NY Medicaid. EHR Incentive Program

Transcription

1 Eligible Hospitals Participation Year 2-3 (MU1) Webinar 1

2 Background Original Legislation The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009 (ARRA). The HITECH Act Established: Medicaid Medicare Office of the National Coordinator for Health Information Technology (ONC) Certified EHR Technology Goals of the HITECH Act: Improve patient quality of care Promote the adoption and meaningful use of health information technology Increase health information exchange Standardize health information technology 2

3 Medicaid Provides incentive payments to: eligible professionals eligible hospitals as providers: adopt, implement, or upgrade, and subsequently: demonstrate meaningful use of ONC certified EHR technology 3

4 Eligible Hospitals Acute Care Hospitals At least 10% Medicaid patient volume throughout all participation years. An average patient length of stay of 25 days or fewer CMS Certification Number (CCN) that falls in the range or May be eligible to receive both Medicaid and Medicare Incentive Payments Children's Hospitals Hospital that is separately certified as a children's hospital Predominantly treats individuals under the age of 21 No Medicaid patient volume requirements CCN that falls in the range

5 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS Walkthrough 5

6 What is Meaningful Use (MU)? Meaningful Use means providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity. Achieving Meaningful Use Using certified EHR in a meaningful manner Using certified EHR technology for electronic exchange of health information to improve quality of health care Using certified EHR technology to submit clinical quality and other measures Meaningful Use Stages Stage 1 sets the baseline for electronic data capture and information sharing Stage 2 builds upon Stage 1 measures to grow the MU of CEHRT Stage 3 will continue to expand MU and be developed through future rule making 6

7 Participation Year 2-3 (MU1) Meaningful Use Requirements EHs must attest to having met 17 out of 22 Meaningful Use Stage 1 objectives and report on 15 Clinical Quality Measures: 12 required core objectives and, 5 objectives out of a menu set of 10 Based on Inpatient and Emergency Department (POS 21 or 23) Participation Year 2-3 Attestation Reporting Period: Continuous 90 day / 1 quarter reporting period in the Federal Fiscal Year All Meaningful Use attestation should fall under the same reporting period Attestation for participation year 2/3 (2014) ends on September 30, 2014 Attestation grace period: December 29,

8 AIU/Meaningful Use Reporting Each participation year, hospitals must attest to Adoption/ Implementation/Upgrade (AIU) or Meaningful Use of certified EHR technology. Medicaid (1 st Participation Year): AIU Medicaid (2 nd /3 rd Participation Years): Meaningful Use Medicare (All Participation Years): Meaningful Use In any year that a hospital is required to attest to Meaningful Use for both programs, Medicare Meaningful Use attestation must be completed prior to attesting for Medicaid. 8

9 EHR Reporting Periods in PY2013 Hospital Participating In: Payment Year Medicaid Incentive Program Only Medicaid 1 st, then Medicare in same FY Medicaid 1 st, then Medicare in a later FY Medicare and Medicaid Simultaneously / Medicare 1 st, then Medicaid in a later FY 1 st payment year AIU AIU (Medicaid); MU, 90 Day Period (Medicare) AIU MU, 90 Day Period 2 nd payment year MU, 90 Day Period MU, 1 quarter reporting period MU, 90 Day Period MU, 1 quarter reporting period 3 rd payment year MU, 1 quarter reporting period MU, 1 quarter reporting period MU, 1 quarter reporting period MU, 1 quarter reporting period CMS Keyword: FAQ10826 (EH Reporting Period Table) EHR Reporting Period based on the Federal Fiscal Year: October1-September 30 9

10 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS Walkthrough 10

11 MU Stage 1 Core Set Objectives Eligible Hospitals (EH) must attest to all 12 MU Stage 1 Core Set objectives. MU Stage 1 Core Set Requirements EHs must attest to all 12 core objectives: 9 core threshold objectives 3 core activity objectives Participation Year 2: 90 day or one quarter reporting period in the Federal Fiscal Year Participation Year 3: One quarter (2014 Only) reporting period in the Federal Fiscal Year For a full list, please consult the CMS MU Stage 1 Requirements Summary 11

