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Page 1: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Meaningful Use and the EHR Incentive Program

NIHB Annual Consumer Conference

Page 2: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

EHR Incentive Program

• The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.

Page 3: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

• Eligibility

• Certified EHR

• Meaningful Use Measures

• Clinical Quality Measures

Meaningful Use

Page 4: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Provider Eligibility

Page 5: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

• Eligibility

• Certified EHR

• Meaningful Use Measures

• Clinical Quality Measures

Meaningful Use

Page 6: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Certified RPMS EHR Requirements

Name Space

Package or Application Version Patch Release Date

AG Patient Registration 7.1 9 12/3/10

APCL Export 3.0 27 11/10/10

APSP Pharmacy MOD-ePrescribing (eRx) 7.0 1010 4/29/11

BGP Clinical Reporting System (CRS) 11.0 3 6/22/11

BJMD C32 1.0 1 6/24/11

BJPC PCC Mgmt Reporting 2.0 6 6/2/11

BMC Referred Care Information System (RCIS) 4.0 7 5/12/11

BQI iCare 2.1 3/11/11

BRN Release of Information (ROI) 2.0 3 4/13/11

BYIM Immunization Exchange Message 2.0 01 2/24/11

BGO Electronic Health Record (EHR) 1.1 8 6/10/11

LR Lab 5.21027 or 372 or

33412/07/10

PXRM EHR Reminders 1.5 1007 4/13/10

BPHR Personal Health Record (PHR) 1.0 6/22/11

Central Ensemble 2009.1.6 921.0.10414 2011

GuardianEdge/ Symantec 8.0 3/31/11

IPSEC (Windows) 2010

VanDyke (AIX) 2010

WinHasher 1.6 2011Universal Client -Continuity of Care Record (CCR)*

1.0 4/27/11

Page 7: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

• Eligibility

• Certified EHR

• Meaningful Use Measures

• Clinical Quality Measures

Meaningful Use

Page 8: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Meaningful Use Measures

• Yes/No Measures– Implement drug-drug and drug-allergy

checks– Generate at least one report listing patients

with a specific condition

• Measures with Targets– Record smoking status for more than 50%

of patients– Provide patient-specific education

resources for more than 10% of patients

Page 9: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Meaningful Use Measures

EP Core Set Measures (15) EH Core Set Measures (14)

Provide clinical summaries for office visits

ePrescribing

Provide electronic copy of discharge instructions upon

request

Use CPOE for medication ordersImplement drug-drug and drug-allergy checks

Record demographics

Record smoking status

Maintain up-to-date problem list, medication list, medication allergy list

Record and chart changes in vital signs

Implement one clinical decision support ruleReport clinical quality measures

Protect electronic health information (security risk analysis)

Provide patients an electronic copy of health info upon request

Capability to electronically exchange key clinical information (perform test)

Page 10: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Meaningful Use Measures

EP Menu Set Measures (10) EH Menu Set Measures (10)

Send reminders to patientsProvide patients with timely

electronic access to their health information

Record advance directives

Submit electronic data on reportable lab results to public

health agencies

Implement drug formulary checks

Incorporate clinical lab test results into certified EHR

Generate lists of patients by specific conditions

Provide summary of care records for patients referred to other providers/facilities

Use certified EHR to identify and provide patient-specific education resources

Perform medication reconciliation for patients referred to the EP/EH

Submit electronic data to immunization registriesSubmit electronic syndromic surveillance data to public health

agencies

Page 11: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

• Eligibility

• Certified EHR

• Meaningful Use Measures

• Clinical Quality Measures

Meaningful Use

Page 12: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Clinical Quality Measures: EPs

• Core/Alternate Core Set (6)– Hypertension– Tobacco Use Assessment/Cessation

Intervention– Adult Weight Screening/Follow-up–Weight Assessment/Counseling for Children – Adult Influenza Immunization– Childhood Immunization

• Additional Measures (38)– Breast Cancer Screening; Cervical Cancer

Screening; Colorectal Cancer Screening

Page 13: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Clinical Quality Measures: EHs

• Emergency Department (2)–Median time from ED arrival to ED

departure for admitted patients; median time from admit decision time to ED departure time for admitted patients

• Stroke (7)– Anticoagulation for A-fib/flutter,

discharge on statins, stroke education, etc.

• Venous Thromboembolism (6)– Anticoagulation overlap therapy,

discharge instructions, etc.

