MU) 50 States plus D.C. & Puerto Rico
Eligible professional (EP) AIU to MU Return
Percentages Nationally (June 2015)
EP Year 2 to Year 3 Return Percentage
(June 2015)
EP Year 3 to Year 4 Return Percentage
(June 2015)
Dentists-Only Year 2 to Year 3 Nationally
(June 2015)
Eligible hospital (EH) Return Percentage for
Payment Year 1 to Year 2 (June 2015)
Wisconsin Medicaid EHR Incentive
Program
Health Information Technology
Landscape Assessment
Denise Webb, Wisconsin eHealth Program
Director and State Heath IT Coordinator
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Wisconsin HIT Landscape Assessment Topics
Process
Data Sources Wisconsin Medicaid data warehouse
Attestation system (Medical Assistance Provider Incentive Repository - MAPIR)
CMS EHR Incentive Program Public Use Files
Tools Business Objects
Microsoft Excel
Tableau
Report highlights
Eligible Hospitals summary
Eligible Professionals summary
What’s next and Q&A
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ELIGIBLE HOSPITALS SUMMARY
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Location of Eligible Hospitals Highest Stage of Certified
EHR Technology (CEHRT) Adoption
Figure based on Medicare & Medicaid EHR Incentive Program Data
115 Wisconsin Eligible
Hospitals are Stage 1
Meaningful Users
10 Wisconsin Eligible
Hospitals Adopted,
Implemented or
Upgraded CEHRT
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Eligible Hospital Meaningful Use Core Measures Analysis
Title Measure Threshold Wisconsin Average Percentage
Core Measure 1: Computerized
Physician Order Entry (CPOE)
for Medication Orders
More than 30 percent 90.30%
Core Measure 3: Maintain
Problem List
More than 80 percent 96.13%
Core Measure 4: Active
Medication List
More than 80 percent 98.65%
Core Measure 5: Medication
Allergy List
More than 80 percent 98.88%
Core Measure 6: Record
Demographics
More than 50 percent 97.34%
Core Measure 7: Record Vital
Signs
More than 50 percent 94.03%
Core Measure 8: Record
Smoking Status
More than 50 percent 96.40%
Core Measure 11: Electronic
Copy of Health Information
More than 50 percent 95.71%
Core Measure 12: Electronic
Copy of Discharge Instructions
More than 50 percent 95.30%
Figure based on Medicare & Medicaid EHR Incentive Program Data
*Measures with Numerator and Denominator only
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Eligible Hospital Meaningful Use Menu Measures Analysis
Title Measure Threshold Wisconsin Average
Percentage Menu Measure 2: Advance
Directives
More than 50 percent 93.93%
Menu Measure 3: Incorporate
Clinical Lab Test Results
More than 40 percent 96.56%
Menu Measure 5: Patient-
Specific Education Resources
More than 10 percent 85.94%
Menu Measure 6: Medication
Reconciliation
More than 50 percent 89.58%
Menu Measure 7: Transition of
Care Summary
More than 50 percent 78.95%
Figure based on Medicare & Medicaid EHR Incentive Program Data
*Measures with Numerator and Denominator only
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Eligible Hospital CEHRT Vendors
Figure based on Medicare & Medicaid EHR Incentive Program Data
* The following vendors were used in one attestation: Allscripts,
ExitCare, IHM Services, Interface People, RWHC QI Program and
SCC Soft Computer
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Location of Eligible Hospitals Top 5 CEHRT Vendors
Figure based on Medicare & Medicaid EHR Incentive Program Data
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Regional Summary of Top 5 CEHRT Vendors with Medicaid
Population
Figure based on Medicare & Medicaid EHR Incentive Program Data
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Location of Eligible Hospitals Non-Top 5 CEHRT Vendors
Figure based on Medicare & Medicaid EHR Incentive Program Data
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ELIGIBLE PROFESSIONALS
SUMMARY
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Location of Eligible Professionals Highest Stage of CEHRT