12 MU Stage 1 Core Set Objectives Core Objective Measure (1-9) Min. Threshold 1 Use Computerized Provider Order Entry (CPOE) 30% 2 Implement drug interaction checks Enable EHR Functionality 3 Maintain problem list 80% 4 Maintain active medication list 80% 5 Maintain medication allergy list 80% 6 Record demographics 50% 7 Record vital signs 50% 8 Record smoking status 50% MU Stage 1 Core Objectives on next slide. For a full list of Meaningful Use objective details please consult the CMS Meaningful Use Website 12

13 MU Stage 1 Core Set Objectives (Cont d) Core Objective Measure (10-15) Min. Threshold 9 Implement clinical decision support rule Implement 1 Rule 10 Provide electronic copy of health information 50% 11 Provide electronic copy of discharge instructions 50% 12 Protect electronic health information Security Risk Analysis 2013 Change to MU Stage 1 Core Requirements Electronic transmission of key clinical information was removed as a Stage 1 core requirement for Payment Year 2013 and beyond. CQM reporting transitioned from a core requirement to a definition requirement of MU For a full list of Meaningful Use objective details please consult the CMS Meaningful Use Website 13

14 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS Walkthrough 14

15 MU Stage 1 Menu Set Objectives In addition to meeting all MU Stage 1 Core Objectives, EHs must also attest to an addition subset of MU Stage 1 Menu Set Objectives. MU Stage 1 Menu Set Requirements EHs must attest to 5 out of 10 menu set requirements: Public Health Reporting (PHR) Requirement: Must select 1 of 3 PHR Objectives Participation Year 2: 90 day or one quarter Participation Year 3: One quarter (2014 Only) reporting period in the Federal Fiscal Year For a full list, please consult the CMS Meaningful Use Website 15

16 MU Stage 1 Menu Set Objectives Menu Objective Measure (1-10) Min. Threshold Public Health Rep. 1 Implement drug formulary checks Enable EHR functionality 2 Record advance directives 50% 3 Incorporate clinical lab test 40% 4 Generate patient lists Generate at least 1 report 5 Identify patient-specific education resources 10% 6 Perform medication reconciliation 50% 7 Provide summary care record 50% 8 Submit immunization registries data Perform 1 test X 9 Submit reportable lab results Perform 1 test X 10 Submit syndromic surveillance data Perform 1 test X 16

17 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS Walkthrough 17

18 Clinical Quality Measures (CQMs) Clinical Quality Measures (CQMs) can be measures of processes, experiences and/or outcomes of patient care, observations or treatment that relate to one or more quality aims for health care such as effective, safe, efficient, patientcentered, equitable, and timely care. CQMs Requirements EHs must report on all 15 clinical quality measure: CMS CQM Specification Webpage HITSP Quality Measures Technical Note 18

19 CQM Measures CQM Description NQF ED-1 Median time from ED arrival to ED departure for admitted ED patients NQF 0495 ED-2 Admit decision time to ED departure time for admitted patients NQF 0497 Stroke-2 Discharged on anti-thrombotic therapy NQF 0435 Stroke-3 Anticoagulation therapy for atrial fibrillation/flutter NQF 0436 Stroke-4 Thrombolytic therapy NQF 0437 Stroke-5 Antithrombotic therapy by end of hospital day two NQF 0438 Stroke-6 Discharged on statin medication NQF 0439 Stroke-8 Stroke education NQF 0440 Stroke-10 Assessed for rehabilitation NQF 0441 *Report all CQMs, even if zeroes are produced by certified EHR system. For a full list of CQM details please consult the CMS Clinical Measures List 19

