meaningful use: introduction to meaningful use eligible...
TRANSCRIPT
Meaningful Use:
Introduction to Meaningful Use
Eligible Providers
Introduction to Meaningful Use:
Webinar Overview
Define Meaningful Use
Review Meaningful Use Key Dates & Program Incentives
Discuss the 4 Components Necessary to Achieve
Meaningful Use
Introduce Meaningful Use Core Requirements, Menu
Measures, & Clinical Quality Measures
Provider/Admin Q&A
• American Recovery and Reinvestment Act of 2009/Health Information
Technology for Economic and Clinical Health Information (ARRA/HITECH)
Act, established programs under Medicare and Medicaid to provide
incentive payments to eligible professionals that demonstrate
“meaningful use” of certified electronic health record (EHR) technology.
• HITECH Act allocates 19 billion for the adoption, upgrade, and or
implementation of EHR technology. These incentive programs (Medicare
and Medicaid) are designed to support eligible professionals during health
IT transition.
Simply, "meaningful use" means providers must demonstrate that they're using
certified EHR technology in ways that can be measured in quality and in quantity.
What is Meaningful Use?
Meaningful Use-Objectives
Meaningful Use is Using Certified EHR Technology to:
Improve Quality, Safety, Efficiency and Reduce Health Disparities:
Use of EHR
Computerized order entry
Electronic Prescribing/refill automation
Record Problem list, medications, allergies, etc
Engage patients and families:
Patient portals and electronic copies of
After Visit Summaries
Educational material
Improve Care Coordination
Medication Reconciliation
Exchange of Data with external Providers
Improve Population and Public Health
Electronic Reporting to Registries
Maintain Patient Privacy and Security
• Graduated Approach: Implemented in 3 Stages
Stages of Meaningful Use:
Medicare & Medicaid
FOCUS OF:
Stage 1
(2011)
Data capture and sharing
Stage 2
(2013)
Advanced clinical processes
Stage 3 (2015)Improved outcomes
Meaningful Use:
Medicare Incentive Payment Structure• Eligible providers can earn up to $44,000 if the provider receives at least $24,000 in
Medicare payments and successfully meets all meaningful use requirements by
Oct 1, 2012. The last year to begin participation in the Medicare EHR incentive
program is 2014 to avoid penalties is 2015.
0 First Payment Year
Funding Year 2011 2012 2013 2014 2015 +
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
2016 $ 2,000 $ 4,000 $ 4,000
Total $ 44,000 $ 44,000 $ 39,000 $ 24,000
Incentive
Totals
Decrease in
2013
Medicare payment reductions begin for providers who do not demonstrate meaningfuluse
Meaningful Use:
Medicaid Incentive Payment Structure
Adoption Year Adoption Year
Funding Year 2011 2012 2013 - 2016
2011 $ 21,250
No payment adjustments/
no penalties
2012 $ 8,500 $ 21,250
2013 $ 8,500 $ 8,500
2014 $ 8,500 $ 8,500
2015 $ 8,500 $ 8,500
2016 $ 8,500 $ 8,500
2017 $ 8,500
Total $ 63,750 $ 63,750 $ 63,750
Eligible providers can earn up to $63,750 if the provider attests and
successfully meets all meaningful use requirements. The last year to begin
participation in the Medicaid EHR incentive program is 2016. Incentive
payments do not decrease with time and there are no imposed penalties.
Medicare EHR Incentive Program
Managed by CMS
Eligible Providers can receive a maximum incentive amount of $44,000 (over 5
consecutive years (2011-2016) of program participation)
Payment reductions begin in 2015 for providers who are eligible but choose not to
participate
In the first year and all remaining years providers have MU objectives and associated
measures they must meet to get incentive payments
Medicare EHR Incentive Program
Medicaid EHR Incentive Program
Medicaid EHR Incentive Program
Each State Manages Its Own Program
Eligible Providers can receive a maximum incentive amount is $63,750 (over 6 years
(2011-2021) of program participation)
No Medicaid payment reductions if providers choose not to participate
In the first year, providers can receive an incentive payment for adopting,
implementing or upgrading a certified EHR
In all remaining years, providers must meet the same MU objectives and associated
measures as Medicare
How Do I
Successfully
Achieve
Meaningful Use?
