Overview of Meaningful Use Regulations and Implementation Issues January 27, 2010 Joel White Executive Director Health IT Now Coalition.

Slides:



Advertisements
Similar presentations
Dedicated to Hope, Healing and Recovery 0 Dec 2009 Interim/Proposed Rules Meaningful Use, Quality Reporting & Interoperability Standards January 10, 2010.
Advertisements

Update on Recent Health Reform Activities in Minnesota.
Accelerating Reform Initiative February 2010 Learning Session Critical Factors Influencing Implementation: Information Systems Presented by: Rebecca Novak.
Medicaid and Meaningful Use – The “Other” EHR Incentive Program: What Hospital Leaders Should Know About the Medicaid EHR Incentive Program Wisconsin Hospital.
By James Phelps Actuarial Specialist Reimbursement Unit Utah Medicaid and Health Financing.
Denise B. Webb State Health IT Coordinator May 9, 2013.
EHR Incentive Program & Meaningful Use in Washington State An Overview.
Understanding Meaningful Use Presented by: Allison Bryan MS, CHES December 7, 2012 Purdue Research Foundation 2012 Review of Stage 1 and Stage 2.
Implementing the American Reinvestment & Recovery Act of 2009.
Slide 1 Regional Care Collaborative March 26, 2015.
CMS NPRM proposes requirements for Stage 3 of EHR Incentive Programs (in FR March 30, 2015) In conjunction with.
Bill Finerfrock Executive Director
Meaningful Use, Standards and Certification Under HITECH—Implications for Public Health InfoLinks Community of Practice January 14, 2010 Bill Brand, MPH,
Meaningful Use The Catalyst for Connected Health Sameer Bade Strategic Product Planner.
Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.
1 Dinetia M. Newman Balch & Bingham LLP MEANINGFUL USE: HISTORY AND TIPS ON IMPLICATIONS FOR FORREST GENERAL HOSPITAL Presented.
MEANINGFUL USE UPDATE 2014 Mark Huang, M.D. Chief Medical Information Officer Rehabilitation Institute of Chicago Associate Professor Department of PM.
Medicare & Medicaid EHR Incentive Programs
Montana Medicaid Electronic Health Records Incentive Program for Eligible Hospitals This presentation will focus on information related to your registration.
Criteria for HIT Stimulus Funding: Meaningful Use and Certification Requirements May 4, 2010 Meaningful Use Critical Access Hospital September 16, 2010.
Protecting and Promoting the Practice of Good Medicine Getting Started with Meaningful Use: The impact on the professional eligible provider MMIC Health.
Meaningful Use ID498 Tasha Gotter June 11, Introduction  Positive impact on health care  Positive impact on patients  Provides accurate information.
August 12, Meaningful Use *** UDOH Informatics Brown Bag Robert T Rolfs, MD, MPH.
Meaningful Use and Financial Incentives Michele Madison
A First Look at Meaningful Use Stage 2 John D. Halamka MD.
Meaningful Use Stage 2 Esthee Van Staden September 2014.
Saeed A. Khan MD, MBA, FACP © CureMD Healthcare ACOs and Requirements for Reporting Quality Measures Meaningful Use Are you still missing out? © CureMD.
Kevin Larsen MD Medical Director, Meaningful Use Office of the National Coordinator of Health IT Improving Outcomes with HIT ASCO Oct
Daniel T. Golder, DDS, MBA Chief Information Officer Oklahoma Foundation for Medical Quality This material is provided by the Oklahoma Foundation for Medical.
Overview of Meaningful Use Regulations and Implementation Issues January 7, 2010 Joel White Executive Director Health IT Now Coalition.
Series 1: Meaningful Use for Behavioral Health Providers From the CIHS Video Series “Ten Minutes at a Time” Module 2: The Role of the Certified Complete.
HP Provider Relations October 2011 Electronic Health Records (EHR) Incentive Program.
Mel Borkan June 18, 2010 Meaningful Use and Ohio Medicaid.
Update on Federal HIT Legislation Kirsten Beronio Mental Health America.
What Did I Work on in Washington? John Glaser April 16, 2010.
EMR Remedies Electronic Health Record Solutions Copyright – EMR Remedies Corporate Overview and General Information on Federal.
Robert H. Roswell, M.D. Oklahoma Hospital Association September 1, 2009.
INTRODUCTION TO THE ELECTRONIC HEALTH RECORD CHAPTER 1.
