NY Medicaid. EHR Incentive Program

Transcription

1 Eligible Professionals Participation Year 2 (MU1) Webinar 1

2 Background Original Legislation The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009 (ARRA). The HITECH Act Established: Medicaid Medicare Office of the National Coordinator for Health Information Technology (ONC) Certified EHR Technology Goals of the HITECH Act: Improve patient quality of care Promote the adoption and meaningful use of health information technology Increase health information exchange Standardize health information technology 2

3 Medicaid Provides incentive payments to: eligible professionals eligible hospitals as providers: adopt, implement, or upgrade, and subsequently: demonstrate meaningful use of ONC certified EHR technology 3

4 What are the patient volume criteria? Eligible Professionals must meet one of the following conditions throughout all participation years: Demonstrate a minimum 30% Medicaid patient volume, or Be a pediatrician* and demonstrate a minimum 20% Medicaid patient volume, or Practice predominantly in a Federally Qualified Health Center or Rural Health Center and demonstrate a minimum 30% patient volume attributable to needy individuals * For the purposes of the Medicaid, NY defines a pediatrician as an M.D. or D.O. who satisfies at least one of the following: 1. Has a current board certification in pediatrics or a pediatric subspecialty from the American Board of Pediatrics (ABP) or the American Osteopathic Board of Pediatrics (AOBP) 2. Focuses on treating patients 18 years old and younger, and attests that the majority of care (at least 50% of encounters) were for patients 18 years old or younger 4

5 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS and Meaningful Use 5

6 What is Meaningful Use (MU)? Meaningful Use means providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity. Achieving Meaningful Use Use certified EHR in a meaningful manner Use certified EHR technology for electronic exchange of health information to improve quality of health care Use certified EHR technology to submit clinical quality and other measures Being a Meaningful User Have to have 50% of their total patient encounters at locations where certified EHR technology is available Would base all meaningful use measures only on encounters that occurred at locations where certified EHR technology is available 6

7 Meaningful Use Requirements Participation Year 2 EPs must attest to having met 20 out of 25 meaningful use stage 1 objectives: 15 required core objectives and, 5 objectives out of a menu set of 10 Requirement: Must pick 1 of 2 public health reporting objectives Participation Year 2 Attestation Continuous 90 day period within the participation year All Meaningful Use Stage 1 reporting should fall under the same reporting period Meaningful Use reporting may be yes/no or numerator/denominator attestation Attestation for participation year 2 ends on March 31, 2013 Some exclusion apply to certain eligible professionals 7

8 EHR Reporting Periods Meaningful Use Stage 1 begins in participation year 2 of the EHR Incentive Program and continues to participation year 3. Participation Year 1 Must attest to Adopt/Implement/Upgrade to a certified EHR system Participation Year 2 Report on Meaningful Use Stage 1 for any continuous 90 day period during the participation year Participation Year 3 Report on Meaningful Use Stage 1 for the entire participation year Participation Year 4-6 TBD 8

9 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS and Meaningful Use 9

10 MU Stage 1 Core Set Objectives Eligible Professionals (EP) must attest to all 15 MU Stage 1 Core Set objectives. MU Stage 1 Core Set Requirements EPs must attest to all 15 core objectives: 10 core threshold objectives 5 core activity objectives Participation Year 2: 90 day reporting period in the calendar year (2012) Participation Year 3: 1 year reporting period in the calendar year (2013) For a full list, please consult the CMS MU Stage 1 Requirements Summary 10

11 MU Stage 1 Core Set Objectives Core Objective Measure (1-9) 1 Use Computerized Provider Order Entry (CPOE) 30% Min. Threshold 2 Implement drug interaction checks Enable EHR Functionality 3 Maintain problem list 80% 4 Generate E-prescribing (erx) 40% 5 Maintain active medication list 80% 6 Maintain medication allergy list 80% 7 Record demographics 50% 8 Record vital signs 50% 9 Record smoking status 50% MU Stage 1 Core Objectives on next slide. For a full list of Meaningful Use objective details please consult the CMS Meaningful Use Website 11

12 MU Stage 1 Core Set Objectives (Cont d) Core Objective Measure (10-15) Min. Threshold 10 Report clinical quality measures (CQMs) Report 6 CQMs 11 Implement clinical decision support rule Implement 1 Rule 12 Provide electronic copy of health information 50% 13 Provide clinical summaries 50% 14 Capability to electronic exchange of clinical information Performed 1 test 15 Protect electronic health information Security Risk Analysis. For a full list of Meaningful Use objective details please consult the CMS Meaningful Use Website 12

13 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS and Meaningful Use 13

14 MU Stage 1 Menu Set Objectives In addition to meeting all MU Stage 1 Core Objectives, EPs must also attest to an addition subset of MU Stage 1 Menu Set Objectives. MU Stage 1 Menu Set Requirements EPs must attest to 5 out of 10 menu set requirements: PHR Requirement: Must pick 1 of 2 public health reporting objectives Participation Year 2: 90 day reporting period in the calendar year (2012) Participation Year 3: 1 year reporting period in the calendar year (2013) For a full list, please consult the CMS Meaningful Use Website 14

