Transcript
Page 1: Meaningful Use: Introduction to Meaningful Use Eligible ...health-connect.med.nyu.edu/sites/default/files/health-connect/Webinar_EP_Meaningful_Use...Introduction to Meaningful Use:

Meaningful Use:

Introduction to Meaningful Use

Eligible Providers

Page 2: Meaningful Use: Introduction to Meaningful Use Eligible ...health-connect.med.nyu.edu/sites/default/files/health-connect/Webinar_EP_Meaningful_Use...Introduction to Meaningful Use:

Introduction to Meaningful Use:

Webinar Overview

Define Meaningful Use

Review Meaningful Use Key Dates & Program Incentives

Discuss the 4 Components Necessary to Achieve

Meaningful Use

Introduce Meaningful Use Core Requirements, Menu

Measures, & Clinical Quality Measures

Provider/Admin Q&A

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• American Recovery and Reinvestment Act of 2009/Health Information

Technology for Economic and Clinical Health Information (ARRA/HITECH)

Act, established programs under Medicare and Medicaid to provide

incentive payments to eligible professionals that demonstrate

“meaningful use” of certified electronic health record (EHR) technology.

• HITECH Act allocates 19 billion for the adoption, upgrade, and or

implementation of EHR technology. These incentive programs (Medicare

and Medicaid) are designed to support eligible professionals during health

IT transition.

Simply, "meaningful use" means providers must demonstrate that they're using

certified EHR technology in ways that can be measured in quality and in quantity.

What is Meaningful Use?

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Meaningful Use-Objectives

Meaningful Use is Using Certified EHR Technology to:

Improve Quality, Safety, Efficiency and Reduce Health Disparities:

Use of EHR

Computerized order entry

Electronic Prescribing/refill automation

Record Problem list, medications, allergies, etc

Engage patients and families:

Patient portals and electronic copies of

After Visit Summaries

Educational material

Improve Care Coordination

Medication Reconciliation

Exchange of Data with external Providers

Improve Population and Public Health

Electronic Reporting to Registries

Maintain Patient Privacy and Security

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• Graduated Approach: Implemented in 3 Stages

Stages of Meaningful Use:

Medicare & Medicaid

FOCUS OF:

Stage 1

(2011)

Data capture and sharing

Stage 2

(2013)

Advanced clinical processes

Stage 3 (2015)Improved outcomes

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Meaningful Use:

Medicare Incentive Payment Structure• Eligible providers can earn up to $44,000 if the provider receives at least $24,000 in

Medicare payments and successfully meets all meaningful use requirements by

Oct 1, 2012. The last year to begin participation in the Medicare EHR incentive

program is 2014 to avoid penalties is 2015.

0 First Payment Year

Funding Year 2011 2012 2013 2014 2015 +

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

2016 $ 2,000 $ 4,000 $ 4,000

Total $ 44,000 $ 44,000 $ 39,000 $ 24,000

Incentive

Totals

Decrease in

2013

Medicare payment reductions begin for providers who do not demonstrate meaningfuluse

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Meaningful Use:

Medicaid Incentive Payment Structure

Adoption Year Adoption Year

Funding Year 2011 2012 2013 - 2016

2011 $ 21,250

No payment adjustments/

no penalties

2012 $ 8,500 $ 21,250

2013 $ 8,500 $ 8,500

2014 $ 8,500 $ 8,500

2015 $ 8,500 $ 8,500

2016 $ 8,500 $ 8,500

2017 $ 8,500

Total $ 63,750 $ 63,750 $ 63,750

Eligible providers can earn up to $63,750 if the provider attests and

successfully meets all meaningful use requirements. The last year to begin

participation in the Medicaid EHR incentive program is 2016. Incentive

payments do not decrease with time and there are no imposed penalties.

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Medicare EHR Incentive Program

Managed by CMS

Eligible Providers can receive a maximum incentive amount of $44,000 (over 5

consecutive years (2011-2016) of program participation)

Payment reductions begin in 2015 for providers who are eligible but choose not to

participate

In the first year and all remaining years providers have MU objectives and associated

measures they must meet to get incentive payments

Medicare EHR Incentive Program

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Medicaid EHR Incentive Program

Medicaid EHR Incentive Program

Each State Manages Its Own Program

Eligible Providers can receive a maximum incentive amount is $63,750 (over 6 years

(2011-2021) of program participation)

No Medicaid payment reductions if providers choose not to participate

In the first year, providers can receive an incentive payment for adopting,

implementing or upgrading a certified EHR

In all remaining years, providers must meet the same MU objectives and associated

measures as Medicare

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How Do I

Successfully

Achieve

Meaningful Use?

