navigating meaningful use stage 2 - sept 2012

7/31/2019 Navigating Meaningful Use Stage 2 - Sept 2012

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Justin T. Barnes

VP, Greenway Medical Technologies

Chairman Emeritus, EHR Association

Navigating Meaningful Use Stage 2

Follow Justin Barnes @HITAdvisor

Ask Questions & Follow TodaysConversation #askHIT


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Healthcare Reform/ Transformation

27% Medicare SGR rate cut pending for 2013 2012 doc fix cost $21.1B

MedPAC recommendations to realign fee-schedule to support primary care and ACOs,bundled payments, capitated models & shared savings programs

MedPAC SGR recommendation slides ~ http://tiny.cc/u58gy

PPACA Legislation/ Regulation

National & Global Efforts

Create efficiencies, increase access and stabilize rocketing costs

As compared globally, we ranked #1 on costs but avg. 20-40 on outcomes

Beginning the Shift to Paying for Reporting & Quality

27+ legislatures have proposed bills on accountable care

Accountable Care Organizations (ACO)

Patient-Centered Medical Homes (PCMH)
http://tiny.cc/u58gyhttp://tiny.cc/u58gyhttp://tiny.cc/u58gy


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EHR Meaningful Use

Over $27B available with no cap. Protected in Medicare Trust Fund Stage 1 criteria well within expectations ~ 14/15 Core Measures & 5/10 Menu Stage 2 criteria will include ~ 17 Core Measures & 3/6 Menu As of July, over 271,000+ care providers registered for Meaningful Use Over $6.6 Billion in incentives paid to eligible providers & hospitals already!

Over $195 Million just to Nurses & PAs under Medicaid Meaningful Use Stage 2 Overview Chart ~ http://tiny.cc/kybkjw

EHR Certification 6 ONC-ATCB Certifying Entities CCHIT remains industry gold standard

Regional Extension Centers Operations underway at various levels of execution Find your local REC ~ http://bit.ly/zUb3O9

Health Information Exchanges Operations underway at various levels of operation
http://tiny.cc/kybkjwhttp://t.co/6X7yBVfehttp://t.co/6X7yBVfehttp://t.co/6X7yBVfehttp://t.co/6X7yBVfehttp://t.co/6X7yBVfehttp://tiny.cc/kybkjwhttp://tiny.cc/kybkjwhttp://tiny.cc/kybkjw


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To improve the quality, safety, and efficiency ofcare while reducing disparities

To engage patients and families in their care

To promote public and population health

To improve care coordination

To promote the privacy and security of EHRs


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Sec. 4101: Medicare Incentives for Eligible Professionals

EHR Meaningful Use ~ Began 01/03/2011 Medicare MU Attestation ~ Began 04/18/2011

Pay Out ~ Began mid-May 2011

Sec. 4201: Medicaid Incentives for Eligible Professionals

1st

Pay Out Year ~ All state-based but 40+ states currently paying 1st Medicaid Pay Year is for EHR Adoption, Implementation or Upgrade (AIU):

No MU reporting required. (Much different than Medicare)

2nd Pay Out Year ~ Expected mid-2012

2nd 6th Medicaid Payment Years for EHR Meaningful Use & Reporting

Section 4102/ 4201 Incentives for Hospitals

Meaningful Use year ~ Began 10/01/2010

Pay Out ~ Began mid-May 2011


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for Meaningful Useof a CertifiedEHR

NowLearn/Install

1stYear

$18k2nd

Year$12k 3

rdYear

$8k4th

Year$4k

5thYear

$2k

Up to

$44k

per provider

2015 2016+

Medicare Penalties

for No EHR

1% AnnualPenalty

Reductions

StimulusFormula

75% ofAllowables up

to Annual MaxAbove

Incentives over 5 years


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Must start EHR Meaningful Use by Oct 3rd, 2012 to receive the $44,000 max incentiveAll EPs and EHs allowed a 90-day reporting period in 2014


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for Meaningful Useof a CertifiedEHR

1st

Year$21,250

2ndYear

$8.5k3rd

Year$8.5k 4

thYear

$8.5k5th

Year$8.5k

6thYear

$8.5k

Up to

$63,750per provider

2015 2016+

No Medicaid Penalties

0%Penalty

Reductions

Medicaid Incentives up to$63,750 for Providers/EligibleProfessionals with a 30%Medicaid patient volume or

Pediatricians with at least a20% Medicaid patient volume.Pediatricians below 30% maybe reimbursed at 2/3s ($42,500)of the total allowable incentive.

