The Alabama Regional Extension Center

The Alabama Regional Extension Center

The Alabama Regional Extension Center is part of the Center for Strategic Health Innovation (CSHI) in the College of Medicine at the University of South Alabama.

Our mission is to furnish assistance; defined as education, outreach, and vendor neutral technical assistance; to help providers in Alabama to select, successfully implement, and meaningfully use certified EHR technology to improve the quality and value of healthcare in Alabama.

Mission Statement Mission Statement

Why is there a Stage 2 Modification for 2015?

•  Align with Stage 3 to achieve overall goals of programs.

•  Synchronize reporting period objectives and measures to reduce burden.

•  Continue to support advanced use of Health IT to improve outcomes for patients.

Stage of Meaningful Use

First Year Demonstrating Meaningful Use 2015 2016 2017 2018

2019 & Future Years

2011Modified Stage 2

Modified Stage 2

Modified Stage 2 or Stage 3

Stage 3 Stage 3

2012Modified Stage 2

Modified Stage 2

Modified Stage 2 or Stage 3

Stage 3 Stage 3

2013Modified Stage 2

Modified Stage 2

Modified Stage 2 or Stage 3

Stage 3 Stage 3

2014Modified Stage 2

Modified Stage 2

Modified Stage 2 or Stage 3

Stage 3 Stage 3

2015Modified Stage 2

Modified Stage 2

Modified Stage 2 or Stage 3

Stage 3 Stage 3

2016- NA - Modified Stage

2Modified Stage 2 or Stage 3

Stage 3 Stage 3

•  Stage 1 providers will have additional exclusions in 2015

•  Stage 1 providers will have additional exclusions in 2016 for most measures except measures like Health Information Exchange measure

REPORTING PERIODS

•  All EPs and EHs can report for any 90 days in 2015

•  First time EP and EH participants in 2016, any 90 day period

•  Returning participants in 2016 onwards, full year reporting

•  90 day reporting for providers starting Stage 3 in 2017

•  Stage 1 Year 1 Medicaid providers can always report for any continuous 90 days, regardless of the year

WHEN CAN WE ATTEST FOR 2015?

Despite the change to a 90-day EHR reporting period in 2015, providers will NOT be able to attest to meaningful use for an EHR reporting period in 2015 prior to January 4, 2016.

REMOVED FROM MU REPORTING

•  Record Demographics•  Record Vital Signs•  Record Smoking Status•  Clinical Summaries•  Structured Lab Results•  Patient List•  Patient Reminders•  Summary of Care•  Measure 1 – Any Method•  Measure 3 – Test

•  Electronic Notes•  Imaging Results•  Family Health History

STAGE 1 ALTERNATE EXCLUSIONS IN 2015

•  Maintaining the specifications for objectives and measures that have a lower threshold or other measure differences between Stage 1 and Stage 2;

•  Establishing exclusion for Stage 2 measures that do not have an equivalent Stage 1 measure associated with any Stage 1 objective,

•  or where the provider did not plan to attest to the menu objective that would now be otherwise required

MODIFIED STAGE 2 MEASURES

1.  Protect Electronic Health Information – Risk Analysis•  Conducted anytime during calendar year, but before attestation•  Encryption of ePHI in storage

2.  Clinical Decision Support – 5 rules + Drug/drug, drug/allergy interaction

•  Stage 1 option – 1 rule•  Stage 2 – rules must be related to 4 or more CQMs

3.  Computerized Provider Order Entry (CPOE) – 60% Medication, 30% Radiology and 30% Laboratory•  Stage 1 providers report 30% medication only•  Exclusions available

MODIFIED STAGE 2 MEASURES

4.  Electronic Prescribing (eRx) – 50% EP and 10% EH•  Stage 1 providers can report 40%•  Includes formulary checking•  Hospitals can exclude in 2015 or 2016