Adoption
Figure based on Medicare & Medicaid EHR Incentive Program Data
7,925 Wisconsin Eligible
Professionals are Stage 1
Meaningful Users
1,500 Wisconsin Eligible
Professionals Adopted,
Implemented or Upgraded
CEHRT
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Location of Dentists Highest Stage of CEHRT Adoption
Figure based on Medicare & Medicaid EHR Incentive Program Data
60 Wisconsin Dentists are
Meaningful Users
162 Wisconsin Dentists
Adopted, Implemented or
Upgraded CEHRT
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Location of Nurse Practitioner & Nurse Services Highest
Stage of CEHRT
Figure based on Medicaid EHR Incentive Program Data OnlyEentive
285 Wisconsin Nurse
Practitioner and Nurse
Services Providers are
Meaningful Users
442 Wisconsin Nurse
Practitioner and Nurse
Services providers
Adopted, Implemented or
Upgraded CEHRT
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Location of Physicians Highest Stage of CEHRT Adoption
Figure based on Medicare & Medicaid EHR Incentive Program Data
7,567 Wisconsin Physicians
are Meaningful Users
886 Wisconsin Physicians
Adopted, Implemented or
Upgraded CEHRT
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Location of Physician Assistant Highest Stage of CEHRT
Adoption
Figure based on Medicaid EHR Incentive Program Data Only
13 Wisconsin Physician
Assistants are Meaningful
Users
10 Wisconsin Physician
Assistants Adopted,
Implemented or Upgraded
CEHRT
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Eligible Professional Meaningful Use Core Measures
Analysis
Title Measure Wisconsin Average Percentage
Core Measure 1: CPOE for
Medication Orders
More than 30 percent 92.67%
Core Measure 3: Maintain
Problem List
More than 80 percent 97.43%
Core Measure 4: e-
Prescribing
More than 40 percent 90.12%
Core Measure 5: Active
Medication List
More than 80 percent 98.78%
Core Measure 6: Medication
Allergy List
More than 80 percent 98.97%
Core Measure 7: Record
Demographics
More than 50 percent 97.43%
Core Measure 8: Record Vital
Signs
More than 50 percent 92.19%
Core Measure 9: Record
Smoking Status
More than 50 percent 95.60%
Core Measure 12: Electronic
Copy of Health Information
More than 50 percent 93.65%
Core Measure 13: Clinical
Summaries
More than 50 percent 84.89%
Figure based on Medicaid EHR Incentive Program Data Only
*Measures with Numerator and Denominator only
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Eligible Professional Meaningful Use Menu Measures
Analysis
Figure based on Medicaid EHR Incentive Program Data Only
*Measures with Numerator and Denominator only
Title Measure Wisconsin Average Percentage
Menu Measure 2: Clinical
Lab Test Results
More than 40 percent 95.79%
Menu Measure 4: Patient
Reminders
More than 20 percent 68.64%
Menu Measure 5: Patient
Electronic Access
At least 10 percent 74.33%
Menu Measure 6: Patient-
Specific Education
Resources
More than 10 percent 70.24%
Menu Measure 7:
Medication
Reconciliation
More than 50 percent 91.38%
Menu Measure 8:
Transition of Care
Summary
More than 50 percent 91.21%
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Eligible Professional CEHRT Vendor Landscape
Figure based on Medicare & Medicaid EHR Incentive Program Data
* The following vendors were used in 50-100 attestations: eClinicalWorks, IOD Inc., LSS Data Systems, McKesson, SRSsoft
** The following vendors were used in 10-49 attestations: AmazingCharts, Aprima, Athenahealth, Business Computer Applications,
CPSI, Data Strategies, DR Systems, Elekta, e-MDs, Greenway , Healthland, Henry Schein , ImagingElements, Indian Health
Service, Instant Health Care, MEDITECH, MPN Software, Patterson Dental, Practice Fusion, SOAPware
***The following vendors were used in 1-9 attestations: Abraxas, ADP AdvancedMD, Advanced Data, Altapoint Data Systems,
CareCloud, ChartLogic, CompuGroup, Compulink, Connexin, Core Solutions, Crowell Systems, CureMD, Defran Systems,
