ehr incentive program update to hit policy committee
TRANSCRIPT
http://www.cms.gov/EHRIncentivePrograms/
Medicare & Medicaid EHR Incentive Programs
HIT Policy CommitteeDecember 5, 2012
http://www.cms.gov/EHRIncentivePrograms/
Registration and Payment Data
2
http://www.cms.gov/EHRIncentivePrograms/
Active Registrations
Active Registrations – October 2012
3
http://www.cms.gov/EHRIncentivePrograms/
Active Registrations
Active Registrations – October 2012
4
http://www.cms.gov/EHRIncentivePrograms/
Medicare Incentive Payments
5
Medicare Incentive Payments – October 2012 Meaningful Use (MU)
http://www.cms.gov/EHRIncentivePrograms/
Medicare Incentive Payments
6
Medicare Incentive Payments – October 2012 Meaningful Use
For final CMS reports, please visit: http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp
http://www.cms.gov/EHRIncentivePrograms/
Medicare Incentive Payments
7
Medicare Incentive Payments – October 2012 Meaningful Use
http://www.cms.gov/EHRIncentivePrograms/
Medicare Incentive Payments
8
Medicaid Incentive Payments – October 2012 (Both MU and AIU)
For final CMS reports, please visit: http://www.cms.gov/EHRIncentivePrograms/56_DataAndReports.asp
http://www.cms.gov/EHRIncentivePrograms/
Medicare Incentive Payments
9
Medicaid Incentive Payments – October 2012
http://www.cms.gov/EHRIncentivePrograms/
EHR Incentive Programs
10
EHR Incentive Programs – October 2012 Totals
http://www.cms.gov/EHRIncentivePrograms/
EHR Incentive Programs
11
EHR Incentive Programs – October 2012 Totals
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
12
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)
13
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)
14
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)
15
http://www.cms.gov/EHRIncentivePrograms/
Medicare & Medicaid Payments
16
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
http://www.cms.gov/EHRIncentivePrograms/
Medicare & Medicaid Payments
17
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
http://www.cms.gov/EHRIncentivePrograms/
EHR Incentive Programs Attestation Data
18
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
19
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
20
http://www.cms.gov/EHRIncentivePrograms/
EP Quality, Safety, Efficiency, and Reduce Health Disparities
21
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
http://www.cms.gov/EHRIncentivePrograms/
EP Quality, Safety, Efficiency, and Reduce Health Disparities
22
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%
http://www.cms.gov/EHRIncentivePrograms/
EP Engage Patients and Their Families
23
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%
http://www.cms.gov/EHRIncentivePrograms/
EP Improve Care Coordination
24
Objective Performance Exclusion Deferral
Medication reconciliation 90% 3% 54%Summary of care at transitions 90% 3% 84%
http://www.cms.gov/EHRIncentivePrograms/
EP Improve Population and Public Health
25
Objective Performance* Exclusion Deferral
Immunizations 35% 45% 20%Syndromic Surveillance 6% 25% 69%
*Performance is percentage of attesting providers who conducted test
http://www.cms.gov/EHRIncentivePrograms/
EH Quality, Safety, Efficiency, and Reduce Health Disparities
26
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
http://www.cms.gov/EHRIncentivePrograms/
EH Quality, Safety, Efficiency, and Reduce Health Disparities
27
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%
http://www.cms.gov/EHRIncentivePrograms/
EH Engage Patients and Their Families
28
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%
http://www.cms.gov/EHRIncentivePrograms/
EH Improve Care Coordination
29
Objective Performance Deferral
Medication reconciliation 85% 70%Summary of care at transitions 82% 91%
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%
30
*Performance is percentage of attesting providers who conducted test
http://www.cms.gov/EHRIncentivePrograms/
REC Reported Challenges
31
Full report: http://dashboard.healthit.gov/data/
http://www.cms.gov/EHRIncentivePrograms/
Overall Top Ten MU Measures
32
http://www.cms.gov/EHRIncentivePrograms/
Practice Issue Challenges
33
http://www.cms.gov/EHRIncentivePrograms/
Vendor Issue Challenges
34
http://www.cms.gov/EHRIncentivePrograms/
Top Five Challenges by Practice Type
35
http://www.cms.gov/EHRIncentivePrograms/
Top Five MU Measures
36
http://www.cms.gov/EHRIncentivePrograms/
For questions, please contact:
Robert AnthonyOffice of E-Health Standards and ServicesCenters for Medicare & Medicaid [email protected]
37