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.
• Eligibility
• Certified EHR
• Meaningful Use Measures
• Clinical Quality Measures
Meaningful Use
Provider Eligibility
• Eligibility
• Certified EHR
• Meaningful Use Measures
• Clinical Quality Measures
Meaningful Use
Certified RPMS EHR Requirements
Name Space
Package or Application Version Patch Release Date
AG Patient Registration 7.1 9 12/3/10
APCL Export 3.0 27 11/10/10
APSP Pharmacy MOD-ePrescribing (eRx) 7.0 1010 4/29/11
BGP Clinical Reporting System (CRS) 11.0 3 6/22/11
BJMD C32 1.0 1 6/24/11
BJPC PCC Mgmt Reporting 2.0 6 6/2/11
BMC Referred Care Information System (RCIS) 4.0 7 5/12/11
BQI iCare 2.1 3/11/11
BRN Release of Information (ROI) 2.0 3 4/13/11
BYIM Immunization Exchange Message 2.0 01 2/24/11
BGO Electronic Health Record (EHR) 1.1 8 6/10/11
LR Lab 5.21027 or 372 or
33412/07/10
PXRM EHR Reminders 1.5 1007 4/13/10
BPHR Personal Health Record (PHR) 1.0 6/22/11
Central Ensemble 2009.1.6 921.0.10414 2011
GuardianEdge/ Symantec 8.0 3/31/11
IPSEC (Windows) 2010
VanDyke (AIX) 2010
WinHasher 1.6 2011Universal Client -Continuity of Care Record (CCR)*
1.0 4/27/11
• Eligibility
• Certified EHR
• Meaningful Use Measures
• Clinical Quality Measures
Meaningful Use
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)
Provide clinical summaries for office visits
ePrescribing
Provide electronic copy of discharge instructions upon
request
Use CPOE for medication ordersImplement drug-drug and drug-allergy checks
Record demographics
Record smoking status
Maintain up-to-date problem list, medication list, medication allergy list
Record and chart changes in vital signs
Implement one clinical decision support ruleReport clinical quality measures
Protect electronic health information (security risk analysis)
Provide patients an electronic copy of health info upon request
Capability to electronically exchange key clinical information (perform test)
Meaningful Use Measures
EP Menu Set Measures (10) EH Menu Set Measures (10)
Send reminders to patientsProvide patients with timely
electronic access to their health information
Record advance directives
Submit electronic data on reportable lab results to public
health agencies
Implement drug formulary checks
Incorporate clinical lab test results into certified EHR
Generate lists of patients by specific conditions
Provide summary of care records for patients referred to other providers/facilities
Use certified EHR to identify and provide patient-specific education resources
Perform medication reconciliation for patients referred to the EP/EH
Submit electronic data to immunization registriesSubmit electronic syndromic surveillance data to public health
agencies
• Eligibility
• Certified EHR
• Meaningful Use Measures
• Clinical Quality Measures
Meaningful Use
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.
1
Medicare Incentive Program
Requirements and Amounts for EPs who begin in 2011 or 2012Year Requirement Incentive
2Demonstrate MU for full calendar year
$12,000
3Demonstrate MU for full calendar year
$8,000
4Demonstrate MU for full calendar year
$4,000
5Demonstrate MU for full calendar year
$2,000
Demonstrate MU for 90-day period $18,000
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 $12,000
CY 2015 $2,000 $4,000 $8,000 $8,000 $0
CY 2016 $2,000 $4,000 $4,000 $0
Total $44,000 $44,000 $39,000 $24,000 $0
Medicaid Incentive Payments
Requirements and Amounts for EPsYear Requirement Incentive
2
1Adopt/Implement/Upgrade to certified EHR technology
$21,250
Demonstrate MU for 90-day period $8,500
3Demonstrate MU for full calendar year
$8,500
4Demonstrate MU for full calendar year
$8,500
5Demonstrate MU for full calendar year
$8,500
6Demonstrate MU for full calendar year
$8,500
EHR Incentive Program Registrationwww.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
Support providers and hospitals in
achieving MU
Reward providers and hospitals for
achieving MU
Regional Extension Center
EHR Incentive Program
EHR certification rule Meaningful use rule
Provider Responsibilities
Completing Milestone = REC Funding
Demonstrating MU =Incentive Payment
• Register with
CMS/State
• Achieve MU
• Attest/submit each
year
• Sign up with REC
• Go live with certified
EHR
• Achieve MU
Regional Extension Center
EHR Incentive Program
Regional Extension Center EHR Incentive Program
ONC CMS
NIHB AI/AN REC EPs/EHs
1. Provider signs up with NIHB AI/AN REC
2. Provider “goes live” with certified EHR
3. Provider achieves meaningful use
IHS
$$$ $$$$$
NIHB REC M1: Sign Up
http://nihb.org/rec/rec.php
NIHB REC M2: Go Live
NIHB REC M3: 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 Medicaid EPs/EHs)
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 FrenchUnited South and Eastern [email protected]@ihs.gov
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