Incentives over 6 years


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http://www.cms.gov/EHRIncentivePrograms/40_MedicaidStateInfo.asp#TopOfPage
http://www.cms.gov/EHRIncentivePrograms/40_MedicaidStateInfo.asphttp://www.cms.gov/EHRIncentivePrograms/40_MedicaidStateInfo.asp


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Foster the increased EHR adoption nationally within the foundationStage 1 reporting criteria

Allow time for EHR providers to embed more sophisticated Stage 2requirements and certification into their technology

Stage 1 Medicare and Medicaid incentive funds extended throughthe end of 2013 for EPs

EPs beginning program in 2011 can receive within stage onemeasures:

Medicare program incentives totaling $38,000 Medicaid program incentive totaling $38,250


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Eligible professional Stage 2 begins Wednesday, January 1st, 2014

Eligible hospitals would begin Stage 2 on Thursday, Oct. 31, 2013

EPs must achieve 17 core measures and choose 3 of 6 menu items

EHs and Critical Access Hospitals (CAH) must achieve 16 coremeasures and choose 3 of 6 menu items

EPs choose 9 from 64 potential Clinical Quality Measures (CQM),which now align closely with PQRS, Shared Savings, etc.

2014 will allow a 90-day reporting period for all EPs and EHs


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Changes to denominator ofCPOE

Now includes lab & radiology orders; measurement on orders instead ofunique patients

Changes to the age limitations forvital signs From 2 years old to 3 years old

Elimination of the "exchange of key clinical information core infavor of a "transitions of care & patient summary data

Replacing "provide patients with an electronic copy of theirhealth information objective with a "view online, download andtransmit


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The use ofcomputerized provider order entry (CPOE) formedication orders increases from 30% to 60%

Addition of labs and radiology to this quality measure with 30% threshold

Generate and transmit permissible scripts electronically (eRx)increases from 40% to 50%

Threshold levels to increase from 50% to 80% for the following:

Recording demographics

Record and chart changes in vital signs (over age 3)

Record smoking status for patients over 13 years of age


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Secure electronic messaging is utilized to communicate withpatients on relevant health information >5% of unique patients

Provide clinical summaries to >50% of patients within 1 businessday

Protect electronic health information by conducting or reviewing asecurity risk analysis and implement security updates asnecessary

Increase from one clinical decision support to five,encompassing drug-drug and drug-allergy checks.


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Patients are provided online access to their health information(via a web portal) on >50% of the occasions, while >5% uniquepatients actually view, download or transmit that data to a third party

Successful ongoingsubmission of electronic immunization datato an immunization registry is now required, previously only a testwas required

Provide a summary of care record for >50% of transitions of careand electronically transmit >10% across vendor types and

organizations Combines Stage 1 core items problem list, active medication list and

active medication allergy list


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Incorporate >55%of clinical lab-testresults into Certified EHR

Generate at least one report listing patients by specificconditions to use for quality improvement, reduction of disparities,research, or outreach

Use clinically relevant information to identify >10% of uniquepatients who should receive reminders for follow-up

Provide patient-specific education resources identified byCertified EHR Technology to >10% of patients with an office visit

When an EP receives a patient from another setting of care, theyshould perform medication reconciliation >50% of transitionscare


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More than 10% of all scans and tests whose result is an imageordered by the EP during the reporting period are made available

Record patient family health history for more than 20% of all uniquepatients seen by the EP during the reporting period

Ongoingsubmission of cancer cases to a state cancer registry

Ongoingsubmission of specific cases to a specialized registry (otherthan cancer)

Ongoingsubmission of electronic syndromic surveillance data to apublic health agency

Record


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Stage 3 will propose higher standards to meet Meaningful Use

