Meaningful Use and the EHR Incentive Program NIHB

Meaningful Use and the EHR Incentive Program NIHB Annual Consumer Conference

EHR Incentive Program • The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to eligible professionals (EPs), eligible hospitals (EHs) and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.

Meaningful Use • Eligibility • Certified EHR • Meaningful Use Measures • Clinical Quality Measures

Provider Eligibility

Meaningful Use • Eligibility • Certified EHR • Meaningful Use Measures • Clinical Quality Measures

Certified RPMS EHR Requirements Name Space AG APCL APSP BGP BJMD BJPC BMC BQI BRN BYIM BGO LR PXRM BPHR Package or Application Patient Registration Export Pharmacy MOD-e. Prescribing (e. Rx) Clinical Reporting System (CRS) C 32 PCC Mgmt Reporting Referred Care Information System (RCIS) i. Care Release of Information (ROI) Immunization Exchange Message Electronic Health Record (EHR) Lab EHR Reminders Personal Health Record (PHR) Central Ensemble Guardian. Edge/ Symantec IPSEC (Windows) Van. Dyke (AIX) Win. Hasher Universal Client -Continuity of Care Record (CCR)* Version Patch Release Date 7. 1 9 12/3/10 3. 0 7. 0 11. 0 2. 0 4. 0 2. 1 2. 0 1. 1 5. 2 1. 5 1. 0 2009. 1. 6 8. 0 27 1010 3 1 6 7 1. 6 11/10/10 4/29/11 6/22/11 6/24/11 6/2/11 5/12/11 3/11/11 4/13/11 2/24/11 6/10/11 12/07/10 4/13/10 6/22/11 2011 3/31/11 2010 2011 1. 0 4/27/11 3 01 8 1027 or 372 or 334 1007 921. 0. 10414

Meaningful Use • Eligibility • Certified EHR • Meaningful Use Measures • Clinical Quality Measures

Meaningful Use Measures • Yes/No Measures – Implement drug-drug and drug-allergy checks – Generate at least one report listing patients with a specific condition • Measures with Targets – Record smoking status for more than 50% of patients – Provide patient-specific education resources for more than 10% of patients

Meaningful Use Measures EP Core Set Measures (15) EH Core Set Measures (14) Use CPOE for medication orders Implement drug-drug and drug-allergy checks Record demographics e. Prescribing Maintain up-to-date problem list, medication allergy list Record and chart changes in vital signs Record smoking status Implement one clinical decision support rule Report clinical quality measures Provide patients an electronic copy of health info upon request Provide clinical summaries for office visits Provide electronic copy of discharge instructions upon request Capability to electronically exchange key clinical information (perform test) Protect electronic health information (security risk analysis)

Meaningful Use Measures EP Menu Set Measures (10) EH Menu Set Measures (10) Implement drug formulary checks Incorporate clinical lab test results into certified EHR Generate lists of patients by specific conditions Record advance directives Send reminders to patients Provide patients with timely electronic access to their health information Use certified EHR to identify and provide patient-specific education resources Perform medication reconciliation for patients referred to the EP/EH Provide summary of care records for patients referred to other providers/facilities Submit electronic data to immunization registries Submit electronic syndromic surveillance data to public health agencies Submit electronic data on reportable lab results to public health agencies

Meaningful Use • Eligibility • Certified EHR • Meaningful Use Measures • Clinical Quality Measures

Clinical Quality Measures: EPs • Core/Alternate Core Set (6) – Hypertension – Tobacco Use Assessment/Cessation Intervention – Adult Weight Screening/Follow-up – Weight Assessment/Counseling for Children – Adult Influenza Immunization – Childhood Immunization • Additional Measures (38) – Breast Cancer Screening; Cervical Cancer Screening; Colorectal Cancer Screening

Clinical Quality Measures: EHs • Emergency Department (2) – Median time from ED arrival to ED departure for admitted patients; median time from admit decision time to ED departure time for admitted patients • Stroke (7) – Anticoagulation for A-fib/flutter, discharge on statins, stroke education, etc. • Venous Thromboembolism (6) – Anticoagulation overlap therapy, discharge instructions, etc.

