Meaningful Use for Eligible Professionals€¦ · Meaningful Use for Eligible Professionals Ohio...
Transcript of Meaningful Use for Eligible Professionals€¦ · Meaningful Use for Eligible Professionals Ohio...
Medicaid Provider Incentive Program
Presenters
Emma Esmont, Management Analyst
John Mack, Project Manager
Elbony McIntyre, Project Manager
July 18, 2012
Meaningful Use for
Eligible Professionals Ohio Association of Community Health Centers
Agenda Topics
RECAP
Eligibility
Patient Volume
AIU
Meaningful Use Overview
Meaningful Use in MPIP System
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RECAP
RECAP: MPIP Eligibility
Eligible Professionals: physicians, optometrists,
dentists, certified nurse midwives, nurse practitioners
and physician assistants (when practicing at an
FQHC/RHC so led by a PA) An eligible professional cannot be hospital-based
An eligible professional is hospital-based if 90% or more of
his/her Medicaid encounters are furnished in an inpatient
hospital (POS 21) or an emergency room (POS 23) setting in
the calendar year prior to the payment year
This exclusion does not apply to the eligible professional
qualifying as practicing predominantly through an FQHC or
RHC
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RECAP: Patient Volume
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Eligible Participants Medicaid Patient
Volume Requirements
OR
The eligible
professional
practices
predominantly
through an FQHC or
RHC
— 30% needy
individual patient
volume threshold
Physicians 30%
- Pediatricians 20%
Optometrist 30%
Dentists 30%
Certified Nurse Midwives 30%
Nurse Practitioners 30%
Physician Assistants (PAs) when
practicing at an FQHC/RHC that is
so led by a PA
30%
An eligible professional practices predominantly if over 50% of an eligible professional’s
total patient encounters over a period of six months in the most recent calendar year
occur through an FQHC/RHC.
Any continuous 90-day period in the preceding calendar year
Medicaid Patient Volume Medicaid Patient Encounters – (Medicaid Patient Encounters * County SCHIP Factor)
Total Patient Encounters
Needy Individual Patient Volume
Medicaid Patient Volume for eligible professionals practicing
predominantly through an FQHC/RHC
Needy Individual Patient Encounters
Total Patient Encounters
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RECAP: Patient Volume Calculation
Reminder! Patient Volume Selection
Pediatricians that do not have a Medicaid Patient Volume of
30%, but have a Medicaid Patient Volume of at least 20%, may
attest as a Pediatrician.
Eligible professionals practicing predominantly through an
FQHC/RHC that do not have a Medicaid Patient Volume of
30%, but have a Needy Individual Patient Volume of at least
30%, may attest as an eligible professional practicing
predominantly through an FQHC/RHC.
MPIP allows eligible professionals to enroll as part of a group
practice/clinic in order to meet Patient Volume thresholds
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Eligible professionals must attest to adopting, implementing, or
upgrading to certified EHR technology to be eligible for MPIP
Adopt: Acquiring, purchasing, or securing access to certified EHR
technology
Implement: Installing or commencing utilization of certified EHR
technology capable of meeting meaningful use requirements
Upgrade:
Expanding the available functionality of certified EHR technology
capable of meeting meaningful use requirements at the practice site,
including staffing, maintenance, and training, or
Upgrading from existing EHR technology to certified EHR technology
per the EHR certification criteria published by the ONC
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RECAP: Year 1 AIU Requirement
Meaningful Use
What is Meaningful Use?
To be eligible for incentives, eligible professionals must be
able to demonstrate that they are using certified EHR
technology for three fundamental purposes:
Meaningful use: e-prescribing, electronic patient health histories,
clinical decision support tools, and other meaningful uses
Connectivity: connecting to other providers through a health
information exchange to improve access to the full view of a
patient’s health history
Reporting: Submitting information on clinical quality measures
and other measures in accordance with federal standards
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What is Meaningful Use?
Meaningful use is using certified EHR technology to: Improve quality, safety, efficiency, and reduce health
disparities
Engage patients and families in their health care
Improve care coordination
Improve population and public health
Maintain privacy and security
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Meaningful Use: A Staged Approach
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https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/MU_Stage1_ReqOverview.pdf
What is Meaningful Use: A Staged Approach
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Stage 2 implementation changed to 2014
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Meaningful Use Criteria – Stage 1
Eligible professionals must complete:
15 core objectives
5 of 10 menu set objectives
1 of 5 must be a public health measure
6 clinical quality measures (CQMs)
3 core or alternate core, 3 of 38 from menu set
All measures have been pre-selected and defined by CMS in collaboration with ONC
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15+ 5+ 6= MU
EHR Reporting Periods
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Payment Year Medicaid Incentive
Program Only
1st payment year AIU
2nd payment year MU, 90 day reporting period
3rd payment year and subsequent
MU, 12 month reporting period
Note: To be considered a meaningful EHR user, at least 50 percent of an eligible professional’s patient encounters during
the EHR reporting period must occur at a practice/location or practices/locations equipped with certified EHR technology.
