Preparing for Meaningful Use Stage 2 Bill Beighe, CIO Becky Shoemaker, HIE Project Manager

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1 SCHIE Mission 1 To improve the quality and efficiency of health care for all stakeholders in the Santa Cruz community. To deliver technology assistance, guidance and information on best practices to providers with the goal of creating a healthcare delivery system that offers a seamless, integrated experience for patients and providers. Provide services and tools to participating healthcare providers to become meaningful users of EHRs connected to the Santa Cruz Health Information Exchange. To support these efforts that we believe are foundational for Accountable Care, Clinical Integration, Medical Home and payment and health care reform.

2 Preparing for Meaningful Use Stage 2 Bill Beighe, CIO Becky Shoemaker, HIE Project Manager July 11, 2013

3 Slides and Presentation Presentation slides are available at PMG Portal for PMG Providers

4 Covered in this presentation Stage 2 Meaningful Use New clinical quality measures Payment adjustments and hardships

5 Meaningful Use Stage 1 through 3

6 Meaningful Use Stage 1 vs. Stage 2 Stage 1 Stage 2 Focus is on data capturing and sharing Focus: More data and more structured data and advanced clinical processes Emphasis on health information exchange between providers to improve care coordination for patients.

7 Stage 2 Timing Starting in 2014, providers participating in the EHR Incentive Programs who have met Stage 1 for two or three years will need to meet meaningful use Stage 2 criteria. Starting no later than October 2014

8 Medicare MU Incentives

9 Medicaid / MediCal MU Incentives

10 Consolidated Medicare and Medicaid MU Timeline

11

12 Changes to Menu Objective Exclusions You can continue to claim exclusions if applicable, but starting in 2014 these exclusions will no longer count towards the number of menu objectives needed.

13 Changes from Stage 1 to Stage 2 Stage 1 Stage 2 Eligible Professionals 15 core objectives 5 of 10 menu objectives 20 total objectives Eligible Professionals 17 core objectives *must meet all 17 3 of 6 menu objectives **exclusions are not counted 20 total objectives

14 Stage 2 Patient Access Objectives Use secure electronic messaging to communicate with patients on relevant health information. Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP (replaces Stage 1 objective). For more than 10% of transitions & referrals EPs that transition or refer their patient to another setting must provide a summary of care record electronically. SCHIE Webinar in Q4 for in-depth look at patient communication options.

15 New Stage 2 Menu Objectives for EPs Record electronic notes in patient records Imaging results accessible through certified electronic health record technology (CEHRT) Record patient family health history Identify and report cancer cases to a State cancer registry

16 Clinical Quality Measures for 2014 and beyond Beginning in 2014, all providers regardless of their stage of meaningful use will report on CQMs in the same way. EPs must report on 9 out of 64 total CQMs. In addition, all provider must select CQMs from at least 3 of the 6 key health care policy domains recommended by the Department of Health and Human Services National Quality Strategy: 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 For more detailed information on 2014 CQMs and electronic reporting options visit: Guidance/Legislations/EHRIncentivePrograms/Downloads/ClinicalQualityMeasureTipsheet.pdf

17 Payment Adjustments & Hardship Medicare EPs who are not meaningful users will be subject to a payment adjustment beginning on January Santa Cruz Providers are not eligible for hardship exclusions.

18 Payment Adjustment Time Table for EPs

19 19 EP EHR Payment Adjustments Example if Not a Meaningful User in 2014

20 PQRS Incentive Payment and Payment Adjustments In 2013, physicians and other eligible professionals who successfully report quality measure data can earn a 0.5% incentive payment on their total allowed charges for covered Medicare Part B Physician Fee Schedule (PFS) services provided during the reporting period. Earning an incentive payment in 2013 will avoid the 2015 penalty adjustment. Reporting Period * 2016* Incentive Amount 0.5% 0.5% Penalty Amount -1.5% -2.0% *The 2015 payment adjustment is based on PQRS participation during the 2013 reporting period **The 2016 payment adjustment is based on PQRS participation during the 2014 reporting period

21 Summary Stage 2 Core and Menu Objectives

22 Santa Cruz Providers Connect or enhance your connection with the SCHIE Contact us at for more information or see the website Vendor Coordination PMG contracted McKesson and Cal-Med all set Others need to talk to your vendor SCHIE and SC HSA Public Health are coordinating the Public Health Meaningful Use Approach. Webinar targeted for later this summer.

23 MU 2 Timeline Santa Cruz Providers July 2013 Sep Dec 13 Jan-July 14 October 14 Complete checklist IZ Registry Gateway via SCHIE If year 1 is Oct 3 rd Last day to begin 90-day reporting period for CY 2013 Planning and checklist execution Go Live SCHIE Connectivity Go Live by Oct 1 ICD-10 on Oct 1 PQRS (Penalty if not done by 12/31) SCHIE Connectivity

24 Santa Cruz Provider Checklist MU2 Is your software vendor promising MU 2 certification? What are hardware, software, license implications? Pick a target date for MU 2 software upgrade Suggest June 2014 Schedule your upgrade and workflow training Target go-live with MU 2 version Suggest July 2014 Last Date for go-live October 1, 2014

25 Resources

26 Coming up next Direct Messaging July 18 th 12:30pm-1:00pm Registration links available on PMG Portal under Events, Thank you for your participation in todays webinar. Feel free to contact Bill Beighe or Becky Shoemaker at (831) or by