Meaningful Use 2.0. Presentation to the CIBH September 2, 2015

Transcription

1 Meaningful Use 2.0 Presentation to the CIBH September 2, 2015

2 Funding Background 2 On February 17, 2009, the President signed the American Recovery and Reinvestment Act of 2009 (ARRA). Title XIII of Division A and Title IV of Division B of ARRA, together cited as the Health Information Technology for Economic and Clinical Health Act (HITECH Act). The HITECH Act authorizes incentive payments to eligible Medicare and Medicaid providers for meaningful use of certified electronic health record (EHR) technology California funded four Regional Extension Centers to support over 10,000 Primary Care providers to select and implement and EHR through Stage 1 Meaningful Use. RECs were not funded to assist specialists or groups with more than 10 providers DHCS awards 4 vendors contracts for REC like support for Meaningful Use of EHRs.

3 What is New? 3 $37,500,000 over three years has been awarded to continue to address Medi- Cal provider challenges to meaningfully use EHR technology, now: include specialists (Board Certified MDs, NPs and PAs) and providers practicing in large size practice settings provides funding for EHR, MU support Any Stage includes support for HIE Continues for 3 years starting July 2015

4 Awardees 4 Object Health is one of four awardees under the Medi-Cal Technical Assistance funding to support providers in Meaningful Use. Awardees are: CalHIPSO 3200 EPs Cal Optima- 800 EPs L.A. Care Health Plan EPs Object Health 1400 EPs

5 Medi-Cal meaningful use refresher

6 Medi-Cal Program Overview 6 Program runs from 2011 through is the LAST Year to start the program! Maximum incentive amount is $63,750 (across 6 years of program participation). No Medicaid payment reductions if you choose not to participate (for now). In the first year, providers can receive an incentive payment for adopting, implementing, or upgrading a certified EHR (AIU) = $21,500 In all remaining years, providers will meet meaningful use guidelines.

7 Medi-Cal Meaningful Use Program Definitions TODAY 7 CMS Modifications to Meaningful Use in Proposed Rule May 7, This rule is expected to pass as early as September When it does, the DHCS SLR will shut down!

8 Who is eligible? 8 Eligible Professional includes physicians*, nurse practitioners, dentists, certified nurse midwives, optometrists, and physician assistants who, individually or with a group, meet the 30% Medicaid encounter volume (20% for pediatricians) requirement for the Medi- Cal (EHR) Incentive Program. *board certified by a specialty board which is a member of the American Board of Medical Specialties (except family practice, obstetrics and gynecology, pediatrics, and general internal medicine)

9 Eligible Provider Special Considerations 9 Pediatricians Incentive payments for pediatricians who meet 20% Medicaid patient volume but fall short of 30% Medicaid patient volume are reduced to two-thirds of the incentive payment. These pediatricians would receive $14,167 in the first year and $5,667 in subsequent years. Pediatricians who do qualify with at least 30% Medi-Cal patient volume should not designate themselves as pediatricians and should not upload documentation of board eligibility or board certification. These physicians will receive the full incentive payments. Hospital-Based Disqualification Providers cannot be hospital based. This is defined as furnishing 90% or more of professional services in an inpatient hospital setting or emergency room connected to a hospital in the calendar year preceding the payment year. Services delivered in an outpatient clinic located in a hospital do not count as hospital-based.

10 Eligible Provider 30% Medi-Cal Encounter Documentation 10 Encounter is One Provider/One Day Multiple encounters with the same provider on the same day can only be counted as one encounter. Definition of Medi-Cal Encounter Effective Jan 1, 2013, providers may count billable services provided to Medi-Cal enrolled patients as Medi-Cal encounters regardless of whether Medi-Cal paid for any part of the services. To be considered billable, services must be covered by Medi-Cal. Providers rendering services to Medi-Cal-enrolled patients, regardless of whether they are approved by Medi-Cal as fee-for-service or managed care providers, may be eligible for Medi-Cal EHR Incentive Program payments.

11 Medi-Cal Incentive Program Timing is Everything 11 Incentive Program Payments to Providers Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 AIU $21,250 Last year Is 2016 First MU $8, days MU $8,500 Full year MU $8,500 Full year MU $8,500 Full year MU $8,500 Full year Performance & Payment possible in same year Performance of one full calendar year, Attestation and Payment the following year Exception: 2015 all submissions are for 90 days

12 Object Health approach

13 Object Health Program Goals 13 Work with our health plan, medical association, community association, professional society, and other partners to provide relevant and effective outreach and education to support program enrollment and achievement of meaningful use by eligible professionals in our Target Group 2016 IS THE LAST YEAR TO START THE MU PROCESS FOR MEDI-CAL. Support Eligible Professionals in successfully attesting to meaningful use by staying informed of federal rulings and updates and changes to the State Level Registry (SLR) THE SLR WILL CLOSE AS SOON AS THE NEXT WEEK TO ATTESTATIONS FOR 2015 AND WILL NOT OPEN UNTIL THE MIDDLE OF 2016! Deploy proven techniques for successful EHR Implementation and Project Management to ready practices for Meaningful Use- MEANINGFUL USE REQUIRES ONLY 90 DAYS THIS YEAR AND WILL CHANGE IN SUBSEQUENT YEARS!

14 Object Health Program Goals 14 Provide industry standard Workflow Redesign for optimized use of EHR to achieve Meaningful Use Assist Eligible Professionals in connecting to a clinically appropriate and qualified HIE infrastructure Provide EP's with customized, effective and efficient assistance that is tailored to their unique needs in attaining and advancing in the stages and years of Meaningful Use Support and actively manage the attestation process in the SLR with the eligible providers Assist specialists and solo practitioners with cost effective EHR solutions.

15 Team 15 Object Health is partnering in each Target Group for enrollment and technical assistance. Partner Enrolling HIE Onsite MU Tech Assist CDCB-Funded LHDs San Joaquin and Stanislaus Imperial County Riverside and San Bernardino Orange County Intrepid Ascent Intrepid Ascent ICMS IEEHRC E2o Health

16 CDBC-Funded Local Health Departments 16 Intrepid Ascent is currently working with 10 Local Health Departments (LHD) through the Lifetime of Wellness and Prevention First programs CDC funding through the Chronic Disease Control Branch (CDCB) of CDPH Assisting LHDs in promoting the monitoring of clinical quality measures for diabetes and hypertension that are also part of the MU program Approved by DHCS to support these county LHDs with MU through the EHR TA program, including behavioral health: Alameda, Fresno, Madera, Merced, Sacramento, San Joaquin, Shasta Potentially BHS only in Solano, Monterey, and Tulare

17 Medi-Cal Incentive Program Re-Cap 17 PAYOFF Scheduled for Stage 1 Scheduled for Stage 2 New AIU MU-90 MU Year 1 MU 1-90 MU MU Year 2 MU 1-90 MU MU Year 3 MU 90 MU MU Year 4 MU 90 MU MU Providers scheduled for Stage 1 in 2015 can do MU with Exclusions. Providers scheduled for Stage 2 in 2015 must do MU (new definition). Everyone does only 90 continuous days of reporting for 2015 ONLY. Everyone does 365 days in 2016 if you have already completed a 90 day.

18 Contact Us 18 If you have questions or would like more information please contact us at: Lori L. Hack, Object Health Mark Elson, Intrepid Ascent