Switching Between the Medicare EHR incentive program and MPIP
An eligible professional who switches to MPIP from the Medicare EHR
incentive program is placed in the payment year that the eligible
professional would have been in had the eligible professional begun in,
and remained in, the Medicare EHR incentive payment program.
Applicability of Meaningful Use Objectives
Some meaningful use objectives are not
applicable to every eligible professional’s clinical
practice. In these cases, the eligible
professional would be excluded from meeting
that specific objective
e.g. a dentist who does not perform
immunizations, or a certified nurse mid-wife who
does not e-prescribe
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Meaningful Use Denominators
Two types of percentage based measures are included
in demonstrating meaningful use:
1. Denominator = all patients seen during the EHR reporting period.
The denominator is all patients whether or not their records are kept using the EHR technology.
2. Denominator = actions or subsets of patients seen during the EHR reporting period.
The denominator only includes patients, or actions taken on behalf of those patients, whose records are kept using the EHR technology.
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Important Definition
Unique Patient
If a patient is seen by an eligible professional
more than once during the EHR reporting period,
then for purposes of measurement that patient is
only counted once in the denominator for the
measure
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Meaningful Use
MPIP System
Meaningful Use in the MPIP System
Enrollment
Attestation- 4 Steps
(1) Registration Verification Status
(2) Patient Volume Status
(3) Meaningful Use Status
(4) MPIP Payment Status
Confirmation Number
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NPI # and Password
Make a note of this information
Save & Continue
Make sure to select after entering information (e.g. after completing each screen)
Entered data will be saved prior to completing entire attestation, which may be completed at a later date
Always select & then Logout before exiting MPIP
MPIP – Helpful Hints
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MPIP Log In
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Provider NPI and Password
Enter NPI and Password – then click Log In
Enter NPI and Password –
then click Log In
Welcome to MPIP
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Page has the same look as AIU
Click Enrollment to
begin
Page has the
same look as AIU
Click Enrollment to begin
Page similar to AIU
Enrollment Home
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The top record will begin the
MU attestation process
Click Enroll to start MU
attestation for calendar
year 2012
Note: ‘Paid’ status is from Payment Year 1
Step 1- Registration
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Basic questions, same
questions as AIU
Verify all Registration Information
To update your National Provider Information, go to
the CMS web site at the following link:
https://ehrincentives.cms.gov/hitech/login.action
Step 1- Registration
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Click “Yes” if enrolling as a group
Who the payment is assigned to
Same questions asked as in AIU
If using needy individual patient
volume, select “yes” and select
affiliated FQHC/RHC
Step 1- Registration: Group Practice
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Click “Yes” if enrolling as a group
Who the payment is assigned to
Click the Radio button “Yes”
if enrolling as a group
Step 1- Provider Registration: Group Selection
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This will show the groups
associated with this NPI or
an eligible professional can
create a group
Step 1- Registration: Payment Assignment
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The Payee ID selected for the previous
payment year will be displayed by default.
Click Select Medicaid ID if you want to
change/update the Payee.
Click the radio button to select a payee and then click
Select & Continue to save the payee ID and return to
the Enrollment Status page
Completion of Step 1
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The Payee ID selected for the previous
payment year will be displayed by default.
Click Select Medicaid ID if you want to
change/update the Payee. Click the radio button to selected a
payee and then Select & Continue to
save the payee ID and return to the
Enrollment Status page If all information is correct, select
Save & Continue to navigate to
Step 2 – Medicaid Patient
Volume Determination
Step 2- Medicaid Patient Volume
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Select Start Date for 3-month reporting
period – for Patient Volume determination
If using out-of-state encounters, select Yes.
Identify which States/Territories.
Select the county in which your are located to display
the applicable SCHIP Percentage.
Step 2- Patient Volume Continued
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Enter Medicaid encounters and Total Patient
encounters for 3-month period
Upload supporting documentation then click
Save & Continue to proceed to Step 3
Step 2- Needy Individual Patient Volume
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If using Needy Individual Patient Volume,
the SCHIP factor is not applied
Enter Needy Individual Patient encounters and
Total Patient encounters for 3-month period
Upload supporting documentation then click
Save & Continue to proceed to Step 3
Step 3- MU Status: Summary of Measures
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Enter encounters
associated with EHR
Select Start MU Info Attestation
Step 3- MU Status: EHR Technology
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90 day reporting period, in current CY
Adding EHR location
System will EHR Certification
ID from previous payment
year
If using the same certified EHR solution from previous
payment year, select Yes then Save & Continue
Step 3- MU Status: EHR Technology cont.
