HealthBridge is one of the nation’s largest and most successful health

information exchange organizations.

HealthBridge is one of the nation’s largest and most successful health

information exchange organizations.

David Groves, Executive Director

April Smith, Project Manager

Tri-State Regional Extension Center

Tri-State REC: How Clinicians Can Qualify for Meaningful Use

& Federal Incentives

What do you need to know to get paid?

ARRA & HITECH Acts

• On Feb. 17, 2009, President Obama signed the American Recovery and Reinvestment Act of 2009 (ARRA).

• The health IT provisions of the Recovery Act together are known as the Health Information Technology for Economic and Clinical Health Act or HITECH Act. 

• HITECH Act authorizes creation of a number of new programs and roughly $40 Billion in new spending.

• The US Department of Health and Human Services (DHHS) and the States were tasked with promoting the “meaningful use” of health information technology through the use of incentives.

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services.

Meaningful Use – Who is eligible for incentives?

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Eligible Providers in Medicare Eligible Providers in Medicaid

Eligible Professionals (EPs) Eligible Professionals (EPs)Doctor of Medicine or Osteopathy Physicians (Pediatricians have special eligibility

& payment rules)Doctor of Dental Surgery or Dental Medicine Nurse Practitioners (NPs)

Doctor of Podiatric Medicine Certified Nurse-Midwives (CNMs)

Doctor of Optometry Dentists

Chiropractor Physician Assistants (PAs) who lead a Federally Qualified Health Center (FQHC) or rural health clinic (RHC)

Eligible Hospitals Eligible HospitalsAcute Care Hospitals Acute Care Hospitals

Critical Access Hospitals (CAHs) Children’s Hospitals

Funding is available...

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

MEDICARE EP Incentive Payment - Based on First Calendar Year EP receives

Calendar Year CY 2011 CY 2012 CY 2013 CY 2014 CY 2015and later

2011 $18,000

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

Medicaid funding higher

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

MEDICAID EP Incentive Payment - Based on First Calendar Year EP receives

Calendar Year

CY 2011 CY 2012 CY 2013 CY 2014 CY 2015 CY2016

2011 $21,250

2012 $8,500 $21,250

2013 $8,500 $8,500 $21,250

2014 $8,500 $8,500 $8,500 $21,250

2015 $8,500 $8,500 $8,500 $8,500 $21,250

2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250

2017 $8,500 $8,500 $8,500 $8,500 $8,500

2018 $8,500 $8,500 $8,500 $8,500

2019 $8,500 $8,500 $8,500

2020 $8,500 $8,500

2021 $8,500

TOTAL $63,750 $63,750 $63,750 $63,750 $63,750 $63,750

Medicaid MU Thresholds

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Entity Minimum Medicaid Patient Volume Threshold

For Eligible Professionals (EPs)Physicians 30%

-Pediatricians 20%

Dentists 30%

CNMs 30%

PAs when practicing at an FQHC/RHC that is so led by a PA

30%

NPs 30%

**Or the Medicaid EP practices predominantly in an FQHC or RHC—30% needy individual patient volume threshold

For Eligible HospitalsAcute care hospitals 10%

Children’s hospitals No requirement

Meaningful use is complex

To receive incentives, for example, practices have to use technology for:

• Medication and allergy lists • E-Prescribing• Access to electronic lab results• Electronic orders• Electronic claims submission• Checking insurance eligibility• Clinical summary to other providers and patients• Clinical decision support• Health information exchange• Quality reporting to the federal government• Among others…

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

The Challenges

• Government regulations are complex.• Final Rule on “Meaningful Use” expected from

HHS by June 30, 2010• As many as 30% of all EHR implementations

fail. • EHR Selection can be time consuming and risky• EHR adoption will impact workflow• EHR use will bring new challenges with regard

to security and privacy of patient records• EHR Implementation alone is not enough

An Overview

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

There is help

Tri-State Regional Extension Center (REC)

WHAT IS IT?

• New federally-funded collaboration led by HealthBridge

• GOAL: Help eligible professionals

• implement technology

• achieve meaningful use and

• qualify for incentives

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Tri-State REC Service Area

State

Ohio

(11 counties)

Kentucky

(37 counties)

Indiana

(19 counties)

Tri-State REC Partners

State

Ohio

(11 counties)

Kentucky

(37 counties)

Indiana

(19 counties)

NEKY

RHIO

WHAT SERVICES WILL THE TRI-STATE REC OFFER?

