Grec Program Overview
-
Upload
lloyd-sirmons -
Category
Documents
-
view
1.263 -
download
0
description
Transcript of Grec Program Overview
Dominic H. Mack MD, MBAProject Director, GREC
Deputy Director,National Center for Primary Care
Morehouse School of [email protected]
404-756-8960www.primarycareforall .org
Georgia Regional Extension Center(GREC)
HITECH Act
1. Re-Establish ONC for HIT to develop rules by 2010
2. Savings -quality, care coordination & error reduction
3. Strengthening Federal privacy and security law4. $20 billion Health information technology infrastructure 60-70 Regional Extension Centers 32 centers have been awarded Medicare and Medicaid incentives
Meaningful Use Definition & RulesThe Recovery Act specifies the following 3 components of
Meaningful Use:
1.Use of certified EHR in a meaningful manner (ex: e-prescribing)
2.Use of certified EHR technology for electronic exchange of health information to improve quality of health care
3.Use of certified EHR technology to submit clinical quality and other measures
14
Stage 1- Health Outcome Initiatives
Improving quality, safety, efficiency, and reducing health disparities
•Engage patients and families in their health care
•Improve care coordination•Improve population and public health •Ensure adequate privacy and security
protections for personal health information
GREC MissionGREC’s mission is to furnish assistance to help
Georgia’s providers select, successfully implement, and meaningfully use certified EHR technology to improve clinical outcomes and the quality of care provided to their patients.
Vision: GREC will work collaboratively with valued partners to assure the adoption of certified EHR technology to improve the quality of health for the community while eliminating the disparate gap of healthcare throughout Georgia.
GREC Goals and ServicesTo use a community oriented approach to provide outreach
and education to facilitate the adoption and meaningful use of EHR.
To work collaboratively with statewide partners across the 18 public health districts of GA to develop and implement programs to meet GREC objectives.
To select HIT products that meet provider’s needs and helps them to meet patient centered medical home standards.
To provide equitable group purchasing agreements for Georgia’s priority primary care providers.
To build up competent technical teams to obtain meaningful use of EHR throughout the state and grow Georgia’s HIT workforce.
To work collaboratively with State HIE (GA. DCH) to meet all meaningful use criteria.
To provide excellent quality service to our customers in order to build a national reputation as a reliable HIT resource for providers.
AmeriChoice Andrew Young School of Policy Studies
GA Academy of Family Physicians
GA Association for Primary Health Care
GA Hospital Association GA Institute of Technology
GA Chapter of the of Pediatrics GA Department of Community Health (DCH)
GA DCH Office of Health Information Technology and Transparency
GA State Medical Association GA State Office of Rural Health GA State Policy Institute
GMCF (QIO) Greenway Medical Technologies Hispanic Health Coalition of GA
Governor’s Office of Workforce Investment
Kibbe Group, Founding Director of the Center for HIT for the of Family Physicians
Morehouse School of MedicineOffice of Sponsored Research Administration
Kids Health First Pediatric , Independent Practice Association
Statewide Area Health Education Centers Network
The Center for Pan Asian Community Services, inc.
Medical College of GA N.W. GA Healthcare Partnership Technical College System of GA (TCSG)
University System of GA WellCare of GA Macon State College
The following organizations, serving over 9,000 PCPs, submitted letters of partnership
Key Statewide Statistics
Map of GeorgiaPCP: 15,563 Priority PCP: 8040Total Number Served:
1608 (Yr 1) 5225 (Yr 5)Georgia Population:
9,965,744Total patients served (projected) : 2.8
million
Georgia Healthcare CoverageMedicaid 12.2% 1,150,800
Medicare 10.1% 958,200
Employer 54.8% 5,185,900
Individual 3.4% 325,400
Other Public 1.7% 164,300
Uninsured 17.8% 1,682,400
Total 9,467,100
Kaiser Family State Health Facts 2007-2008
Organization Chart
Statewide Organization
Pyramid of Providers
Meaningful Use SummaryEPs25 Objectives and Measures8 Measures require ‘Yes’ or ‘No’ as structured data17 Measures require numerator and denominatorEligible Hospitals and CAHs23 Objectives and Measures10 Measures require ‘Yes’ or ‘No’ as structured
data13 Measures require numerator and denominatorReporting Period –90 days for first year; one year
subsequently
Examples of Meaningful Use EHR criteriaUse CPOEImplement drug-drug, drug-allergy, drug-formulary checksMaintain an up-to-date problem list of current and active
diagnoses based on ICD-9-CM or SNOMED CT®Check Insurance eligibility & submit claims electronicallyMaintain active medication allergy listRecord demographics Record and chart changes in vital signsRecord smoking status for 13 and oldProvide electronic syndromic surveillance data