15 MU Stage 1 Menu Set Objectives Menu Objective Measure (1-10) Min. Threshold Public Health Rep. 1 Implement drug formulary checks Enable EHR Functionality 2 Incorporate clinical lab-test results 40% 3 Generate patient lists Generate 1 Report 4 Send patient reminders 20% 5 Provide patient electronic access 10% 6 Identify patient-specific education resources 10% 7 Perform medication reconciliation 50% 8 Provide summary care record 50% 9 Submit immunization registries data Perform 1 test X 10 Submit syndromic surveillance data Perform 1 test X. For a full list of Meaningful Use objective details please consult the CMS Meaningful Use Website 15

16 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS and Meaningful Use 16

17 Clinical Quality Measures (CQMs) Clinical Quality Measures (CQMs) can be measures of processes, experiences and/or outcomes of patient care, observations or treatment that relate to one or more quality aims for health care such as effective, safe, efficient, patientcentered, equitable, and timely care. CQMs Requirements EPs must attest to 6 out of 41 CQMs: 3 Core / Alternate Core Clinical Quality Measures, and 3 Clinical Quality Measures out of 38 from menu set 17

18 CQM Core Objectives Core Objective Measure (1-3) 1 Hypertension: Blood Pressure Measurement NQF Preventive Care and Screening Measure Pair: Tobacco Use Assessment Tobacco Cessation Intervention 18 NQF / PQRI Number NQF Adult Weight Screening and Follow-up NQF 0421 / PQRI 128 If the EP has a zero denominator for any above measures then select an alternate core objective measure to satisfy the three core objective requirement requirement. Alternate Core Objective Measure (1-3) 1 Weight Assessment and Counseling for Children and Adolescents 2 Preventive Care and Screening: Influenza Immunization for Patient >= 50 Years Old NQF / PQRI Number NQF Childhood Immunization Status NQF For a full list of CQM details please consult the CMS Clinical Measures List NQF 0041 / PQRI 110

19 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS and Meaningful Use 19

20 Public Health Reporting CMS Meaningful Use Stage 1 Menu Set objectives require EPs to select one of two Public Health Reporting (PHR) objectives. EP must perform at least one test of certified EHR technology's capacity to submit electronic data to the public health agency EP is then required to perform a follow-up submission if the test is successful EPs must attest to 1 of 2 PHR objectives: Submit immunization registries data Submit syndromic surveillance data Frequently Asked Questions CMS allows providers to use fictional data for testing if the public health agency allows it Initial testing can be done once at the group level to suffice for all EPs under that group Follow up submissions must be by individual EP Failing the test still meets the CMS objective for MU Stage 1 If infrastructure doesn t exist then the EP must choose PHR objective that is achievable 20

21 Immunizations Registries Immunization exchange must be reported to one of the two NYS Immunization Registries based on where the immunization is administered. Measure: Performed at least one test of certified EHR technology's capacity to submit electronic data to immunization registries and follow up submission if the test is successful. New York State Immunization Information System (NYSIIS) For NYS providers outside of the five boroughs of New York City Meaningful Use and Data Exchange Testing Resources NYSIIS Frequently Asked Questions Technical Support: or Program Support: or Citywide Immunization Registry (CIR) For NYS providers inside the five boroughs of New York City Meaningful Use and Data Exchange Testing Resources Support: or

22 Syndromic Surveillance Syndromic Surveillance Reporting must be reported to one of the two NYS Immunization Registries based on where the surveillance takes place. Measure: Performed at least one test of certified EHR technology's capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful. Electronic Clinical Laboratory Reporting System (ECLRs) Currently only supporting Hospitals outside of the five boroughs of New York City Meaningful Use and Syndromic Surveillance Resources Future support for Eligible Professionals Support: or Primary Care Information Project (PCIP) For NYS providers inside the five boroughs of New York City Meaningful Use and Syndromic Surveillance Resources (NYC) Support: 22

23 Meaningful Use Stage 1 Introduction to Meaningful Use Meaningful Use Stage 1 Core Objectives Meaningful Use Stage 1 Menu Objectives Clinical Quality Measures Public Health Reporting MEIPASS and Meaningful Use 23

24 MEIPASS and Meaningful Use Medicaid Administrative Support Service (MEIPASS) Providers do not need to re-register to the All MEIPASS prerequisites are still valid for participation year 2 All Eligible Professional (EP) MU Stage 1 attestations will be reported in MEIPASS Providers must print, sign, and return (by mail) an attestation form before payment may be issued will start accepting participation year 2 attestations in the 4 th quarter of calendar year 2012 until March 31,2013 Providers must attest to the Medicaid patient volume to maintain eligibility in the 24

25 Meaningful Use Resources CMS Meaningful Use State 1 Resources Meaningful Use Website CMS Frequently Asked Questions (FAQs) CMS Clinical Quality Measures (CQMs) Resources Clinical Quality Measures Website Guide to Clinical Quality Measures Clinical Quality Measure Reporting Measure Table 25

26 State Resources Program Resources Provider Information on emedny.org Application Process Overview MEIPASS: EP Login Other Resources New York State Medicaid HIT Plan (NY-SMHP) CMS Website for the Medicare and Medicaid s ONC Home Page 26

27 Questions? CMS Help Desk Program Registration, Meaningful Use, CQM 1 (888) MEIPASS Call Center epaces Password Resets, MEIPASS Access Assistance meipasshelp@csc.com 1 (877) Support Team Calculation, Registration, Eligibility hit@health.state.ny.us 1 (800) Version