• Basic Resources on Technology and Meaningful Use

• Group Purchased EHRs and Technology Solutions

• On-Site Consulting

• Quality Reporting Support

WHAT REC DOLLARS CANNOT DO:

• Pay for an EHR, hardware or other software

HealthBridge Tri-State Regional Extension Center (REC)

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

HealthBridge Tri-State Regional Extension Center (REC)

WHO WILL IT HELP?

• Priority Primary Care

Practitioners (PPCP)

• Primary Care = FPs, OB/Gyn, Peds, Int. Med

• Additional focus on: • Small practices (<10 prescribers;

physicians, PAs, ARNPs) • Community health centers • Rural clinicians and those with critical

access hospitals• Practices and clinics that serve the

underserved.

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Timeline for maximum payment: • Stage I applications will be accepted between Jan. 2011

and Dec. 2012• Implementing an EHR takes ~ 12 mos. • If you haven’t started planning for an EHR, now is the

time to start. • If you have an EHR, you will need to make sure it is

certified and can meet meaningful use requirements.

These things simply take time.

Time is money.

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

• Maximize funding available to you

• Speed adoption timeline

• Avoid common mistakes

• Help manage your vendor’s work

• Prepare a roadmap for achieving meaningful use and help your practice get there

How will the REC help?

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Bottom line: REC will help practices

• maximize funding

• minimize expenses and

• improve quality and efficiency of the practice

Why Work with the Tri-State REC?

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

First Step: Sign the Provider Agreement

What’s in it? In Binder under REC Info Tab:

• Basic Agreement (Pgs 1-2)

• Exhibit A: Basic outline of roles & responsibilities

• Exhibit B: Overview of Meaningful Use Proposed Rules

• Exhibit C: Practice and Location Data (feds require REC to collect this information)

• Exhibit D: Tri-State REC Contacts Assigned to Practice

• Exhibit E: Fee Schedule

**Feds only supply 90% of costs; REC required to generate revenue

• Exhibit F: Business Associate Agreement

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Fee Schedule

Provider Type Designation

EHR Practice Already Using

EHR

HIE Participant Practice Actively Using HIE-

Offered Clinical Technology

Paper-Based Practice

Not using an EHR or HIE technology

Early Adoption Period:

Through 6/30/10(Limited to the first 300 PPCPs ONLY)

Fee Waived Fee Waived $1,000 per physician

PPCP No Charge$500 per physician(Capped at $5,000)

$2,000 per physician (Capped at $20,000)

Non-PPCP$5,000 per physician(Capped at $40,000)

$7,000 per physician(Capped at $55,000)

$9,000 per physician(Capped at $75,000)

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Second Step: Planning

• Tri-State REC staff will perform

• MU Gap Analysis or

• Readiness Assessment

• If you already have an EHR, then Tri-State REC staff will perform an independent assessment of whether it meets meaningful use criteria.

• If you don’t have an EHR, Tri-State REC staff will perform an EHR readiness assessment

• Then Tri-State REC staff will help you develop and execute a plan to get to meaningful use.

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Third Step: Vendor Selection/Modification

• REC staff will assist practice with looking at options, selecting vendor and providing best practices in vendor contracting.

• Group Purchased EHR Available through REC• Other options:

• Health System Stark-Safe Harbor EHR offerings• OSIS • Purchase independently

• Also support practice in selection of hardware, IT support, and other elements needed

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Fourth Step: Implementation

• Assist with identifying health information exchange requirements under meaningful use

• Provide options for how to meet HIE requirements• Workflow, Change Management Assistance• Vendor – Project Management • Provide recommendations and assistance with quality

reporting, e-prescribing and other meaningful use requirements

• For select practices, assist with intensive quality improvement and enhanced work flow redesign

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

• Advise practices in how to maximize their incentive funding

• Assist with completing application process for meaningful use incentive payments

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .

Fifth Step: Qualifying

Next Steps

• Review and sign provider agreement and return to

HealthBridge to initiate work REC.

• Fees are waived through June 30th for eligible practices.

• Contact us via phone, email or online if you have

additional questions. Tri-State REC Information

Phone: 513-469-7222, option 3

Email: rec@healthbridge.org

Online: www.healthbridge.org

REC support is provided under cooperative agreement 90RC0025/01 from the Office of the National Coordinator for HIT, US Dept. of Health and Human Services .