5.  Summary of Care – 10% electronic•  Stage 1 exclusion in 2015•  Modified definition – transmit the summary of care record

electronically

6.  Patient Education – 10%•  Stage 1 exclusion in 2015•  Anytime before attestation during the reporting period

year

MODIFIED STAGE 2 MEASURES

7.  Medication Reconciliation – over 50%•  Stage 1 exclusion in 2015

8.  Patient Electronic Access to Health Information – 50% have access, and 1 patient views

•  Stage 1 exclusion for 2nd measure in 2015•  1 patient views, downloads or transmits in 2015 and 2016•  5% access in 2017

9.  Secure Message•  Stage 1 exclusion in 2015•  Function enabled in 2015, 1patient in 2016 & 5% in 2017•  Provider initiated messages should be counted

MODIFIED STAGE 2 MEASURES

10.  Public Health Reporting - EP’s must meet 2, EH’s and CAH’s must meet 3

Measure Number & Name Measure Specification

Measure 1 – Immunization Registry Reporting

The EP, EH or CAH is in active engagement with a public health agency to submit immunization data.

Measure 2 – Syndromic Surveillance Reporting

The EP, EH or CAH is in active engagement with a public health agency to submit syndromic surveillance data.

Measure 3 – Specialized Registry Reporting

The EP, EH or CAH is in active engagement with a public health agency to submit data to a specialized registry.

Measure 4 – Electronic Reportable Laboratory Results Reporting

The EP, EH or CAH is in active engagement with a public health agency to submit Electronic Laboratory Results.

If you were in Stage 1 for 2015, there are alternate options & exclusions for Modified Stage 2.

Measure Alternative/ExclusionCDS Rules Attest to 1 rule + Drug and Allergy Warnings

CPOE Attest to 30% Medication, No Lab or X-ray

eRx Attest to > 40%

Summary of Care Exclude if you were not intending to attest to this.

Patient Education Exclude if you were not intending to attest to this

Medication Reconciliation Exclude if you were not intending to attest to this

View, Download and Transmit (Portal) Exclude from the second part of the measure

Secure Messaging Exclude - it was not required for Stage 1 providers

Registry Reporting May attest to only one measure

Will I be able to attest in 2015 with my 2014 Edition CEHRT?

•  YES! No changes have been made to the ONC CEHRT requirements for objectives and measures of meaningful use for EHR reporting periods in 2015 through 2017.

•  Providers continue to use technology certified to the 2014 Edition for EHR reporting period in 2015 and subsequent years until they transition to health information technology certified to the 2015 Edition that is required for EHR reporting period in 2018.

Note: Providers may upgrade early to technology certified to the 2015 Edition for EHR reporting period prior to 2018 as outlined in final rule.

PAYMENT ADJUSTMENTS !

If a provider incurs a payment adjustment in 2016 for not meeting meaningful use in 2014, the provider’s Medicare claims will be adjusted by 2% for claims rendered between 1/1/2016 and 12/31/2016. 

If the same provider successfully attests to meaningful use in 2015, they will avoid the 3% payment adjustment to their 2017 Medicare claims.

Note: Per Vidya  P.  Sellappan,  CMS,  Center  for  Clinical  Standards  and  Quality  (CCSQ)

•  Contact  ALREC  regardless  of  your  stage  of  Meaningful  use  

•  ALREC  will  work  with  you  to  determine  needs  for  upgrading  to  and/or  adhering  to  a  2014  EHR  CerBficaBon  Standards  

•  ALREC  will  support  you  in  achieving  and  aFesBng  to  MU  objecBves  

How to Get Customized Local Assistance !!

CMS Final Rulehttps://www.federalregister.gov/articles/2015/10/16/2015-25595/

medicare-and-medicaid-programs-electronic-health-record-incentive-program-stage-3-and-modifications

 2015 EP Tip Sheet

https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stage3_EP.pdf

2014 Clinical Quality Measure Tip Sheethttp://go.cms.gov/OpyQdZ

ONLINE TOOLS FOR MORE INFORMATION���

Contact Information

ALREC775 North University BLVD

TRP II, Suite 250Mobile, AL 36608

www.al-rec.org

Main: (251) 414-8170Fax: (251) 414-8171

The Alabama Regional Extension Center is proud to be part of the Center for Strategic Health Innovation (CSHI) in the College of Medicine at the University of South Alabama.