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4 Components to Successfully

Achieve Meaningful Use

MEANINGFUL

USE OF EHR Compliance with

the MU Measures

and Clinical

Quality Reporting

Report or Attest to

20 MU measures

(15 core, 5 menu)

CERTIFIED

EHR

Ensure EHR is

certified by ONC

Approved Testing

Body

Epic is certified for

MU

ELIGIBILITY/

REGISTRATION

Determine eligibility

to receive Medicare

or Medicaid

incentive

Register for incentive

program

REPORTING/

ATTESTATION

For Medicare Year 1

report after

demonstrating 90

consecutive days of

meaningful use. For

duration of program

report after full year

of demonstrating

MU

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Doctor of Medicine

Doctors of Osteopathy

Doctors of Dental Medicine

or Surgery

Meaningful Use: Eligible Providers

Doctor of Optometry

Doctors of Podiatric

Medicine

Chiropractor

Nurse Practitioners

Certified Nurse-Midwives

Physician Assistants (PAs)

when working at an FQHC or RHC

that is so led by a PA

Medicare-only

Eligible Providers

Medicaid-only

Eligible Providers

Could be eligible for either

Medicare or Medicaid

(but not both in single year)

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Additional Meaningful Use

Eligibility RequirementsMedicare Eligibility(must meet all of the following to qualify)

If you are a physician that participates with Medicare and see patients in an office and

outpatient setting

Physicians who see Medicare patients must have Part B allowed charges

Each eligible professional is only eligible for one incentive payment per year regardless of

how many practices or locations at which he or she provide services.

Hospital based professionals are not eligible for incentive payments An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital

inpatient or emergency room setting. (POS 21 or POS 23)

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Additional Meaningful Use

Eligibility Requirements

Medicaid Eligibility (must meet one of the following to qualify)

If you are a physician that participates with Medicaid and see patients in an office and

outpatient setting

Physicians who have a minimum of 30% Medicaid patient volume

(Medicaid or Medicaid Managed Care)

Physicians must have a minimum of 20% Medicaid patient volume and is a pediatrician

Hospital based professionals are not eligible for incentive payments An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a

hospital inpatient or emergency room setting. (POS 21 or POS 23)

Practice predominately in a Federally Qualified Health Center or Rural Health Center and have a

minimum of 30% patient volume attributable to need individuals

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Meaningful Use: Registration Overview• Registration is required to participate in the EHR incentive program

• As an eligible provider you are only required to register once for the duration of the

incentive program.

• CMS offers third party registration. Required for third party registration

Identity & Access Management Account (I&A)

Association with the eligible providers NPI

• Eligible providers can register without having implementing certified EHR.

• Eligible Professionals cannot register for a Medicaid EHR Incentive Program until

their state's program has launched and the state's site has opened.

• Providers eligible for both the Medicare and Medicaid EHR Incentive Programs must

choose which incentive program they wish to participate in when they register.

Before 2015, an eligible provider may switch programs only once after the first

incentive payment is initiated..

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Requirements for Registration

National Provider Identifier (NPI)

Provider Enrollment, Chain and Ownership System

(PECOS)

National Provider and Provider Enumeration

System (NPPES) User ID and Password

Payee Tax Identification Number (TIN) (benefits

reassignment only)

Payee National Provider Identifier (NPI) (benefits

reassignment only)

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CERTIFIED

EHR

Certified EHR Technology

• The Medicare and Medicaid EHR Incentive Programs require the use of

certified EHR technology. Standards and certification criteria for EHR

technology have been adopted by the Secretary of the Department of

Health and Human Services.

EHR technology must be tested and certified by an Office of the

National Coordinator (ONC) Authorized Testing and Certification Body

(ATCB) in order for a provider to qualify for EHR incentive payments.

You do not need to have certified EHR technology in place to register

for the EHR incentive programs. However before you can receive an

EHR incentive payment you must successfully demonstrate meaningful

use of a certified EHR

For a list of certified EHRs go to the ONC website

http://onc-chpl.force.com/ehrcert

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MEANINGFUL

USE OF EHR

Meaningful Use of EHR

Stage 1 Meaningful Use Criteria:

Criteria for stage 1 meaningful use is focused on electronically capturing health

information in a coded format so information can be used for reporting and

tracking purposes.

• To demonstrate meaningful use a provider must attest to successfully

meeting required functional measures

• Functional Measures:

15 Core Objectives

5 Menu Measures from a menu list of 10

6 total Clinical Quality Measures (3 core or

alternate core and 3 out of 38 from an additional set)

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Stage 1: Requirements OverviewThe table below outlines the “core set” of meaningful use objectives.

