Meaningful Use Stage

Transcription

1 Meaningful Use Stage Marcela Reyes, CHTS- CP Sevocity Product Manager !!

2 ! What is Meaningful Use?! How do I parbcipate?! Medicare or Medicaid?! Register! ADest Meaningful Use Stage 1! MU Stage 2! Clinical quality measures! Payment adjustments and hardships! Medicaid program changes 2

3 Meaningful Use Defined Meaningful use is using certified electronic health record (EHR) technology to: Improve quality, safety, efficiency, and reduce health disparities Engage patients and family Improve care coordination, and population and public health Maintain privacy and security of patient health information 3

4 Meaningful Use Defined (con t) Ultimately, it is hoped that the meaningful use compliance will result in: Better clinical outcomes Improved population health outcomes Increased transparency and efficiency Empowered individuals More robust research data on health systems Meaningful use sets specific objectives that eligible professionals (EPs) and hospitals must achieve to qualify for CMS. 4

5 Stages of Meaningful Use Advanced clinical processes Improved outcomes Data capturing and sharing Stage 2 Stage 3 Stage 1

6 Stages of MU 6

7 Eligibility Medicare? Medicaid? 7

8 8

9 Differences between Programs 9

10 Medicare Payments IncenBve payments depend the program parbcipabon year. The incenbve payment is 75% of your Medicare allowed charges up to a maximum annual cap. As required by law, President Obama issued a sequestrabon order on March 1, Under these mandatory reducbons, Medicare EHR incenbve payments made to eligible professionals and eligible hospitals will be reduced by 2%. 10

11 Medicaid Payments The total maximum incentive amount $63,750 over six years of program participation. Participation in the program does not have to take place across consecutive years can receive the maximum Medicaid incentive payment as long as you begin participating in the program by 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. 11

12 EHR Incentive Registration Sites RegistraBon Sites Medicare Medicare & Medicaid EHR IncenBve Program RegistraBon & ADestaBon System Medicaid Medicare & Medicaid EHR IncenBve Program RegistraBon & ADestaBon System Medicaid State InformaBon 12

13 Meaningful Use Stage Measures 13

14 Meaningful Use Stage 2 Core Objectives EP must meet all 17 Core Objective Measures:

15 Meaningful Use Stage 2 Core Objectives (con t)

16 EP must select 3 out of 6: Meaningful Use Stage 2 Menu Objectives 16

17 2014 Changes 1. EHRs Meeting ONC 2014 Standards starting in 2014, all EHR Incentive Programs participants will have to adopt certified EHR technology that meets ONC s Standards & Certification Criteria 2014 Final Rule 2. Reporting Period Reduced to Three Months to allow providers time to adopt 2014 certified EHR technology and prepare for Stage 2, all participants will have a threemonth reporting period in

18 Aligning CQMs Across Programs CMS s commitment to alignment includes finalizing the same CQMs 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 InpaBent Quality ReporBng Program Physician Quality ReporBng System Children s Health Insurance Program ReauthorizaBon Act Medicare Shared Savings Program and Pioneer ACOs 18

19 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. 19

20 2014 CQMs EPs Report 9 out of 64 CQMs Selected CQMs must cover at least 3 of the 6 NQS domains Recommended core CQMs: 9 for adult populations 9 for pediatric populations 20

21 Sevocity ecqm Manual 21

22 All providers must select CQMs from at least 3 of the 6 HHS National Quality Strategy domains: Selecting ecqms Patient and Family Engagement Patient Safety Care Coordination Population and Public Health Efficient Use of Healthcare Resources Clinical Processes/ Effectiveness 22

23 Payment Adjustments The HITECH Act stipulates that for Medicare EP, subsection (d) hospitals and CAHs, a payment adjustment applies if they are not a meaningful EHR user. An EP, subsection (d) hospital or CAH becomes a meaningful EHR user when they successfully attest to meaningful use under either the Medicare or Medicaid EHR Incentive Program Adopt, implement and upgrade meaningful use A provider receiving a Medicaid incentive for AIU would still be subject to the Medicare payment adjustment. 23

24 EP EHR Reporting Period Payment adjustments are based on prior years reporbng periods. The length of the reporbng period depends upon the first year of parbcipabon. For an EP who has demonstrated meaningful use in 2011 or 2012: Payment Adjustment Year Based on Full Year EHR Repor<ng Period * * Special 3 month EHR reporbng period To Avoid Payment Adjustments: EPs must conbnue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years. 24

25 EP EHR Reporting Period For an EP who demonstrates meaningful use in 2013 for the first Bme: Payment Adjustment Year Based on 90 day EHR Repor<ng Period 2013 Based on Full Year EHR Repor<ng Period 2014* * Special 3 month EHR reporbng period To Avoid Payment Adjustments: EPs must conbnue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years. 25

26 EP EHR Reporting Period EP who demonstrates meaningful use in 2014 for the first Bme: Payment Adjustment Year Based on 90 day EHR Repor<ng Period 2014* 2014 Based * Special on Full 3 month Year EHR EHR Repor<ng reporbng Period period *In order to avoid the 2015 payment adjustment the EP must a:est no later than October 1, 2014, which means they must begin their 90 day EHR reporfng period no later than July 1,

27 EP Hardship Exceptions EPs can apply for hardship exceptions in the following categories: 1. Infrastructure EPs must demonstrate that they are in an area without sufficient internet access or face insurmountable barriers to obtaining infrastructure (e.g., lack of broadband). 2. New EPs Newly practicing EPs who would not have had time to become meaningful users can apply for a 2-year limited exception to payment adjustments. 3. Unforeseen Circumstances Examples may include a natural disaster or other unforeseeable barrier. 4. EPs must demonstrate that they meet the following criteria: Lack of face-to-face or telemedicine interaction with patients Lack of follow-up need with patients 5. EPs who practice at multiple locations must demonstrate that they: Lack of control over availability of CEHRT for more than 50% of patient encounters 27

28 EP Hardship Exceptions EPs whose primary specialties are anesthesiology, radiology or pathology: As of July 1 st of the year preceding the payment adjustment year, EPs in these specialties will receive a hardship exception based on the 4 th criteria for EPs EPs must demonstrate that they meet the following criteria: Lack of face-to-face or telemedicine interaction with patients Lack of follow-up need with patients 28

29 Applying for Hardship Exceptions Applying: EPs, eligible hospitals, and CAHs must apply for hardship exceptions to avoid the payment adjustments. Granting Exceptions: Hardship exceptions will be granted only if CMS determines that providers have demonstrated that those circumstances pose a significant barrier to their achieving meaningful use. Deadlines: Applications need to be submitted no later than April 1 for hospitals, and July 1 for EPs of the year before the payment adjustment year; however, CMS encourages earlier submission For More Info: Details on how to apply for a hardship exception will be posted on the CMS EHR Incentive Programs website in the future: 29

30 Medicaid-Specific Changes Proposed expanded definition of a Medicaid encounter: Include any encounter with an individual receiving medical assistance under 1905(b), including Medicaid expansion populations and zero pay Medicaid claims Permit inclusion of patients on panels seen within 24 months instead of just 12 Permit patient volume to be calculated using last 12 months, instead of on the CY 30

31 Resources CMS EHR IncenBve Programs Web Page EP Clinical Quality Measures For 2014 EHR IncenBve Programs EP 2015 Hardship ExcepBon ApplicaBon Stage 2 SpecificaBon Sheets for EPs 31

32 Sources & References EHRIncentivePrograms/Downloads/Stage2_Guide_EPs_9_23_13.pdf 32