Page 14: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

1

Medicare Incentive Program

Requirements and Amounts for EPs who begin in 2011 or 2012Year Requirement Incentive

2Demonstrate MU for full calendar year

$12,000

3Demonstrate MU for full calendar year

$8,000

4Demonstrate MU for full calendar year

$4,000

5Demonstrate MU for full calendar year

$2,000

Demonstrate MU for 90-day period $18,000

Page 15: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Medicare Incentive Payments

Payment Year

First Year EP Demonstrates MU

2011 2012 2013 2014 2015

CY 2011 $18,000

CY 2012 $12,000 $18,000

CY 2013 $8,000 $12,000 $15,000

CY 2014 $4,000 $8,000 $12,000 $12,000

CY 2015 $2,000 $4,000 $8,000 $8,000 $0

CY 2016 $2,000 $4,000 $4,000 $0

Total $44,000 $44,000 $39,000 $24,000 $0

Page 16: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Medicaid Incentive Payments

Requirements and Amounts for EPsYear Requirement Incentive

2

1Adopt/Implement/Upgrade to certified EHR technology

$21,250

Demonstrate MU for 90-day period $8,500

3Demonstrate MU for full calendar year

$8,500

4Demonstrate MU for full calendar year

$8,500

5Demonstrate MU for full calendar year

$8,500

6Demonstrate MU for full calendar year

$8,500

Page 17: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

EHR Incentive Program Registrationwww.cms.gov/ehrincentiveprograms/

Page 18: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

EHR Incentive Program Registration

Page 19: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

EHR Incentive Program Registration• Medicare EPs:

– Register with CMS

• Medicaid EPs:– Register with CMS – Register with state Medicaid program

• Hospitals:– Register as dual-eligible

• With CMS for Medicare• With state Medicaid program for Medicaid

Certified EHR is not required for registration!

Page 20: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Regional Extension Center

The RECs will support and serve health care providers to help them quickly become adept and meaningful users of EHRs. RECs are designed to make sure that primary care clinicians get the help they need to use EHRs.• Provide training and support services to

assist providers in adopting EHRs • Offer information and guidance to help

with EHR implementation • Provide technical assistance

Page 21: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

REC vs Incentive Program

Support providers and hospitals in

achieving MU

Reward providers and hospitals for

achieving MU

Regional Extension Center

EHR Incentive Program

EHR certification rule Meaningful use rule

Page 22: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Provider Responsibilities

Completing Milestone = REC Funding

Demonstrating MU =Incentive Payment

• Register with

CMS/State

• Achieve MU

• Attest/submit each

year

• Sign up with REC

• Go live with certified

EHR

• Achieve MU

Regional Extension Center

EHR Incentive Program

Page 23: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Regional Extension Center EHR Incentive Program

ONC CMS

NIHB AI/AN REC EPs/EHs

1. Provider signs up with NIHB AI/AN REC

2. Provider “goes live” with certified EHR

3. Provider achieves meaningful use

IHS

$$$ $$$$$

Page 24: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

NIHB REC M1: Sign Up

http://nihb.org/rec/rec.php

Page 25: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

NIHB REC M2: Go Live

Page 26: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

NIHB REC M3: Achieve MU

• Medicare EPs– Provide CMS Attestation ID

• Medicaid EPs and others– Provide attestation data from RPMS-EHR

reports

Page 27: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Things to Do Now

• Sign up with the NIHB REC

• Designate a Meaningful Use Coordinator

• Install RPMS EHR patches and other required software applications for certification

• Review MU Measures and redesign workflows

• Register for EHR Incentive Program (pending launch of State program for Medicaid EPs/EHs)

Page 28: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

2011 Timeline

• Hospitals–Medicare: Last 90-day period within FY

2011 to demonstrate MU is July 1 – Sept 30, 2011

–Medicaid: Check with state about deadlines

• Providers–Medicare: Last 90-day period within CY

2011 to demonstrate MU is Oct 1 – Dec 31, 2011

–Medicaid: Check with state about deadlines

Page 29: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Resources

• www.usetinc.net/ehr– Resources– Frequently Asked Questions

• www.cms.gov/ehrincentiveprograms/– EHR Incentive Program Eligibility,

Registration– Status of State Medicaid Programs– Frequently Asked Questions

• www.ihs.gov/meaningfuluse/– Resources– MU Listserv– RPMS-EHR Certification Info

Page 30: Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference.

Contact

Vicki FrenchUnited South and Eastern [email protected]@ihs.gov


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