Health Information Technology The Texas Landscape Presentation to TASSCC 2010 Nora Belcher Texas e-Health Alliance August 3, 2010.
David G. Schoolcraft Ogden Murphy Wallace, PLLC
AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 Health Information Technology for Economic and Clinical Health Act (HITECH Act) Regina.
Configuring Electronic Health Records Meaningful Use and Implementation Lecture a This material (Comp11_Unit8a) was developed by Oregon Health & Science.
Medicaid HIT Program Jon Barley, Ph.D., Chief Bureau of Health Services Research Office of Ohio Health Plans
Discussion with BEACON Council ODJFS/OHP Medicaid Provider Incentive Program.
Accounting for Electronic Health Record Payments July 25, 2012 Draffin & Tucker, LLP
Component 11: Configuring EHRs Unit 2: Meaningful Use of the Electronic Health Record (EHR) Lecture 1 This material was developed by Oregon Health & Science.
Unit 1b: Health Care Quality and Meaningful Use Introduction to QI and HIT This material was developed by Johns Hopkins University, funded by the Department.
American Recovery and Reinvestment Act: Summary of Health-related Provisions April 15, 2009.
Issues and Challenges for Medicaid Eligible Providers: From AIU to Stage 1 Meaningful Use Clint Kuntz, CEO Fairfield Community Health Center
Component 11/Unit 2a Meaningful Use of the Electronic Health Record (EHR)
Health Information Technology EHR Meaningful Use Milestones for HIT Funding Michele Madison
Terminology in Health Care and Public Health Settings Unit 15 Overview / Introduction to the EHR.
West Virginia Information Technology Summit November 4, 2009.
Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. Assessing Your Needs and Preparing RFPs… Brian Anderson Southeast Zone MedSeries4.
BENEFITS OF ELECTRONIC HEALTH INFORMATION. Health IT Video from HealthIT.gov (Please wait for the video to load and click on the arrow to play)
Washington and Idaho Regional Extension Center: Job Shadow Program Peggy Evans, PhD, CPHIT WIREC Director John Hartgraves WIREC Technical Manager Bellevue.
Creating an Interoperable Learning Health System for a Healthy Nation Jon White, M.D. Acting Deputy National Coordinator Office of the National Coordinator.
Medicaid EHR Incentive Program Updates eHealth Services and Support September 24, 2014 Today’s presenter: Nicole Bennett, Provider Enrollment and Verification.
Final Rule Regarding EHR Certification Flexibility for 2014 Today’s presenters: Al Wroblewski, Client Services Relationship Manager Thomas Bennett, Client.
By: Rebecca Cameron Amie Dennis Amy Everson Debborah Stokes.
Terminology in Healthcare and Public Health Settings Electronic Health Records Lecture a – Introduction to the EHR This material Comp3_Unit15 was developed.
Health Datapalooza Mini Summits IV: Payer – How States and Others Are Using Medicare Data to Manage Populations May 10, 2016 Mylia Christensen, Executive.
Moving Toward HITECH Healthcare EHR Adoption at the Dawn of a New Era
HIT Policy Committee Health Information Exchange Workgroup Comments on Notice of Proposed Rule Making (NPRM) and Interim Final Rule (IFR) Deven McGraw,
Today’s Webinar: Meaningful Use Implications for Small Community and Critical Access Hospitals Audio Access Code: champions.
Sachin H. Jain, MD, MBA Office of the National Coordinator for Health IT United States Department of Health and Human Services The Nation’s Health IT Agenda:
Rural Health Summit June 11, 2010.
NURS 737: Nursing Informatics Concepts and Practice in System Adoption
How to receive your incentive dollars quickly
Presentation transcript:

Overview of Meaningful Use Regulations and Implementation Issues January 27, 2010 Joel White Executive Director Health IT Now Coalition

2 Agenda Welcome About HIT Now Overview of Rules –IFR Standards, Implementation Specifications and Certification –Medicare –Medicaid So what? Conclusion

3 HIT Now Coalition Founded in Spring of Central goal is advancing the adoption and use of health information technology to improve quality and outcomes and to lower costs. 55 Diverse Organizations representing patients, providers, payers, brokers and unions. 501(c)(4).

