Meaningful Use Update: How to Prepare Dr. Denise W. Hines, PMP, FHIMSS Director-Outreach & Education GA HIT Regional Extension Center

Overview Resources to Assist with EHR Implementations –CMS EHR Incentive Programs –Regional Extension Centers (RECs) Current & Future Requirements for EHR Adoption –Stages of Meaningful Use –Health Information Exchanges –New Models of Care Delivery Questions

CMS EHR Incentive Programs Over $27B Available –260,000+ care providers registered –$6.7 Billion+ paid to eligible providers & hospitals –$176 Million+ paid to nurses& PA’s under Medicaid –100,000+ hospitals and doctors received payment EHR Adoption –% of U.S. Hospitals that adopted EHRs has doubled from 16 to 35% between 2009 and 2011 (AHA, 2011). –55% of practices adopted an EHR last year (National center for Health Statistics, 2012) –3 of 4 patients with paper records want their doctor to adopt an EHR (National Partnership for Women & Families, 2012) –Incentives are the #1 reason for EHR adoption growth

Medicare Incentive Program Eligible Professionals (EPs) Doctor of Medicine or Osteopathy Doctor of Dental Surgery or Dental Medicine Doctor of Podiatric Medicine Doctor of Optometry Chiropractor Total payout is $44K/4 years Eligible Hospitals Acute Care, Critical Access Hospitals Average payout for Care/Caid is $3-11M per facility Providers must Demonstrate MU 90days then 1 year period Penalties

5 Medicaid Incentive Program Eligible Professionals (EPs) Physicians Nurse Practitioners (NPs) Certified Nurse-Midwives (CNMs) Dentists Physician Assistants Total payout is $63,750/6years Eligible Hospitals Acute Care, Critical Access, Children’s Hospitals Average payout Care/Caid is $3-11M per facility Year 1-Provider must show proof of AIU EHR Starting Year 2-Provider must Demonstrate MU No Penalties

Georgia Medicaid Incentive Program (MIP) Administered by the Georgia DCH A 10-year program $480M to stimulate the Georgia economy Opened on September 5, 2011 Payments issued as of July 31, 2012 –990 Eligible Professionals &Hospitals –TOTAL: $73,023, Providers are now preparing for Year 2 of the Program- Year 2 open for hospitals; EP’s will be open in Oct.

Regional Extension Centers Purpose-Help 100,000 PCPs, Rural Health & CAHs nationally reach meaningful use Services: –Assist in EHR selection process –Assess progress toward Meaningful Use –Support Practice through selection, implementation, training, go-live –Track Progress toward Meaningful Use –Meaningful Use Certification –HIT Education Over 62 centers across the nation ~140,000 enrolled providers to date Year 2 of the 4 year program Most RECs are ending provider enrollment and focused on meeting MU

GA-Health Information Technology Regional Extension Center (GA-HITREC) MSM-NCPC Awarded $20M to assist GA’s Providers Enrolled (to date) –4200 individual providers –51/56 Critical Access/Rural Hospitals Strategic Objectives Outreach & Education Technical Assistance Business Development (Sustainability) Collaborative efforts with DCH & GA-HIE

GA-Health Information Technology Regional Extension Center (GA-HITREC) GAO report found that providers who partner with RECs are twice as likely to receive Medicare EHR Incentive Payments as those who don’t 80-85% of eligible providers who received Georgia Medicaid EHR incentive payments are GA-HITREC providers GA-HITREC Provider Enrollment Period Reopened: – ~80 provider spots – Providers who have an EHR, Reporting Quality & E- Prescribing

The Goals for Meaningful Use Data capture and sharing Advanced clinical processes Improved outcomes

Stage 1 Meaningful Use Requirements: Use of a certified EHR in a meaningful way Use of a certified EHR for electronic exchange Use of a certified EHR to submit clinical quality data Eligible Professionals (EPs) Must meet 15 core requirements + 5 menu requirements Quality measures required for reporting for EPs – 3 core + 3 menu Eligible Hospitals and Critical Access Hospitals Must meet 14 core requirements + 5 menu requirements Quality measures required for reporting - 15 measures for hospitals Reporting Period Any consecutive 90 days for first year One year subsequently

Stages of Meaningful Use Meaningful Use Stage 1 Effective until 2014 –Hospitals & Providers can receive 3 payments under Stage , 2012, 2013 Meaningful Use Stage 2 –Delayed to allow vendors time to implement new functionality –Final released August 23, 2012 –Attestation for Hospitals start Oct. 31,2013 –Attestation for Professionals start Jan. 1, 2014 –Builds on stage 1 with increased thresholds Exchange of information required Electronic access for patients Updates to quality measures to align with other programs Submission to registries Record patient family health Record imaging results inside EHR

Stages of Meaningful Use Meaningful Use Stage 3 –Ready by 2015 and required by 2016 –Builds upon Stages 1 and 2 with increased thresholds –Creation of collaborative care models with patients –Enhanced bi-directional exchange with public health agencies: Immunization, lab, and syndromic surveillance data –Demonstrate improvement in patient outcomes Patient access to self management tools, upload data Bi-Directional communication among care team, patients, and family members

Health Information Exchange Each designated agency will create a statewide HIE Over $400M to states for planning & implementation States required to submit a HIT strategic plan that includes technical, business, financing mechanisms over a 4 year period for the HIE Required to use national standards HIEs vary across the nation

GA’s HIE Progress DCH is designated state agency for GA’s statewide HIE Awarded $13M to support the planning of the HIE Received approval for strategic plan in 2011 Formed governance structure in 2011 Developed phased approach late 2011: Using existing HIEs to test concepts: –Phase 1- Directed Exchange (2012) –Phase 2- Query-Based Exchange (Patient Search) (2013)

The Path Forward New Models of Care Based on Quality/Healthcare Reform ACOsPCMH Meaningful Use/HIE EHR Adoption

Take Away Points 1.Purpose is to improve health care outcomes and improve our healthcare delivery system. 2.Take advantage of incentives and resources! 3.Providers must ADOPT and USE technology to participate in the healthcare models of the future.

Resources GA-HITREC CMS Incentive Programs GA Medicaid Incentive Program GA HIE

QUESTIONS ????