1. Slide 1 Regional Care Collaborative March 26, 2015

2. Slide 2 Aligning Meaningful Use with Patient Centered Care Presenter: Deborah Johnson Ingram,

3. Slide 3 1.Overview of CMS EHR Incentive (MU stage 2) Program 2.Overview Patient Centered Care 3.Review MU and PC Care Overlap AGENDA

4. Slide 4 Today’s Objective Understand MU & Patient Centered Care Basics Learn MU stage 2 Requirements Highlight difficult Stage 2 measures and discuss solutions for achieving thresholds

5. Slide 5 Meaningful Use Basics

6. Slide 6 CMS EHR Incentive Program Federal and State incentive payment program for Eligible Professionals (EP’s) that either adopt, implement, upgrade or attest to usage of a Certified (ONC) EMR application If an EP qualifies, they will be able to receive payment from either CMS (Medicare providers) or the WV Bureau of Medical Services (Medicaid providers)

7. Slide 7 In 2009 ARRA* defined that MU is the use of: a certified EHR in a meaningful manner, such as e- prescribing certified EHR technology for electronic exchange of health information to improve quality of health care certified EHR technology to submit clinical quality and other measures *American Recovering and Reinvestment Act

8. Slide 8 Simply put, “MU" means providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity Show me how to get the money…

9. Slide 9 Medicaid EHR Incentive Payment Schedule for Eligible Professionals Medicaid EP Qualifies to Receive First Payment in 2011 Medicaid EP Qualifies to Receive First Payment in 2012 Medicaid EP Qualifies to Receive First Payment in 2013 Medicaid EP Qualifies to Receive First Payment in 2014 Medicaid EP Qualifies to Receive First Payment in 2015 Medicaid EP Qualifies to Receive First Payment in 2016 2011$21,250.00$0.00 2012$8,500.00$21,250.00$0.00 2013$8,500.00 $21,250.00$0.00 2014$8,500.00 $21,250.00$0.00 2015$8,500.00 $21,250.00$0.00 2016$8,500.00 $21,250.00 2017$0.00$8,500.00 2018$0.00 $8,500.00 2019$0.00 $8,500.00 2020$0.00 $8,500.00 2021$0.00 $8,500.00 TOTAL Incentive Payments $63,750.00 *

10. Slide 10 Sorry no money for you!

11. Slide 11 Medicare EHR Incentive Program Eligible professionals, eligible hospitals, and critical access hospitals (CAHs) must successfully demonstrate meaningful use of certified electronic health record technology every year they participate in the program.

12. Slide 12 Medicaid Incentive Program Eligible professionals may qualify for incentive payments if they adopt, implement, upgrade or demonstrate meaningful use in their first year of participation. EP’s must successfully demonstrate meaningful use after year 1.** In order to get the money…

13. Slide 13 Louisiana EHR Incentive Program Eligible Professionals (EPs) are: – physicians – nurse practitioners, – certified nurse-midwives, – dentists, – optometrists, – physician assistants (who furnish services in a FQHC or RHC that is led by a physician assistant). Important Dates for EP Attestation – Tuesday, January 20, 2015 -- 1st Day to Attest Using Flexibility Rule – March 31, 2015 - End of Program Year 2014 – April 1, 2015 - Start of Program Year 2015 – March 31, 2017 - Deadline to begin participation in program http://new.dhh.louisiana.gov/index.cfm/page/1159

14. Slide 14 2014 CEHRT Flexibility Rule Delays due to: – software development – certification – implementation – testing – delay in release of the product by the EHR vendor You cannot use the Flex rule due to: – Financial Issues; – Inability to meet one or more measures; – Staff turnover or change; – Provider waited too long to engage a vendor; – Refusal to purchase the requisite software; – Providers who fully implemented 2014 Edition CEHRT and can report in 2014.

15. Slide 15 MEANINGFUL USE STAGE 2

16. Slide 16 What are the criteria's for MU Stage 2? EP’s must complete 20 objectives  17 core objectives  3 objectives out of 6 from menu set  9 Clinical Quality Measures Hospitals must complete 19 objectives  16 core objectives  3 objectives out of 6 from menu set  16 Clinical Quality Measures http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Stage_2.html

17. Slide 17 Clinical Quality Measures EPs must report on 9 of the 64 approved CQMs Eligible Hospitals must report on 16 of the 29 approved CQMs 9 recommended eCQMs for the adult population & pediatric population Selected CQMs must cover at least 3 of the 6 National Quality Strategy domains: Medicaid EPs will electronically report their CQM data to their state 1. Patient and Family Engagement 2. Patient Safety 3. Care Coordination 4. Population/Public Health 5. Efficient Use of Healthcare Resources 6. Clinical Process/Effectiveness

18. Slide 18 MU Stage 2 Core

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21. Slide 21 MU Stage 2 Menu

22. Slide 22 PATIENT CENTERED CARE

23. Slide 23 Defining Patient Centered Care Patient’s needs, safety, and interests must be the foundation of all care delivery Physician-directed Personal physician/clinician- Empanelment Team-based medical practice Whole person orientation- patient centered Coordinated and/or integrated care Quality and safety are prioritized Enhanced access is available Payment appropriately recognizes the added value to patients who have a PCMH

24. Slide 24 Defining Patient Centered Care Patient Centered Care builds on the foundational structure of the Chronic Care Model http://www.improvingchroniccare.org/index.php?p=the_chronic_care_model&s=2

25. Slide 25 Safe services that avoid injuries to patients Timely care delivery that reduces wait times Effective and accessible high quality health care that’s based on scientific knowledge Efficient services that avoids waste of equipment, supplies, ideas & energy Patient-centered care that is respectful of and responsive to patient needs Equitable and unvaried care due to differences in gender, ethnicity, location and socioeconomic status IOM Quality Chasm Report definition of high quality care

26. Slide 26 Alignment of MU and Patient Centered Care Patient Centeredness Physician-directed Personal physician/clinician- Empanelment Team-based medical practice Whole person orientation- patient centered Coordinated and/or integrated care Quality and safety are prioritized Enhanced access is available Meaningful Use Safe Timely Effective and accessible Patient-centered Efficient Equitable and unvaried Patient and Family Engagement Patient Safety Care Coordination Population/Public Health Efficient Use of Healthcare Resources Clinical Process/Effectiveness

27. Slide 27 Deep Dive on Patient Centered & MU Activities You’ve got questions? We’ve got answers!

28. Slide 28 Deep Dive on Patient Centered & MU Activities

29. Slide 29 THANK YOU Deborah Johnson Ingram, PCDC Kelly Maggiore, LPHI