All core set measures are required and must be reported.

Core Set Measures Attestation Type

1. Use CPOE (Exclusion Available) Numerator/Denominator

2. Implement drug-drug and drug-allergy interaction checks (No Exclusion) Yes/No

3. Generate and transmit prescriptions electronically (Exclusion Available)Numerator/Denominator

4. Record Patient Demographics (No Exclusion)Numerator/Denominator

5. Maintain up-to-date problem list (No Exclusion) Numerator/Denominator

6. Maintain active medication list (No Exclusion) Numerator/Denominator

7. Maintain active medication allergy list (No Exclusion) Numerator/Denominator

8. Report vital signs and chart changes (Exclusion Available) Numerator/Denominator

9. Record smoking status for patients 13 years or older (Exclusion Available) Numerator/Denominator

10. Implement one clinical decision support rule (No Exclusion) Yes/No

11. Report clinical quality measures to CMS or States (No Exclusion) Numerator/Denominator

12. Electronically exchange key clinical information among providers and authorized

entities (No Exclusion)Yes/No

13. Provide patients with electronic copy of their health information (No Exclusion) Numerator/Denominator

14. Provide patients with visit clinical summaries (Exclusion Available) Numerator/Denominator

15. Protect electronic health information created or maintained by certified EHR Yes/No

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Stage 1: Requirements OverviewThe table below outlines the “menu set” of meaningful use objectives.

EPs must select 5 of the10 options to report. One menu measure must be a public health.

Menu Set Measures Attestation Type

1. Implement drug-formulary checksYes/No

2. Incorporate clinical laboratory test results into EHRsNumerator/Denominator

3. Generate lists of patients by specific conditions for quality improvement purposesYes/No

4. Use EHR to identify patient-specific education resourcesNumerator/Denominator

5. Perform medication reconciliation between care settingsNumerator/Denominator

6. Provide summary of care record for patients referred/transitioned to another providerNumerator/Denominator

7. Submit electronic immunization data to registries or information systemsYes/No

8. Submit electronic syndromic surveillance data to public health agenciesYes/No

9. Send reminders to patients for preventive and follow-up care (EP)Numerator/Denominator

10. Provide patients with timely electronic access to their health information (EP)Numerator/Denominator

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Stage 1: Requirements Overview• An Eligible Provider Must Report on 6 total Clinical Quality

Measures (CQMs)

An EP must report on these three core

set measures, unless they are not

appropriate to their patient population.

NQF 0013: Hypertension: Blood

Pressure Management

NQF 0028: Preventative Care and

Screening Measure Pair: a. Tobacco

Use Assessment b. Tobacco Cessation

Intervention; and

NQF 0421/PQRI 128: Adult Weight

Screening and Follow-up

“Core set”

If an EP can not report on core set

measures, they must report on three

alternate core measures:

NQF 0041/PQRI 110: Preventative Care

and Screening: Influenza Immunization

for Patients ≥50 Years Old

NQF 0024: Weight Assessment and

Counseling for Children and Adolescents

NQF 0038: Childhood Immunization

Status

“Alternate core set”

Plus an EP must select three additional

measures from a set of 38 quality

measures that was included in the original

proposed rule.

“Additional set”

3 Core Set or Alternate Core Set + 3 Additional Set = 6 CQMs

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Reporting and Attestation

• Eligible providers must report on identified functional measures:

15 Core Objectives

5 Menu Measures from a menu list of 10

6 total Clinical Quality Measures (3 core or alternate core and 3 from an

additional set)

• Reporting and attestation is done at the INDIVIDUAL eligible

professional level

• For the Medicare Program, Reporting period is after 90 consecutive

days of Meaningful Use for the first adoption year and yearly every

subsequent year of participation in the incentive program

• For Medicaid Program, providers do not need to attest to

demonstrate Meaningful Use in the first year of program participation

but during the second year have to report their 90 day data.

REPORTING &

ATTESTATION

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Introduction to Meaningful Use:

Webinar Recap

Define Meaningful Use

Review Meaningful Use Key Dates & Program Incentives

Discuss the 4 Components Necessary to Achieve

Meaningful Use

Introduced Meaningful Use Core Requirements, Menu

Measures, & Clinical Quality Measures

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Upcoming Webinars:

• MU Webinar : Meaningful Use Registration and

Attestation

November 3rd and 15th

• MU Webinar : Guide to Clinical Quality Measures

November 10th and 17th

Dec 1st

• MU Webinar : Workflow Changes for MU Measures

TBA

• MU Webinar: Epic Reporting and Attestation

TBA

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QUESTIONS ?


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