Eligible ProvidersMedicare FFSEligible professionals (EPs)Eligible hospitals and critical access hospitals (CAHs)Medicare Advantage (MA)MA EPsMA-affiliated eligible hospitalMedicaidEPsEligible hospitals
7
Medicaid Eligible Providers Eligible Professionals (EPs)•Physicians (Peds have special eligibility & payment rules)•Nurse Practitioners (NPs)•Certified Nurse-Midwives (CNMs)•Dentists•Physician Assistants (FQHC or RHC that is directed by a PA)Eligible Hospitals•Acute Care Hospitals•Children’s Hospitals
Medicare Eligible ProvidersEligible Professionals (EPs) Doctor of Medicine or OsteopathyDoctor of Dental Surgery or Dental MedicineDoctor of Podiatric MedicineDoctor of OptometryChiropractor Eligible HospitalsAcute Care HospitalsCritical Access Hospitals (CAHs)
Hospital-based Eligible Providers
Hospital-based EPs do not qualify for Medicare EHR incentive payments
Most hospital-based EPs will not qualify for Medicaid EHR incentive payments (FQHCs will qualify)
Defined as an EP who furnishes 90% or more of their services in a hospital setting (inpatient, outpatient, or emergency room)
Eligible Providers in Medicare AdvantageMA Eligible Professionals (EPs) Must furnish, on average, at least 20 hours/week of
patient-care services and be employed by the qualifying MA organization -or-
Must be employed by, or be a partner of, an entity that through contract with the qualifying MA organization furnishes at least 80 percent of the entity’s Medicare patient care services to enrollees of the qualifying MA organization
Qualifying MA-Affiliated Eligible HospitalsWill be paid under the Medicare Fee-for-service EHR
incentive program
Minimum Medicaid pt volume threshold30%-Physicians, Dentist, CNMs, NPs, Pas20%-Pediatricians10%Acute care hospitals0%-Children’s hospitalsOr the Medicaid EP practices predominantly in
an FQHC or RHC—30% needy individual patient volume threshold
Medicare Providers-Meaningful UseMeet requirements in 2011 or 2012$15,000 - $18,000 payments yr 1, $44,000 total by
yr4Declining payments through year 5The later you meet requirements, the less you getNo incentives after 2016 or for first adopters after
2014Provider payments increase 10% in HPSAPayment reduction if not adopted by 2015Excludes hospital based “eligible professionals”Special rules for Medicare Advantage
Medicare
First Calendar Year in which the EP receives an Incentive Payment
Calendar Year
2011 2012 2013 2014 2015 & later
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 $0
2016 $2000 $4,000 $4,000 $0
Total $44,000 $44,000 $39,000 $24,000 $0
Medicaid Providers-Meaningful Use
The Medicaid EHR Incentive Program starts in 2011 and ends in 2021
The latest that a Medicaid provider can initiate the program is 2016
A Medicaid provider can initiate the program under the Adopt, Implement and Upgrade bar but in their 2ndand subsequent years, they must meet MU at the stage that is in place, per rule-making (Stage 3 by 2015).
Medicaid First Calendar Year in which the EP receives an Incentive Payment
Calendar Year
2011 2012 2013 2014 2015 2016
2011 $21,250
2012 $8,500 $21,250
2013 $8,500 $8,500 $21,500
2014 $8,500 $8,500 $8,500 $21,500
2015 $8,500 $8,500 $8,500 $8,500 $21,500
2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,000
2017 $8,500 $8,500 $8,500 $8,500 $8,500
2018 $8,500 $8,500 $8,500 $8,500
2019 $8,500 $8,500 $8,500
2020 $8,500 $8,500
2021 $8,500
Total $63,750
$63,750 $63,750 $63,750 $63,750 $63,750
Medicare Hospitals-Meaningful Use“Eligible hospitals” meet requirements in
2011$2,000,000 base + discharge related
paymentPayments reduced over 4 year periodNon-adopters received reduced payments in
2015Critical access hospital have more generous
formula
Medicaid Hospitals-Meaningful Use
Eligible hospitals, unlike EPs, may receive incentives from Medicare and Medicaid Subsection(d) hospitals, also acute care
Hospitals meeting Medicare MU requirements may be deemed for Medicaid , even if the State has an expanded (approved) definition of meaningful use
31
Workforce development
Insufficient Technical WorkforceNot much education capacity around HITEducation budget cut $1 billionGA Economy – 10% unemployment rateLow broadband access in rural areas
Challenges
Scaling capabilities of education system
HIT is a growing industry in GAHIT intellectual capital in AtlantaLarge lab space Enthusiasm of the state
Workforce development
Strengths
Workforce Development
Cost of Education and training is risingDecreasing funds for education programsEducation level in underserved communities
Threats
Workforce Development
Low technical capabilities leaves room for growth
Development of new partnerships• GA Board or Regents• Technical college System of GA (TCSG)• GAFP• GA Partnership for TeleHealth
New certification programs in education system
Growth of degreed programs
Opportunities
What is the importance of meaningful use to the primary provider?
Thank You