4 HIT Now Members -Aetna -Alliance for Plasma Therapies -American Academy of Nursing -American Cancer Society -American Diabetes Association -American Health Care Association -American Heart Association -American Homeowners Grassroots Alliance -American Telemedicine Association -AmeriSource Bergen -The Boeing Company -Bronx Regional Health Information Organization -Business Roundtable -CIGNA -Consumers for Competitive Choice -The Dow Chemical Company -FasterCures -Genetic Alliance -Health Tech Strategies -Intel -International Brotherhood of Electrical Workers -Latino Coalition -Marshfield Clinic -Mercy Medical Center -Montefiore Medical Center -National Alliance for Caregiving -National Alliance on Mental Illness -National Association of Health Underwriters -National Association of Manufacturers -National Center for Assisted Living -National Disease Clusters Alliance -National Medical Association -National MS Society -National Patient Advocate Foundation -National Retail Federation -New York Presbyterian Hospital -Nortel -Parkinson’s Action Network -Pharmaceutical Care Management Association -Research!America -RetireSafe -Seniors Coalition -Society for Human Resource Management -United Health Group -US Chamber of Commerce -US Oncology -Vanderbilt Center for Better Health -Verizon -WebMD Health Corp -Whitman-Walker Clinic -Women Work! -World Institute on Disability -Xerox Corporation

5 Meaningful Use Overview Two Rules were posted on January 13, 2010 to implement ARRA incentives for health information technology: 1.What is an EHR? Interim Final Rule on EHR Standards, Specifications and Criteria. 2.What must people do to access billions in Medicare and Medicaid incentives? Proposed Rule on Medicare and Medicaid incentives.

6 IFR Overview Criteria –Stage 1 – 2011 –Stage 2 – 2013 (defined in later rule) –Stage 3 – 2015 (defined in later rule) Standards Implementation Specifications Certification

7 IFR Overview The rule sets out standards, implementation specifications and certification criteria for EHRs. 24 criteria categories for eligible providers (EPs) and 22 criteria categories for hospitals. In addition, certified EHRs must include –patient demographic information –provide clinical decision support; –support physician order entry; –capture and query quality information; and –electronically exchange health information.

8 Stages Stage 1 (2011). Focus on electronically capturing health information in a coded format, and using it to track clinical conditions and for care coordination purposes. Stage 2 (2013). Expand on Stage 1 to include continuous quality improvement at the point of care. Stage 2 will be defined in a subsequent rule. Stage 3 (2015). Expand on Stage 2 to promote decision support for high priority conditions, patient access to self management tools, access to comprehensive patient data and improving public health. Stage 3 will be defined in a subsequent rule.

9 IFR Criteria RequirementExample Functional E-Prescribing Computerized Provider Order Entry (CPOE) Reporting quality measures to CMS or States Implementing clinical decision support rules Administrative Check insurance eligibility Electronically submit claims Privacy Encryption Audit trails Verification information is not altered in transit Create a record of disclosures Patient Access Electronic copy of their health information upon request Access to lab results within 96 hours Electronic copy of their discharge instructions

10 IFR Standards There are primary standards and some fall back alternative standards and vocabulary governing information exchange. HHS recognizes the need for a standard vocabulary to promote interoperability. HHS views the standards process as iterative, with new standards to be adopted as needed. HHS states that standards will be increasingly more demanding over time and certified EHR technology will need to include more capabilities.