Many menu items will become core measures

Threshold levels will increase as capabilities of HIT infrastructures grow

Stage 3 will begin in 2016 and the criteria will focus on

Creating a collaborative care model, which encompasses shared decision

making with patients and care givers Support for an interactive and longitudinal care plan, inclusive of patient

goals and advance directives

Real-time and bi-directional communication among care team, patientsand family member

Focus on standardization of key data elements Support for bidirectional communications in public health

Ability to capture, display, monitor, and report patient data


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https://ehrincentives.cms.gov/hitech/login.action
https://ehrincentives.cms.gov/hitech/login.actionhttps://ehrincentives.cms.gov/hitech/login.action


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Assign a Meaningful Use Leader in your Facility

Ensure review of MU Final Rule, CMS/ ONC Site & FAQs Review of MU Stage 2 Proposed Rule & Final Rule Understand how it affects you today and tomorrow

Seek a Trusted Advisor & Partner

Ensure you partner with a company that is in expert in EHRmeaningful use, certification, standards & accountable care

Track record of being proactive in the evolution of healthcare EHR Certification, Standards Development & Interoperability

NCVHS EHR Meaningful Use Hearings

Greenways Justin Barnes testified on EHR Certification,Standards, Implementation and Quality Measures


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Request Reference Sites in your Specialty and with Similar Size

Practices Be practical and seek EHRs that are currently used at POC today Accept references where >70% of care providers use EHR today

Product Workflow is Consistent with your Facility/ PracticeRequirements Ensure the EHR meets you in the middle with regards to workflow

Can be Meaningfully Used at the Point-of-Care

The EHR is easily customizable & flexible to your workflow Easily create customized reports for quality, outcomes & research


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Begin Fostering the EHR Discussion with your

Practice, Hospital or Facility

Use the Meaningful Use Criteria as a Playbook to

Navigate the Future of Healthcare

Understand your Goals for EHR Adoption Financial, quality, patient satisfaction, clinical research, community

leadership, accountable care, all of the above, etc

Begin EHR Product Review Process Today EHR Meaningful Use incentive program well underway

It takes time to properly research, purchase, implement and meaningfullyuse an EHR so experts suggest you get your place in line now


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EHR MU Navigation (http://tiny.cc/6unicw)

Govt Affairs (http://tiny.cc/w5nicw)

Greenways Government Affairs Updates

HHS Privacy Rule (http://tiny.cc/i1nicw)

Important Government & HHS Sites

HHS Breach Notification Rule (http://tiny.cc/xytg5)

CMS Educational Webpages

EHR Meaningful Use Microsite (www.meaningfuluse-emr.com)

CMS ACO/ Shared Savings Page (http://tiny.cc/xqnicw)

CMS Meaningful Use Page (http://tiny.cc/fsnicw)

CMS Stage 2 Final Rule (http://tiny.cc/wceqjw)

ONC Funding Opportunities (http://tiny.cc/mmhvcw)
http://tiny.cc/6unicwhttp://tiny.cc/w5nicwhttp://tiny.cc/i1nicwhttp://tiny.cc/xytg5http://www.meaningfuluse-emr.com/http://tiny.cc/xqnicwhttp://tiny.cc/fsnicwhttp://tiny.cc/wceqjwhttp://tiny.cc/mmhvcwhttp://tiny.cc/mmhvcwhttp://tiny.cc/mmhvcwhttp://tiny.cc/wceqjwhttp://tiny.cc/wceqjwhttp://tiny.cc/wceqjwhttp://tiny.cc/fsnicwhttp://tiny.cc/fsnicwhttp://tiny.cc/xqnicwhttp://tiny.cc/xqnicwhttp://www.meaningfuluse-emr.com/http://www.meaningfuluse-emr.com/http://www.meaningfuluse-emr.com/http://tiny.cc/xytg5http://tiny.cc/xytg5http://tiny.cc/i1nicwhttp://tiny.cc/i1nicwhttp://tiny.cc/w5nicwhttp://tiny.cc/w5nicwhttp://tiny.cc/6unicwhttp://tiny.cc/6unicw


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Justin T. [email protected]

(678) 839-4316

@HITAdvisor
mailto:[email protected]://twitter.com/http://twitter.com/mailto:[email protected]


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navigating meaningful use stage 2 - sept 2012

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