4 Components to Successfully
Achieve Meaningful Use
MEANINGFUL
USE OF EHR Compliance with
the MU Measures
and Clinical
Quality Reporting
Report or Attest to
20 MU measures
(15 core, 5 menu)
CERTIFIED
EHR
Ensure EHR is
certified by ONC
Approved Testing
Body
Epic is certified for
MU
ELIGIBILITY/
REGISTRATION
Determine eligibility
to receive Medicare
or Medicaid
incentive
Register for incentive
program
REPORTING/
ATTESTATION
For Medicare Year 1
report after
demonstrating 90
consecutive days of
meaningful use. For
duration of program
report after full year
of demonstrating
MU
Doctor of Medicine
Doctors of Osteopathy
Doctors of Dental Medicine
or Surgery
Meaningful Use: Eligible Providers
Doctor of Optometry
Doctors of Podiatric
Medicine
Chiropractor
Nurse Practitioners
Certified Nurse-Midwives
Physician Assistants (PAs)
when working at an FQHC or RHC
that is so led by a PA
Medicare-only
Eligible Providers
Medicaid-only
Eligible Providers
Could be eligible for either
Medicare or Medicaid
(but not both in single year)
Additional Meaningful Use
Eligibility RequirementsMedicare Eligibility(must meet all of the following to qualify)
If you are a physician that participates with Medicare and see patients in an office and
outpatient setting
Physicians who see Medicare patients must have Part B allowed charges
Each eligible professional is only eligible for one incentive payment per year regardless of
how many practices or locations at which he or she provide services.
Hospital based professionals are not eligible for incentive payments An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital
inpatient or emergency room setting. (POS 21 or POS 23)
Additional Meaningful Use
Eligibility Requirements
Medicaid Eligibility (must meet one of the following to qualify)
If you are a physician that participates with Medicaid and see patients in an office and
outpatient setting
Physicians who have a minimum of 30% Medicaid patient volume
(Medicaid or Medicaid Managed Care)
Physicians must have a minimum of 20% Medicaid patient volume and is a pediatrician
Hospital based professionals are not eligible for incentive payments An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a
hospital inpatient or emergency room setting. (POS 21 or POS 23)
Practice predominately in a Federally Qualified Health Center or Rural Health Center and have a
minimum of 30% patient volume attributable to need individuals
Meaningful Use: Registration Overview• Registration is required to participate in the EHR incentive program
• As an eligible provider you are only required to register once for the duration of the
incentive program.
• CMS offers third party registration. Required for third party registration
Identity & Access Management Account (I&A)
Association with the eligible providers NPI
• Eligible providers can register without having implementing certified EHR.
• Eligible Professionals cannot register for a Medicaid EHR Incentive Program until
their state's program has launched and the state's site has opened.
• Providers eligible for both the Medicare and Medicaid EHR Incentive Programs must
choose which incentive program they wish to participate in when they register.
Before 2015, an eligible provider may switch programs only once after the first
incentive payment is initiated..
Requirements for Registration
National Provider Identifier (NPI)
Provider Enrollment, Chain and Ownership System
(PECOS)
National Provider and Provider Enumeration
System (NPPES) User ID and Password
Payee Tax Identification Number (TIN) (benefits
reassignment only)
Payee National Provider Identifier (NPI) (benefits
reassignment only)
CERTIFIED
EHR
Certified EHR Technology
• The Medicare and Medicaid EHR Incentive Programs require the use of
certified EHR technology. Standards and certification criteria for EHR
technology have been adopted by the Secretary of the Department of
Health and Human Services.
EHR technology must be tested and certified by an Office of the
National Coordinator (ONC) Authorized Testing and Certification Body
(ATCB) in order for a provider to qualify for EHR incentive payments.
You do not need to have certified EHR technology in place to register
for the EHR incentive programs. However before you can receive an
EHR incentive payment you must successfully demonstrate meaningful
use of a certified EHR
For a list of certified EHRs go to the ONC website
http://onc-chpl.force.com/ehrcert
MEANINGFUL
USE OF EHR
Meaningful Use of EHR
Stage 1 Meaningful Use Criteria:
Criteria for stage 1 meaningful use is focused on electronically capturing health
information in a coded format so information can be used for reporting and
tracking purposes.
• To demonstrate meaningful use a provider must attest to successfully
meeting required functional measures
• Functional Measures:
15 Core Objectives
5 Menu Measures from a menu list of 10
6 total Clinical Quality Measures (3 core or
alternate core and 3 out of 38 from an additional set)
Stage 1: Requirements OverviewThe table below outlines the “core set” of meaningful use objectives.
All core set measures are required and must be reported.
