The NC Medicaid EHR Incentive Program. Presented by: Rachael Williams, Assistant Program Manager

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1 The NC Medicaid EHR Incentive Program Presented by: Rachael Williams, Assistant Program Manager

2 The first milestone on this journey is AIU.

3 AIU Meaningful Use is the goal.

4 CMS Vision Stage 3: Improved Outcomes 2016 Stage 2: Advanced Clinical Processes 2014 Stage 1: Data capture and sharing

5 3,379 EPs 87 EHs $128,475,924 June 2013

6

7 MU Payments by EP Specialty 247 EPs representing 15 specialties Pediatrics 131 Nurse practitioner 33 General/family practice 22

8 EPs are exceeding the required thresholds Example: Measure: Use computerized order entry for medication orders Required threshold: 30 percent Range: 34 percent percent Average: 80 percent

9 Mean = 98% Mean = 98% Mean = 97% Mean = 80% Threshold = 80% Mean = 87% Threshold = 80% Threshold = 80% Threshold = 40% Threshold = 30%

10 Selected Clinical Quality Measures Pediatricians asthma General/family practice diabetes Overall smoking cessation

11 Plans for Data Patterns that could be useful in outreach Sharing data with provider organizations

12 Meeting Stage 1 MU - Program Year 2013 and Beyond 13 Core Measures 5 Menu Measures 6 CQMs Meaningful Use 5

13 Core

14 Menu

15 EP Stage 1 CQM Reporting Requirements 3 Core 3 Alternate 3 Additional 6 to 9 CQMs CQMs (report even if zero) CQMs (1 for every core zero, if applicable) CQMs (required for all) SUCCESS! 15

16 Stage 1 Changes Patient Volume Medicaid-enrolled, regardless of payment liability Can now include Medicaid expansion programs funded by Title 21 funds More flexibility around their 90-day reporting period Practice Predominantly reporting period More flexibility around six-month reporting period Exemption from Hospital-Based Exception

17 Stage 1 Changes - Measures Core: CPOE erx Vital Signs Reporting CQMs Exchanging key clinical information Menu: Public health reporting

18 Stage

19 Meaningful Use Timeline Stage 1 Changes Effective - EHs 1 st day EHs may attest for MU with Stage 1 Changes Stage 2 MU Effective - EHs 9/4/12 10/1/12 1/1/13 12/31/12 4/1/13 10/01/13 1/1/14 Stage 2 Final Rule Released Stage 1 Changes Effective - EPs 1 st day EPs may attest for MU with Stage 1 Changes Stage 2 MU Effective - EPs **Note: There will be new 2014 certification standards and your system must be upgraded to allow for these changes. So this 90 days is giving providers a grace period from the 365-day requirement to allow for adjustment to the new standards.

20 Meeting Stage 2 MU 17 Core Measures 3 Menu Measures 9 CQMs Meaningful Use 5

21

22

23

24 EP Stage 2 CQM Reporting Requirements - update 64 CQMs 15

25 Six Key Health Care Policy Domains: 1. Patient and Family Engagement 2. Patient Safety 3. Care Coordination 4. Population and Public Health 5. Efficient Use of Healthcare Resources 6. Clinical Processes/Effectiveness

26 Public Health Required Core Measures: NCIR Electronic lab reporting Optional Menu Measures: Syndromic Surveillance Cancer Registry Other disease registries

27 State Support of NC HIE NC HIE is the state-designated entity for health information exchange Opt-out legislation NC DHHS issues policy statement to leverage NC HIE for business purposes Electronic submission of clinical quality measures through the NC HIE required to satisfy Stage 2 MU Subsidizing the cost of connectivity for paid Medicaid EHR Incentive Program participants

28 NC Medicaid s Support Strategy Medicaid EHR Incentive Program participants required to use NC HIE Value-added propositions available for all providers: Focus on Public Health Initiatives: One pipe between NC Immunization Registry and NC HIE One pipe between NC Central Cancer Registry and NC HIE One pipe for all other public health reporting for Stage 2 MU Disease registries accessible on the NC HIE Focus on safety-net providers Reduce provider burden by subsidizing cost

29 NC Medicaid s Preparation for MU Stage 1 MU NC-Medicaid Incentive Payment System (NC-MIPS) Manual key-in of aggregate data Stage 2 MU NC HIE as conduit for exchange and electronically reporting: Immunizations; Reportable labs; Patient information to cancer and disease registries; and, Clinical quality measures (Quality Reporting Document Architecture I/III)

30 NC s Strategy to Mitigate Barriers Vendor cost Subsidizing HIE-side costs Leveraging a third-party aggregation tool to extract data Working with vendors who represent the largest number of MU paid practices Privacy/Security Provider outreach and training on safeguards Provider Readiness Targeted outreach Time/Resources needed to meet MU requirements Connection to technical resources

31 Best Practices Physician Hires/Transitions No prior attestations for Medicare or Medicaid Print-offs Reports

32 Best Practices/Lessons Learned Understand what measures you can attest to before getting started Work with your vendor to ensure your EHR is certified for all the measures you can attest to Get the whole team involved.

33 Best Practices/Lessons Learned KEEP ALL DOCUMENTATION EHR report printouts, Measure sets, Data used, Anything having to do at all with the attestation. The EP is going to be held accountable for all the information they attest to so be able to prove everything!

34 Additional Resources **Check out our podcast series!!** NC Medicaid EHR Incentive Program website: CMS Registration website: n.asp NC-MIPS Attestation Portal: ONC Certification Product List: NC DHHS Health IT website: 34

35 Contact Us Our website is your one-stop shop for all MU & EHR information, be sure to bookmark it & check out the podcast series! WE VE MOVED! Also the Help Desk is moving in-house as of June 1, For questions about the program/process/nc-mips Help Desk questions, etc.:

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