(MUHIT) Assistant VP, Quality Solutions Group CA

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1 Meaningful Use of Health IT () Jennifer Lenz Assistant VP, Quality Solutions Group CA

2 ABOUT TODAY S PRESENTATION NCQA Role in P4P P4P Alignment with CMS EHR Incentive Program: MY 2011 Requirements Scoring Documentation Demonstration of MY 2011 Submission 2

3 NCQA S ROLE IN PAY FOR PERFORMANCE NCQA is the Data Aggregator and provides technical support for the Integrated Healthcare Association s Pay for Performance program Measure development Develops technical specifications Provides policy clarifications Data aggregation and reporting Aggregates, validates, reports 3

4 NCQA S ROLE IN PAY FOR PERFORMANCE Clinical Measures Patient Experience Measures Audited Rates using Admin Data OR Audited Rates using Admin Data PAS Scores Survey Tools Plans Group Vendor Group Data Aggregator: NCQA produces one set of scores per Group Physician Group Report Health Plan Report Report Card Vendor 4 4

5 P4P Alignment with CMS EHR Incentive Program: ARRA: CMS EHR Incentive Program implemented in 2011 Measures of Meaningful Use: 25 measures, 15 Core and 10 menu Crosswalk of IT-Enabled Systemness Prioritization and Alignment 14 of the 15 measures selected by CMS to be in the Core Set were considered d a top priority it for IHA Full alignment with Core + 2 Menu + Care Management 5

6 DOMAIN Alignment with CMS +Care Management IT-ENABLED SYSTEMNESS IT Survey + Care Management IT SURVEY Population Management +Decision Support at Point of Care 6

7 MY 2011 Requirements Measures 1-15: Alignment with Core Set 1. CPOE 2. Drug-drug and drug-allergy interaction 3. Problem List and Dx 4. E Rx 5. Active medication list 6. Active allergy list 7. Demographics 8. Vital Signs 9. Record smoking status 10. Report ambulatory clinical measures to CMS 11. Implement one clinical decision support tool 12. Provide patients with e-copy of health information 13. Provide clinical summaries for office visits 14. Capability to exchange key clinical information 15. Protect e-health information 7

8 MY 2011 Requirements Measures 16 17: Selected From Menu Set 1. Generate patient lists by specific conditions 2. Send patient reminders for preventative/follow-up p care Measure 18: Chronic Care Management 1. Chronic Care Management for Diabetes, Depression and one other Clinically Important Condition 8

9 MY 2011 Requirements Scoring and Documentation Attestation only, no documentation attached for measures 1-18 Audit 5% of all submissions Office of the National Coordinator-Authorized Testing and Certification i Bodies (ONC-ATCB) certified software must be used to get full credit for measures POs using an Electronic Health Record (EHR) that is NOT ONC-ATCB Certified are eligible for 75% of the possible points for measures

10 MY 2011 Requirements Scoring and Documentation Percent of PCPs Meeting the Intent of the Measure Points per Measure for ONC-ATCB Certified Software Points per Measures for Non-Certified Software (75% of Possible Points) Weighted score calculated for POs who submit the number of PCPs meeting the functionality of a measure using both ONC-ATCB certified software and non-certified software. For example, 100 out of 100 PCPs meet the criteria 25 out of 100 PCPs use ONC-ATC certified software: (25%* 5) = out of 100 PCPs use non certified software: (75%*3.75) = 2.71 Total Number of points = =

11 MY 2011 Requirements Scoring and Documentation Link to Demonstration for Survey Submission 11

12 Survey Demo 12

13 Survey Demo 13

14 Survey Demo 14

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