Core Set Measures Attestation Type
1. Use CPOE (Exclusion Available) Numerator/Denominator
2. Implement drug-drug and drug-allergy interaction checks (No Exclusion) Yes/No
3. Generate and transmit prescriptions electronically (Exclusion Available)Numerator/Denominator
4. Record Patient Demographics (No Exclusion)Numerator/Denominator
5. Maintain up-to-date problem list (No Exclusion) Numerator/Denominator
6. Maintain active medication list (No Exclusion) Numerator/Denominator
7. Maintain active medication allergy list (No Exclusion) Numerator/Denominator
8. Report vital signs and chart changes (Exclusion Available) Numerator/Denominator
9. Record smoking status for patients 13 years or older (Exclusion Available) Numerator/Denominator
10. Implement one clinical decision support rule (No Exclusion) Yes/No
11. Report clinical quality measures to CMS or States (No Exclusion) Numerator/Denominator
12. Electronically exchange key clinical information among providers and authorized
entities (No Exclusion)Yes/No
13. Provide patients with electronic copy of their health information (No Exclusion) Numerator/Denominator
14. Provide patients with visit clinical summaries (Exclusion Available) Numerator/Denominator
15. Protect electronic health information created or maintained by certified EHR Yes/No
Stage 1: Requirements OverviewThe table below outlines the “menu set” of meaningful use objectives.
EPs must select 5 of the10 options to report. One menu measure must be a public health.
Menu Set Measures Attestation Type
1. Implement drug-formulary checksYes/No
2. Incorporate clinical laboratory test results into EHRsNumerator/Denominator
3. Generate lists of patients by specific conditions for quality improvement purposesYes/No
4. Use EHR to identify patient-specific education resourcesNumerator/Denominator
5. Perform medication reconciliation between care settingsNumerator/Denominator
6. Provide summary of care record for patients referred/transitioned to another providerNumerator/Denominator
7. Submit electronic immunization data to registries or information systemsYes/No
8. Submit electronic syndromic surveillance data to public health agenciesYes/No
9. Send reminders to patients for preventive and follow-up care (EP)Numerator/Denominator
10. Provide patients with timely electronic access to their health information (EP)Numerator/Denominator
Stage 1: Requirements Overview• An Eligible Provider Must Report on 6 total Clinical Quality
Measures (CQMs)
An EP must report on these three core
set measures, unless they are not
appropriate to their patient population.
NQF 0013: Hypertension: Blood
Pressure Management
NQF 0028: Preventative Care and
Screening Measure Pair: a. Tobacco
Use Assessment b. Tobacco Cessation
Intervention; and
NQF 0421/PQRI 128: Adult Weight
Screening and Follow-up
“Core set”
If an EP can not report on core set
measures, they must report on three
alternate core measures:
NQF 0041/PQRI 110: Preventative Care
and Screening: Influenza Immunization
for Patients ≥50 Years Old
NQF 0024: Weight Assessment and
Counseling for Children and Adolescents
NQF 0038: Childhood Immunization
Status
“Alternate core set”
Plus an EP must select three additional
measures from a set of 38 quality
measures that was included in the original
proposed rule.
“Additional set”
3 Core Set or Alternate Core Set + 3 Additional Set = 6 CQMs
Reporting and Attestation
• Eligible providers must report on identified functional measures:
15 Core Objectives
5 Menu Measures from a menu list of 10
6 total Clinical Quality Measures (3 core or alternate core and 3 from an
additional set)
• Reporting and attestation is done at the INDIVIDUAL eligible
professional level
• For the Medicare Program, Reporting period is after 90 consecutive
days of Meaningful Use for the first adoption year and yearly every
subsequent year of participation in the incentive program
• For Medicaid Program, providers do not need to attest to
demonstrate Meaningful Use in the first year of program participation
but during the second year have to report their 90 day data.
REPORTING &
ATTESTATION
Introduction to Meaningful Use:
Webinar Recap
Define Meaningful Use
Review Meaningful Use Key Dates & Program Incentives
Discuss the 4 Components Necessary to Achieve
Meaningful Use
Introduced Meaningful Use Core Requirements, Menu
Measures, & Clinical Quality Measures
Upcoming Webinars:
• MU Webinar : Meaningful Use Registration and
Attestation
November 3rd and 15th
• MU Webinar : Guide to Clinical Quality Measures
November 10th and 17th
Dec 1st
• MU Webinar : Workflow Changes for MU Measures
TBA
• MU Webinar: Epic Reporting and Attestation
TBA
QUESTIONS ?