11 IFR IS and Certification Implementation Specifications Implementation specifications are the instructions or requirements to implement a standard. HHS adopted IS for health plan eligibility, claims transactions, and quality reporting. Certification The rule requires all products must gain new certification and meet all the criteria to qualify as EHR technology for meaningful use incentives. HHS will publish a separate rule to recognize a certification program or programs to replace the current certification process. HHS has indicated the new certification rule will be released “shortly”.

12 Medicare and Medicaid Proposed Rule Provider adoption of an EHR is voluntary, but adoption and use generates incentive payments. Over time, those that don't adopt and use will face Medicare payment reductions. Payments depend on adoption year. –Year one adopters must use a certified EHR for 90 continuous days to qualify for payments. In subsequent years, the use must be demonstrated for the full year. –Year one Medicaid adopters can receive payments for adoption, implementation or upgrading EHRs. This includes staffing, maintenance and training.

13 Proposed Rule Medicare: EP and Hospital eligible for payments if: –Demonstrates use in a meaningful manner. –Demonstrates the technology provides for electronic exchange. –Submits reports on quality measures to HHS. Medicaid: EP and Hospital eligible for payments if: –Engaged in efforts to adopt, implement or upgrade certified EHR technology. –Demonstrates MU as defined by a State and approved by the Secretary. –States may add additional objectives to the definition of meaningful use, but HHS will reject any additions to EHR functionality. Switch: EPs can switch programs once prior to Hospitals can access both incentive programs.

14 Medicare Program – Who Gets Paid? EPs (physicians, not group practices). Hospitals. Critical Access Hospitals. Medicare Advantage organizations with provider employees or affiliates. NOT: SNFs, LTCAHs, Home Health, pharmacy, ESRD

15 Medicare Program EPs – What They Get Paid Is based on adoption year: Additional payments for EPs who predominantly perform in a HPSA. Reimbursement cut in 2015 for EPs who do not meaningfully use.

16 Medicare Hospitals – What They Get Paid Payment based on formula: –(Base payment of $2 million + $200 per discharge for the 1,150 th – 23,000 th discharge) * Medicare Share * Transition Factor –Medicare share takes into account inpatient bed days, total bed days and charity care. –Transition Factor declines over time. Penalties apply for hospitals that do not meaningfully use in FY2015 and beyond. CAHs paid based on reasonable cost times Medicare share plus 20 percent and does not exceed 100 percent. Not available for cost reports after 2016.

17 Medicaid Program – Who Gets Paid? Certain Medicaid providers are eligible for incentive payments if they treat a minimum number of patients who are Medicaid eligible within any 90 day continuous period for a calendar year.

18 Medicaid EP – What They Get Paid

19 Medicaid EPs – What they Get Paid and When

20 Medicaid Hospitals – What They Get Paid Payment based on formula: –((Base payment of $2 million + a discharge related amount for each year) * (yearly transition factor)) * ((Medicaid inpatient bed days + Medicaid MCO bed days)/((total inpatient bed days) * ((estimated total charges – charity care charges)/(estimated total charges))). –Confused? –Example of Hospital A: 20,000 discharges; 34,000 Medicaid bed days; 100,000 total bed days; $1 billion in total charges, $200 million in charity care; Hospital payment = $6.2 million

21 So What? HITN views the rules as we view other IT issues, namely do they: –Promote clinical quality? –Improve patient outcomes? –Lower costs? One example: oncology measures may not be appropriate for oncologists (i.e. screening for mammography). This may promote increased services and costs with little clinical value.

22 Conclusion The rules need to promote tools for physicians that help solve real problems for them. While this challenge shouldn’t be underestimated, the solution needn’t be overcomplicated. AHA, MGMA, HIMSS, others have already weighed in with initial thoughts. HITN is withholding judgment to reflect on how the rules impact quality, outcomes and costs.

23 Questions? Joel White is the Executive Director of the Health IT Now Coalition, a diverse group of organizations representing patients, health providers, health insurers, agents, and brokers, employers and unions that have come together to help integrate information technology into health care. –(202) – Office –(202) – Cell