Meaningful Use: Terms & Timelines, Changes to Stage 1, and Stage 2 Overview

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1 Meaningful Use: Terms & Timelines, Changes to Stage 1, and Stage 2 Overview NYC REACH Primary Care Information Project NYC Department of Health & Mental Hygiene 1

2 Agenda Terms & Timelines of Meaningful Use Changes to Stage Changes to Stage Clinical Quality Measures in 2014 Stage 2 Overview Resources 2

3 Meaningful Use Stages Each stage gets progressively harder to drive toward the ultimate goal Three Stages of Meaningful Use Improved quality of care Stage 3 Stage 2 Stage 1 3

4 Medicare & Medicaid EHR Incentive Programs Medicare EHR incentive Program Managed by CMS EPs can receive up to $44,000 if participation began by 2012 (over 5 successive years) Payment reductions begin in 2015 for EPs who choose not to participate in either program In the 1 st year and all remaining years, providers must meet the MU measures to get incentive payments. Medicaid EHR Incentive Program Managed by states EPs can receive up to $63,750 (over 6 years of participation) No Medicaid payment reductions if EPs choose not to participate In the 1 st year, providers can receive a payment for adopting, implementing or upgrading to a certified EHR In years 2-6, providers must meet the same MU measures as in Medicare 4

5 Terms Defined: Stage 1 vs. Year 1 Stage Stage 1, 2, 3, refers to the measures you are trying to meet. We are currently in Stage 1. Stage 2 goes into effect in 2014 for providers who started in either 2011 or Year Year 1, 2, 3, etc. refers to the number of years of participation in either of the Meaningful Use incentive programs (i.e. Medicare or Medicaid). Payment Year 1 for Medicaid = Adopt/Implement/Upgrade Each stage will become progressively harder. Payment Year 1 for Medicare = Meet MU stage 1 measures for 90 days 5

6 Medicare Meaningful Use Stage Timeline Each eligible professional will spend 2 years in each measure stage UNLESS year 1 was 2011 an you will have 3 years in Stage 1 1 st Year Stage of Meaningful Use TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD 2017 TBD TBD TBD TBD TBD 6

7 EXAMPLE - Meaningful Use Payment: Medicare (Year by Year) Calendar Year Participation Year Meaningful Use Stage Billing Requirement: Minimum Part B Charges Required to get Max Incentive Max Incentive Amount Qualifying Activity Reporting Period i.e. Must meet measure for how long? 2012 Year 1 Stage 1 $24,000 $18,000 Meet Measures 2013 Year 2 Stage 1 $16,000 $12,000 Meet Measures *2014 Year 3 Stage 2 $10,667 $8,000 Meet Measures 2015 Year 4 Stage 2 $5,333 $4,000 Meet Measures 90 days in 2012 Full CY days in 2014 Full CY 2015 * In 2014, every provider will have a 90 day reporting period to allow EHR vendors to update their applications with Stage 2 changes 7

8 EXAMPLE - Meaningful Use Payments: Medicaid (Year by Year) Calendar Year Payment Year Meaningful Use Stage Fixed Incentive Amount Qualifying Activity Reporting Period i.e. must meet measures for how long? Eligibility Period: Medicaid Pt. Vol Calculation based on 2012 Year 1 N/A $21,250 AIU N/A 90 days in Year 2 Stage 1 $8,500 Meet measures 90 days in 2013 *2014 Year 3 Stage 1 $8,500 Meet measures 90 days in Year 4 Stage 2 $ 8,500 Meet measures Full CY days in past 12 months 90 days in past 12 months 90 days in past 12 months * In 2014, every provider will have a 90 day reporting period to allow EHR vendors to update their applications with Stage 2 changes 8

9 Medicaid Meaningful Use Stage Timeline Each eligible professional will spend 2 years in each measure stage NOTE: The Adopt/Implement/Upgrade (AIU) is NOT considered part of Stage 1 1 st Year Stage of Meaningful Use AIU TBD TBD TBD TBD TBD 2012 AIU TBD TBD TBD TBD 2013 AIU TBD TBD TBD 2014 AIU TBD TBD 2015 AIU TBD 2016 AIU AIU

10 Agenda Terms & Timelines of Meaningful Use Changes to Stage Changes to Stage Clinical Quality Measures in 2014 Stage 2 Overview Resources 10

11 Stage 1 Changes in 2013 Computerized Provider Order Entry (CPOE) Record & Chart Changes within Vital Signs Health Information Exchange 11