DrChrono, DrFirst, Emdeon, EyeMD, gloStream, gMed, Health IT Services Group, HealthFusion, Horizon, i2i Systems, Infor-Med,
Integrated Systems Management, Intuitive Medical Software, IO Practiceware, iPatientCare, IRCS, Kareo, KSB, MacPractice,
ManagementPlus, MDIntelleSys, Mdoffice, MedcomSoft, Medflow, MEDHOST, MedInformatix, MedPlus, Medstreaming,
meridianEMR, Modernizing Medicine, NexTech, Nuesoft Technologies, OEMR, Office Ally, Open Dental Software, PatientNOW,
Procentive, Prognosis Health Information Systems, SCC Soft , Shareable Ink, simplifyMD, Soren Technology, Streamline
Healthcare Solutions, SuiteMed, SynaMed, The Echo Group, Tolven, Valant, WEBeDoctor, Xcite Health and Encounterpro
Healthcare Resources
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Location of Eligible Professionals Top 5 CEHRT Vendors
Figure based on Medicare & Medicaid EHR Incentive Program Data
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Regional Summary of Top 5 CEHRT Vendors with Medicaid
Population
Figure based on Medicare & Medicaid EHR Incentive Program Data
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WHAT’S NEXT AND Q&A
IAPD Submission:
Process, Tips, and Q&A
Robert McCarthy, CMS/CMCHO
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IAPD Updates
• IAPDs must be updated at least annually
• IAPD-Update (IAPD-U) are due no later than 60 days
after the occurrence of project changes, such as:
– A projected cost increase of $100,000 or more.
– Schedule extensions of more than 60 days for major milestones.
– Significant changes in planning or implementation approach, or
scope of activities beyond the approved Health Information
Technology (HIT) IAPD.
– Changes in implementation concept or a change to the scope of
the project.
– Changes to the approved cost allocation methodology.
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IAPD Expiration Date Timing Examples
• IAPD Expiration on September 30:
• September: IAPD expires 9/30/15
• August: CMS-37 due 8/15/15 for FFQ1
• Early July: Must submit IAPD-U
• June: Recommend submitting IAPD-U
• IAPD Expiration on June 30:
• June: IAPD expires 6/30/16
• May: CMS-37 due 5/15/16 for FFQ4
• Early April: Must submit IAPD-U
• March: Recommend submitting IAPD-U
Bottom Line:
Submit IAPD to
CMS 3 months
before expiration
date to allow for
enough time for
review and
approval
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• HITECH RO Staff: • http://www.medicaidhitechta.org/ContactUs/CMSStaff.aspx
• IAPD: • Robert McCarthy: 206-615-2505, [email protected]
• Financial Coordinator: • Carrie Feher: 410-786-8905, [email protected]
Key CMS Contacts
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IAPD Resources
MedicaidHITECHTA.org website
http://www.medicaidhitechta.org/ResourceLibrary/Pr
ogramImplementationToolkit/Pathway2/4IAPD.aspx
• IAPD Template
• IAPD Companion Guide
• Financial Management Tips and Key Considerations
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Contracts
All HITECH contracts must be approved before
the State executes the contract or contract
amendment, per 42 CFR 492.324.
Many States execute contracts without prior
approval and run the risk of that funding being
recovered by the Federal government at some
point.
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What’s Next
• Next Performance Progress CoP:
Tuesday August 25, 2015 at 3:00 PM ET
• Please contact Melissa Corrado
[email protected] if you are
interested in sharing your state’s experiences,
ideas, plans, concerns, and/or progress on future
CoPs
• Any additional suggestions can be sent to:
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Resources
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Web www.cms.hhs.gov/EHRIncentiveprograms
www.MedicaidHITECHTA.org
Twitter @CMSgov
HITECH
Staff
Sam Schaffzin: [email protected]
Robert McCarthy: [email protected]
Nick Aretakis: [email protected]