Medicare Incentive Program Requirements and Amounts for EPs who begin in 2011 or 2012 Year Requirement Incentive 1 Demonstrate MU for 90 -day period $18, 000 2 Demonstrate MU for full calendar year $12, 000 3 Demonstrate MU for full calendar year $8, 000 4 Demonstrate MU for full calendar year $4, 000 5 Demonstrate MU for full calendar year $2, 000

Medicare Incentive Payments Payment Year First Year EP Demonstrates MU 2011 2012 2013 2014 2015 CY 2011 $18, 000 CY 2012 $12, 000 $18, 000 CY 2013 $8, 000 $12, 000 $15, 000 CY 2014 $4, 000 $8, 000 $12, 000 CY 2015 $2, 000 $4, 000 $8, 000 $0 $2, 000 $4, 000 $0 $44, 000 $39, 000 $24, 000 $0 CY 2016 Total $44, 000

Medicaid Incentive Payments Requirements and Amounts for EPs Year Requirement Incentive 1 Adopt/Implement/Upgrade to certified EHR technology $21, 250 2 Demonstrate MU for 90 -day period $8, 500 3 Demonstrate MU for full calendar year $8, 500 4 Demonstrate MU for full calendar year $8, 500 5 Demonstrate MU for full calendar year $8, 500 6 Demonstrate MU for full calendar year $8, 500

EHR Incentive Program Registration www. cms. gov/ehrincentiveprograms/

EHR Incentive Program Registration

EHR Incentive Program Registration • Medicare EPs: – Register with CMS • Medicaid EPs: – Register with CMS – Register with state Medicaid program • Hospitals: – Register as dual-eligible • With CMS for Medicare • With state Medicaid program for Medicaid Certified EHR is not required for registration!

Regional Extension Center The RECs will support and serve health care providers to help them quickly become adept and meaningful users of EHRs. RECs are designed to make sure that primary care clinicians get the help they need to use EHRs. • Provide training and support services to assist providers in adopting EHRs • Offer information and guidance to help with EHR implementation • Provide technical assistance

REC vs Incentive Program Regional Extension Center EHR Incentive Program EHR certification rule Meaningful use rule Support providers and hospitals in achieving MU Reward providers and hospitals for achieving MU

Provider Responsibilities Regional Extension Center EHR Incentive Program • Sign up with REC • Register with CMS/State • Go live with certified EHR • Achieve MU • Attest/submit each year Completing Milestone = REC Funding Demonstrating MU = Incentive Payment

Regional Extension Center EHR Incentive Program ONC $ NIHB AI/AN REC 1. 2. 3. CMS $ IHS EPs/EHs Provider signs up with NIHB AI/AN REC Provider “goes live” with certified EHR Provider achieves meaningful use

NIHB REC M 1: Sign Up http: //nihb. org/rec. php

NIHB REC M 2: Go Live

NIHB REC M 3: Achieve MU • Medicare EPs – Provide CMS Attestation ID • Medicaid EPs and others – Provide attestation data from RPMS-EHR reports

Things to Do Now • Sign up with the NIHB REC • Designate a Meaningful Use Coordinator • Install RPMS EHR patches and other required software applications for certification • Review MU Measures and redesign workflows • Register for EHR Incentive Program (pending launch of State program for

2011 Timeline • Hospitals – Medicare: Last 90 -day period within FY 2011 to demonstrate MU is July 1 – Sept 30, 2011 – Medicaid: Check with state about deadlines • Providers – Medicare: Last 90 -day period within CY 2011 to demonstrate MU is Oct 1 – Dec 31, 2011 – Medicaid: Check with state about deadlines

Resources • www. usetinc. net/ehr – Resources – Frequently Asked Questions • www. cms. gov/ehrincentiveprograms/ – EHR Incentive Program Eligibility, Registration – Status of State Medicaid Programs – Frequently Asked Questions • www. ihs. gov/meaningfuluse/ – Resources – MU Listserv – RPMS-EHR Certification Info

Contact Vicki French United South and Eastern Tribes 615 -467 -1578 vfrench@usetinc. org Vicki. French@ihs. gov