20 CQM Measures (Cont d) CQM Description NQF VTE-1 Venous Thromboembolism (VTE) prophylaxis NQF 0371 VTE-2 Intensive Care Unit (ICU) VTE prophylaxis NQF 0372 VTE-3 VTE Patients with overlap of anticoagulation therapy NQF 0373 VTE-4 VTE Patients receiving Unfractionated Heparin (UFH) dosages/platelet count monitoring by protocol (or nomogram) NQF 0374 VTE-5 VTE discharge instructions NQF 0375 VTE-6 Incidence of potentially preventable VTE NQF 0376 *Report all CQMs, even if zeroes are produced by certified EHR system. For a full list of CQM details please consult the CMS Clinical Measures List 20

21 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS Walkthrough 21

22 Public Health Reporting CMS Meaningful Use Stage 1 Menu Set objectives require EHs to select one of three Public Health Reporting (PHR) objectives. EH must perform at least one test of certified EHR technology's capacity to submit electronic data to the public health agency EH is then required to perform a follow-up submission if the test is successful EHs must attest to 1 of 3 PHR objectives: Submit immunization registries data Submit syndromic surveillance data Submit lab results data Frequently Asked Questions CMS allows providers to use fictional data for testing if the public health agency allows it Failing the test still meets the CMS objective for MU Stage 1 22

23 MU Stage 1 PH Matrix Measure Immunizations (M) Syndromic Surveillance (M) NY City Report To Citywide Immunization Registry (CIR) NYC DOHMH NYC Department of Health and Mental Hygiene NYC DOHMH NY State (outside of NY City) Report To NYS Immunization Information System (NYSIIS) NYSDOH Electronic Clinical Laboratory Reporting System (ECLRS) NYSDOH Electronic Lab Reporting (M) Electronic Clinical Laboratory Reporting System (ECLRS) NYSDOH Electronic Clinical Laboratory Reporting System (ECLRS) NYSDOH Helpful Resources New PH Website: Support MUPublicHealthHELP@health.state.ny.us 23

24 Public Health - One Click Away 24

25 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS Walkthrough 25

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35 Overviews and Walkthroughs Website Look for Participation Year 1 (A/I/U) Resources EH Participation Year 1 Webpage Interactive EP Participation Year 1 Walkthrough EH Participation Year 1 Presentation Hospital Workbook Look for Participation Year 2 and 3 (MU Stage 1) Resources EH Participation Year 2 webpage EH Participation Year 3 webpage EH Participation Year 2/3 Presentation Hospital Workbook 35

36 Details and Deadlines Dual Eligible Hospital MU Stage 1 attestations will be reported in the CMS Registration and Attestation System Hospitals must finish the attestation process in MEIPASS Providers must print, sign, and return (by mail) an attestation form before payment may be issued Medicaid Only Eligible Hospital (EH) MU Stage 1 attestations will be reported in MEIPASS All EH 2014 MU Stage 1 and Stage 2 reporting is based on a fiscal year quarter regardless of what participation year the EH is in. will accept PY2 (MU1) attestations until December 29, 2014 MU Stage 1 requirements have changed based on new CMS 2013 guidance outlined in the Stage 2 Final Rule 36

37 Meaningful Use Resources CMS Meaningful Use Stage 1 Resources Meaningful Use Website CMS Frequently Asked Questions CMS Clinical Quality Measures (CQMs) Resources CMS CQM Specification Webpage HITSP Quality Measures Technical Note 37

38 State Resources Provider Information on emedny.org Hospital Webpage MEIPASS: EH Login emedny LISTSERV Other Resources New York State Medicaid HIT Plan (NY-SMHP) CMS Website for the Medicare and Medicaid s ONC Home Page Additional Resources 38

39 Questions? CMS Help Desk Program Registration, Meaningful Use, CQM 1 (888) Support Team Option 1: epaces, ETIN, MEIPASS, Enrollment, General Questions Option 2: Calculation, Registration, Eligibility, Reviews, Rejections hit@health.ny.gov 1 (877) Version