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90 day reporting period, in current CY
Adding EHR location
New CMS EHR Certification ID
If using a different EHR from the previous year:
- Enter new CMS EHR Certification ID
- Select No Radio Button
- Check type(s) of Documentation for upload
- Must be legally and/or financially binding
- Upload documents (required)
- Save & Continue after document upload
Step 3- MU Status: EHR Technology cont.
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90 day reporting period, in current CY
Adding EHR location
Selecting Save & Continue at Step 3 –
will initiate the ONC Web Service to
validate the CMS EHR Certification ID. If
unsuccessful, the user will be prompted to
enter a valid Certification ID.
Step 3 MU Status: Reporting Period
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This is the information needed if adding
an EHR location
Select Start and End Date for MU EHR reporting period • Must be at least 90 days for first MU Attestation
• Reporting period for subsequent MU attestations is 365 days
Click to add a location of an EHR
Step 3- MU Status: Adding EHR Location
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Step 3 MU Status: Patient Encounters
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This is the information needed if adding
an EHR location > 80% of Unique Patients is required for certain MU Objectives
Step 3- MU Status: Summary of Measures
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Enter encounters
associated with EHR
Select Start MU Info Attestation
Step 3- MU Status: Core Measures- Y/N
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Example of a YES/NO Measure
Select Yes if functionality was enabled
for the length of the MU EHR reporting
period, then select Save & Continue
Step 3- MU Status: Core Measures- N/D
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Example of a Numerator/Denominator Measure
Step 3- MU Status: Core Measures- Exclusion
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Exclusion – Example: Eligible professional sees no patients 13 or younger.
If exclusion applies – Eligible professional does not report numerator &
denominator for the measure.
Example of an Exclusion Measure
Step 3- MU Status: Core Measures Summary
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Click on the “Pencil” icon to edit any of the MU info entered
Step 3- MU Status: Menu Measures Summary
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• Eligible professional must report on at least 5 Menu Set measures
• At least 1 of the 5 must be a Public Health measure:
• Immunization registry
• Syndromic surveillance
• Lab results (EH only)
At least one
of these
Step 3- MU Status: Menu Measure- Public Health
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Immunizations
Exclusion applies if an eligible professional did not perform immunizations
during reporting period
Eligible professionals must perform at
least one test of electronic submission to
immunization registry
Indicate if the test was successful
Follow-up submission is required if test is successful
Step 3- MU Status: Menu Measure
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Select Radio buttons, then
enter numerator and
denominator. Once
entered, click Save &
Continue to Proceed.
Step 3- MU Status: CQM Summary
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Clinical Quality Measures (CQMs)
• Eligible professionals must report on 6 (3 from core/3 from a set of 38)
• CQM results must be generated from the certified EHR system
• Zero (0) is an acceptable CQM denominator value if that value was
generated by the certified EHR technology
Step 3- MU Status: CQM Measure
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Enter Numerator
and Denominator
Step 4- MPIP Payment Status
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Step 4- MPIP Payment: Overview
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Eligible professionals will see an
overview of what they are attesting to
before clicking “Confirm & Submit”.
Step 4- MPIP Payment: Attestation Summary
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Summary of what the eligible professional is attesting to
Step 4- MPIP Payment: Legal Notice
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Agree & Continue
Step 4- MPIP Payment: Submission
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One more chance to review Enrollment
Summary before submitting attestation
Medicaid MU Attestation Complete!
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This is the confirmation number
of the completed attestation
Additional Meaningful Use Resources
Public Health Reporting ODH websites: Immunizations
https://odhgateway.odh.ohio.gov/impact/
Electronic Laboratory Reporting
http://www.odh.ohio.gov/odhPrograms/dis/orbitdis/elr1.aspx
Syndromic Surveillance
http://www.odh.ohio.gov/odhPrograms/dis/orbitdis/smedu/
SMEDMainPage.aspx
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Additional Meaningful Use Resources
State Rule
Ohio Administrative Code 5101:3-57
CMS EHR Incentive Programs
https://www.cms.gov/EHRincentivePrograms/
CMS EHR Meaningful Use Overview
https://www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp#TopOfPage
MU Specification Sheets for Eligible Professionals (Core & Menu
Measures)
http://www.cms.gov/EHRIncentivePrograms/Downloads/EP-MU-TOC.pdf
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Contact Us!
MPIP Website
http://www.jfs.ohio.gov/ohp/HIT%20Program.stm
Send us an email! [email protected]
Or call us at 1-877-JFS-MPIP
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Questions