ehr incentive program update to hit policy committee

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http://www.cms.gov/EHRIncentivePrograms/ Medicare & Medicaid EHR Incentive Programs HIT Policy Committee December 5, 2012

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Page 1: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare & Medicaid EHR Incentive Programs

HIT Policy CommitteeDecember 5, 2012

Page 2: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Registration and Payment Data

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Page 3: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Active Registrations

Active Registrations – October 2012

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Page 4: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Active Registrations

Active Registrations – October 2012

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Page 5: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicare Incentive Payments – October 2012 Meaningful Use (MU)

Page 6: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicare Incentive Payments – October 2012 Meaningful Use

For final CMS reports, please visit: http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp

Page 7: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicare Incentive Payments – October 2012 Meaningful Use

Page 8: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicaid Incentive Payments – October 2012 (Both MU and AIU)

For final CMS reports, please visit: http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp

Page 9: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare Incentive Payments

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Medicaid Incentive Payments – October 2012

Page 10: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EHR Incentive Programs

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EHR Incentive Programs – October 2012 Totals

Page 11: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EHR Incentive Programs

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EHR Incentive Programs – October 2012 Totals

Page 12: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

October – by the numbers October – By the Numbers

0.179

0.1790.6462

Eligible Hospitals

5,011 Total

4,114 Total Registered

3,238 Paid

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Page 13: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

October – by the numbers October – By the Numbers

38.10%

42.62%

19.28%

Registered Eligible Professionals

521,600 Total EPsRegistered Medicare EPs (222,307)Registered Medicaid EPs (100,558)

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Page 14: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

October – by the numbers October – By the Numbers

69.07%

16.90%

11.91% 2.13%

Paid Eligible Professionals

521,600 Total EPsMedicare EPs (88,138)Medicaid EPs (62,100)MAO EPs (11,117)

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Page 15: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

October – by the numbers October – By the Numbers

• Nearly 65% of all eligible hospitals have received an EHR incentive payment for either MU or AIU • Nearly 65% have made a financial commitment to put an EHR

in place

• Approximately 26% or 1 out of every 4 Medicare EPs are meaningful users of EHRs

• Approximately 31% -- nearly 1 out of every 3 -- Medicare and Medicaid EPs have made a financial commitment to an EHR

• 58% of Medicare EPs receiving incentives specialists (non primary care)

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Page 16: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare & Medicaid Payments

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Medicare & Medicaid Payments for November 2012

DRAFT ESTIMATES ONLY

Providers Paid Oct-12 LTD

Medicare EPs – [ESTIMATED] 8,250 107,250

Medicaid EPs (AIU + MU) [ESTIMATED] 4,000 66,100Medicaid/Medicare Hospitals** [ESTIMATED] 525 3,750Total Number of UNIQUE Providers Paid 12,775 177,100

Page 17: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Medicare & Medicaid Payments

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Medicare & Medicaid Payments for November 2012

DRAFT ESTIMATES ONLYPayments Oct-12 LTD

Medicare EPs [ESTIMATED] $150,000,000 $1,850,000,000Medicaid EPs [ESTIMATED] $73,000,000 $1,395,000,000

Medicaid/Medicare Hospitals [ESTIMATED] $645,000,000 $6,000,000,000Total $868,000,000 $9,245,000,000

Page 18: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EHR Incentive Programs Attestation Data

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Page 19: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Highlights• On average all thresholds were greatly exceeded, but

every threshold had some providers on the borderline• Drug formulary, immunization registries and patient list

are the most popular menu objectives for EPs• Advance Directives, Clinical Lab Test Results, and Drug

Formulary for hospitals

• Transition of care summary and patient reminders were the least popular menu objectives for EPs• Transition of Care and Reportable Lab Results for hospitals

• Little difference between EP and hospitals• Little difference among specialties in performance, but

differences in exclusions and deferrals

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Page 20: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Providers Included

This data-only analysis shows our earliest adopters who have attested, but does not inform us on barriers to attestation.

At the time of the analysis• 117,514 EPs had attested

• 117,284 Successfully• 230 Unsuccessfully (214 EPs have resubmitted

successfully)

• 2,558 Hospital had attested• All successfully

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Page 21: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EP Quality, Safety, Efficiency, and Reduce Health Disparities

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Objective Performance Exclusion Deferral

Problem List 97% N/A N/AMedication List 97% N/A N/AMedication Allergy List 97% N/A N/ADemographics 91% N/A N/AVital Signs 91% 9% N/ASmoking Status 91% 0.4% N/A

Page 22: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EP Quality, Safety, Efficiency, and Reduce Health Disparities

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Objective Performance Exclusion Deferral

CPOE 83% 17% N/AElectronic prescribing 81% 20% N/AIncorporate lab results 92% 4% 36%Drug-formulary checks N/A 14% 15%Patient lists N/A N/A 26%Send reminders to patients 61% 0.5% 81%

Page 23: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EP Engage Patients and Their Families

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Objective Performance Exclusion Deferral

E – Copy of Health Information 97% 70% N/AOffice visit summaries 79% 2% N/APatient Education Resources 49% N/A 49%Timely electronic access 73% 1% 67%

Page 24: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EP Improve Care Coordination

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Objective Performance Exclusion Deferral

Medication reconciliation 90% 3% 54%Summary of care at transitions 90% 3% 84%

Page 25: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EP Improve Population and Public Health

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Objective Performance* Exclusion Deferral

Immunizations 35% 45% 20%Syndromic Surveillance 6% 25% 69%

*Performance is percentage of attesting providers who conducted test

Page 26: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EH Quality, Safety, Efficiency, and Reduce Health Disparities

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Objective Performance Exclusion Deferral

Problem List 95% N/A N/AMedication List 98% N/A N/AMedication Allergy List 98% N/A N/ADemographics 96% N/A N/AVital Signs 92% N/A N/ASmoking Status 93% 0.6% N/A

Page 27: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EH Quality, Safety, Efficiency, and Reduce Health Disparities

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Objective Performance Exclusion Deferral

CPOE 85% N/A N/AAdvance directives 96% 0.5% 8%Incorporate lab results 95% N/A 14%Drug-formulary checks N/A N/A 15%Patient lists N/A N/A 40%

Page 28: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EH Engage Patients and Their Families

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Objective Performance Exclusion Deferral

E – copy of health information 96% 69% N/AE – copy of discharge Instructions 95% 66% N/A

Patient education resources 73% N/A 58%

Page 29: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EH Improve Care Coordination

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Objective Performance Deferral

Medication reconciliation 85% 70%Summary of care at transitions 82% 91%

Page 30: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

EH Improve Population and Public Health

Objective Performance* Exclusion Deferral

Immunizations 50% 15% 35%Reportable Lab Results 16% 6% 77%Syndromic Surveillance 21% 3% 75%

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*Performance is percentage of attesting providers who conducted test

Page 31: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

REC Reported Challenges

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Full report: http://dashboard.healthit.gov/data/

Page 32: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Overall Top Ten MU Measures

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Page 33: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Practice Issue Challenges

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Page 34: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Vendor Issue Challenges

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Page 35: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Top Five Challenges by Practice Type

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Page 36: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

Top Five MU Measures

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Page 37: EHR Incentive Program Update to HIT Policy Committee

http://www.cms.gov/EHRIncentivePrograms/

For questions, please contact:

Robert AnthonyOffice of E-Health Standards and ServicesCenters for Medicare & Medicaid [email protected]

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