physicians’ use, exchange, and evaluation of electronic medical … · 2019. 1. 23. ·...

Physicians’ Use, Exchange, and Evaluation of Electronic Medical Records Lorie MayerAHCCCS HIT CoordinatorCHiR Annual Stakeholder Leadership MeetingJanuary 23, 2019

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HITECH Act • The Health Information Technology for

Economic and Clinical Health (HITECH) Act, enacted as part of the American Recoveryand Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology

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Steps for MU Implementation for Health Information Technology (HIT)

Stage 1Data Capture and Information Sharing2011-2013

Stage 2Advanced Clinical Practices (Clinical Decision Making Support)2014-2016

Stage 3 Using CEHRT to Improve Outcomes2017-2021

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MU Criteria are Implemented in Three Stages

CHiR Physician Survey

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Collaboration Producing Results • Ongoing partnership between Arizona physician licensure

Boards and applications and ASU/CHIRo Been in place since 1992o Arizona Medical Board and the Arizona Board of

Osteopathic Examiners • AHCCCS joined the survey project in 2007• Publications including: CHIR Health Care Workforce

Reports and Articles and • Physician’s Use Exchange and Evaluation of Electronic

Medical Records 2016- 2018 https://chs.asu.edu/sites/default/files/physicians_use_exchange_evaluation_of_emrs_2016-2018-annual_report-rev20181221-upl20190103.pdf

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AZ Provider EHR Adoption Data • The percentage of Arizona physicians using EMRs increased from

45% in 2007-2009 to 91% in 2016-2018.• Solo practice physicians are less likely to adopt EMRs than are

physicians in other practice settings, but the prevalence of solo practice is declining.*

• The growth in EHR adoption has been partially credited to CMS EHR Incentive Program (Medicare and Medicaid)

• More than 90% of Arizona physicians treat AHCCCS enrollees. • AHCCCS physicians are also more likely to use EMRs than non-

AHCCCS physicians.

*ASU Center for Health Information and Research (CHIR) 6

• Medicaid EP Payments: $108,265,936

• Medicare EP ,Payments: $159,111,555

• Total AZ EP Payments: • $267,377,491

• Dually Eligible EH Payments: $406,720,215

• Medicare EH Payments: $3,059,472

• Medicaid Only EH Payments: $11,910,387

• Total AZ EH Payments: $421,690,074

AZ PI Incentive Payment TotalsSeptember, 2018

Total AZ PI Program Payments:$689,067,565

Data Source: CMS January 2011 to September, 2018

Total All States and Territories:$37,920,483,579

Survey has allowed AHCCCS to:• Track provider EHR Adoption Rates

o Develop comparisons between Medicaid providers and non-Medicaid providers

• Create and build HIE strategies off of the adoption rates

• Monitor for gaps and challenges by county• Satisfaction with existing EHRs vendors to

anticipate major delays in taking on HIE8

Transition to Health Information Exchange

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The CMS Road to Interoperability

10Reaching across Arizona to provide comprehensive quality health care for those in need Data Source CMS Regional 2018

Health Information Exchange with Health Current

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Since 2006: Strategy for Building Out Health Information Exchange (HIE)

10+ Years: Providers want access to real time clinical data elements to improve care delivery • Hospital information • Laboratory Results and• Medication History and Use and now• Value Based Care Payment Arrangements

A single non-governmental organizational entity was needed to ensure better policy coordination, a single set of operating rules, and

an ability to have LOWER COSTS For ALL Participants

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Health Current Monthly Growth (as of January 11, 2019)

HIE Participants (as of January 11, 2019)List of Health Current Participants: 567• ACOs & Clinically Integrated networks (15)• Behavioral Health Providers (79)• Community Providers (269)• FQHCs & Rural Health Clinics (21)• Health Plans (17)• Hospitals & Health Systems (53)• Labs, Imaging Centers & Pharmacies (5)• Long-Term & Post Acute Care (84)• State & Local Government (7)• Emergency Medical Services (18)https://healthcurrent.org/hie/the-network-participants/

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What’s Next for AHCCCS and HIE? • Working with Health Current to address technical and policy challenges for integration

of BH and PH data and Part 2 infrastructure

• Supporting providers to meet bi-directional exchange requirement (Year 3- 2019 Targeted Investments (TI))

• Ongoing support for MU Education and Promoting Interoperability

• AHCCCS identifying top 100 providers with each plan by county to ensure recruiting the highest volume providers

• ADHS/ Public Health Connectivity Discussions ongoing

• Promoting Value Based Payment Program for Providers (Differential Adjusted Payment Rates) https://www.azahcccs.gov/AHCCCS/Downloads/PublicNotices/rates/DifferentialAdjustedPayment_DAP_20181001_FinalNotice.pdf

• Requiring improvements in E-Prescribing Benchmarks for Plans

• Administrative Efficiencies /Eligibility Determinations

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Contact Information

Lorie.Mayer@azahcccs.gov602-417-4420

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