meaningful use update 2014 mark huang, m.d. chief medical information officer rehabilitation...
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MEANINGFUL USE UPDATE 2014
Mark Huang, M.D.
Chief Medical Information Officer
Rehabilitation Institute of Chicago
Associate Professor
Department of PM & R
Feinberg School of Medicine
Northwestern University
DISCLOSURES
No personal disclosures
OBJECTIVES
Provide overview of Erx and Meaningful use programs
Analyze how these programs can impact your practice
Discussion: – steps in how to meet qualifications for the incentive
programs
CMS INCENTIVE PROGRAMS
E-RX INCENTIVE PROGRAM
Electronic Prescribing (eRx) Incentive Program– Section 132 of the Medicare Improvements for
Patients and Providers Act of 2008 (MIPPA) authorized a new and separate incentive program for EPs who are successful electronic prescribers as defined by MIPPA.
– Started 2009, runs to 2014– Penalties were based on eRx compliance in 2012– Exemption deadline was Jan 2013
WHAT IS MEANINGFUL USE?
The American Recovery and Reinvestment Act of 2009 (Recovery Act) includes the Health Information Technology for Economic and Clinical Health Act, (“HITECH Act”) which established programs under Medicare and Medicaid to provide incentive payments to EPs, hospitals, and critical access hospitals for the “meaningful use” of certified EHR technology.
MEANINGFUL USE PROGRAMS
CMS website
MEDICARE MEANINGFUL USE
The last year to begin participation and receive an incentive payment is 2014.
To receive the maximum incentive payment, eligible professionals must have started participation by 2012.
Must demonstrate meaningful use for each year of participation in the program.
Must demonstrate use for ALL patients seen not just medicare patients
MEDICARE MEANINGFUL USE
CMS website
MEDICARE MEANINGFUL USE
CMS website
Penalties start in 2015 (1% payment reduction increasing annually to 5%)
Those who attest in 2014 need have reporting period before Oct 1st to avoid 2015 penalty
WHO CAN PARTICIPATE
Eligible professionals– M.D., D.O.– Must have 10% or more of professional services
claims to CMS provided in an outpatient setting (i.e. less than 90% inpatient medicare related charges)
Practices cannot participate– Each provider must register individually
STAGE 1 OF MEANINGFUL USE
13 Core Objectives:– everyone who participates in the program must
meet.
9 Menu Objectives: – report on 5 out of the 9 available menu objectives
9 Clinical Quality Measures:
CORE MEASURES
– Computerized physician order entry– Drug-drug and drug-allergy interaction checks– E-Prescribing (eRx)– Implement clinical decision support rule– Provide patients with ability to view download and
transmit health information online– Provide clinical summaries for patients for each
office visit– Record demographics
CORE MEASURES 9-15
– Maintain an up-to-date problem list of current and active diagnoses
– Maintain active medication list– Maintain active medication allergy list– Record and chart changes in vital signs (height and
weight– Record smoking status for patients 13 years or
older– Protect electronic health information
MENU ITEMS
Public health objectives: must choose one of following– Submit electronic data to immunization registries
OR
– Submit electronic syndromic surveillance bed at the public health agencies
MENU ITEMS
CMS website
CLINICAL QUALITY MEASURES
There are no thresholds for these you simply have to report on these
Your should be able to produce reports on these automatically
QUALITY MEASURES
CMS website
QUALITY MEASURES
CMS website
QUALITY MEASURES
CMS website
QUALITY MEASURES
CMS website
ADDITIONAL STAGES
Stage 2– Mostly same measure but higher thresholds– New objectives to improve patient care through
better clinical decision support, care coordination and patient engagement (secure messaging)
– Increased software certification requirements
Stage 3– Increased emphasis on communication between
providers, visit summaries, lab and radiology as discrete data
REPORTING PERIODS
Year 1: usually a 90 day period for first year Year 2: typically full calendar year
– Exception when proceeding to next stage, then have 90 day reporting period
– Exception made for 2014 (90 day period allowed)
Typically have to complete registration for attestation for prior year reporting by end of February
IMPACT TO YOUR PRACTICE
Need to invest in certified EHR technology Establish workflows to accommodate meeting
the menu objectives– Increased documentation need to report on quality
measures– Increased need to collect demographic and other
history elements– Who will do this (RN’s, MA’s vs physicians)
Provide patient access to their records electronically
GETTING STARTED
Decide on if you wish to participate – Erx is already incorporated into meaningful use– Larger penalties with meaningful use
If participating, purchase and implement certified EHR technology
Perform workflow analysis Register for attestation Monitor for compliance Complete attestation
CONSIDERATIONS FOR AAPMR
Need to develop rehabilitation specific quality measures
Need to coordinate with other specialties how meaningful use can be modified specifically for specialists
Lobby for post acute care facilities to be eligible for incentives