12 CPOE (Core Measure 1) Structured Medication Ordering Change to Stage 1 Objective: Inclusion of an alternate measure - more than 30 percent of medication orders created by the EP during the EHR reporting period are recorded using CPOE; based on the total number of medication orders created during the reporting period Optional CPOE denominator is available in 2013 and beyond for Stage 1 Original Stage 1 Measure Stage 1 Option for

13 Vital Signs (Core Measure 8) Collect Structured Data Change to Stage 1 Objective: Age limitations on growth charts and blood pressure; The vital signs changes are optional in 2013, but required starting in 2014 Original Stage 1 Measure Stage 1 Option for

14 Electronic Exchange of Key Clinical Information (Core Measure 14): Care Coordination Original Stage 1 Measure Stage 1 Change for

15 Agenda Terms & Timelines of Meaningful Use Changes to Stage Changes to Stage Clinical Quality Measures in 2014 Stage 2 Overview Resources 15

16 On-line Access & e-copy: Patient Engagement Measure of the New Objective: 50% of patients are provided access to their information Change in 2014 coincides with the 2014 certification and standards criteria Original Stage 1 Measure Stage 1 Change for

17 Agenda Terms & Timelines of Meaningful Use Changes to Stage Changes to Stage Clinical Quality Measures in 2014 Stage 2 Overview Resources & Upcoming Webinars 17

18 Electronic Submission of CQMs Beginning in 2014 Beginning in 2014, all Medicare-eligible providers in their second year (and beyond) of demonstrating meaningful use must electronically report their CQM data to CMS. Medicaid providers will report their CQM data to their state, which may include electronic reporting. 18

19 Clinical Quality Measures (CQMs) in 2014 Prior to 2014 Beginning in Guidance/Legislation/EHRIncentivePrograms/2014_ClinicalQualityMeasures.html 19

20 CQM Selection & HHS Priorities All providers must select CQMs from at least 3 of the 6 HHS National Quality Strategy domains: Patient & Family Engagement Patient Safety Care Coordination Population & Public Health Efficient Use of Healthcare Resources Clinical Processes/Effectiveness 20

21 Aligning CQMs Across Programs The same CQMs are used in multiple quality reporting programs for reporting beginning in 2014 Other programs include Hospital IQR Program, PQRS, CHIPRA, and Medicare SSP and Pioneer ACOs Hospital Inpatient Quality Reporting Program Physician Quality Reporting System Children s Health Insurance Program Reauthorization Act Medicare Shared Savings Program and Pioneer ACOs 21 21

22 Agenda Terms & Timelines of Meaningful Use Changes to Stage Changes to Stage Clinical Quality Measures in 2014 Stage 2 Overview Resources 22

23 When Do I Start Stage 2? 23

24 Stage 2 Overview Stage 1 Stage 2 Eligible Professionals 14 Core Measures 5 of 10 Menu Measures 19 Total Objectives Eligible Professionals 17 Core Measures 3 of 6 Menu Measures 20 Total Objectives 24

25 What to Expect in Stage 2 What s New Secure Messaging Family Health History Imaging Results Registry Reports Progress Notes What s Moved Lab Results Patient Lists Patient Education Summary of Care Records Medication Reconciliation Immunizations Patient Reminders Online Patient Information 25

26 New Stage 2 Core Objectives Patient Engagement Patient Portal relevant -Provider must use secure electronic messaging to communicate with patients on relevant health information -Patient Access Objectives: Provide patients with the ability to view online, download, and transmit their health information within four business days of the information being available to the EP -Patient Access Measures: More than 5% of patients must send secure messages to their provider More than 5% of patients must access their health information on-line 26

27 New Stage 2 Core Objectives Electronic Exchange Electronic Information Exchange -Provider must send a summary of care record for more than 50% of transitions of care and referrals. -Provider must electronically transmit a summary of care for more than 10% of transitions of care and referrals. -At least one summary of care document must be sent electronically to a recipient who has a different EHR vendor OR to CMS to test EHR capability. 27

28 Agenda Terms & Timelines of Meaningful Use Changes to Stage Changes to Stage Clinical Quality Measures in 2014 Stage 2 Overview Resources 28

29 Additional Resources My EHR Participation Timeline EHR Incentive Programs: What s New for Stage 1 in 2013 Stage 1 Changes Tipsheet Stage 2 Toolkit 29

30 NYC REACH Resource Library Detailed guides outlining all of the information you need with helpful worksheets 30

31 NYC REACH Member Resources Monthly Member Digests Tips on how to meet the measures Important changes and deadlines Upcoming classes and events Tailored for small and large practices Sent via , available in resource library Please contact us at if you are not receiving your Digest 31

32 Thank You from the PCIP & NYC REACH Teams 32

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