Funding for Health IT and Telehealth Workshop April 8, 2015 Harrisburg, Pennsylvania

Transcription

1 Funding for and Telehealth Workshop April 8, 2015 Harrisburg, Pennsylvania Leila Samy, MPH Rural Health and Veteran Health Office of the National Coordinator US Department of Health and Human Services

2 What I ll Cover Here Leila Samy HHS Office of the National Coordinator 1. Data and trends in and ehealth National, Rural, Critical Access Hospitals (CAH) 2. White House Rural Council initiatives Rural health and Veteran health 3. Links to resources What we have done to support rural health and Veterans Tools and resources for CAHs/rural hospitals adopting health IT Federal financing programs Opportunity for public comment to latest proposed rule regarding health IT certification. 2

3 Hospitals receiving incentive payments for EHR Adoption or Meaningful Use: Click here for animated version 3

4 Percent of Physicians e-prescribing through an Electronic Health Record: Click here for animated version 4

5 Percent of Physicians e-prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, Created by HHS Office of the National Coordinator for, Office of Economic Analysis, Evaluation, and Modeling 5

6 Percent of Physicians e-prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, Created by HHS Office of the National Coordinator for, Office of Economic Analysis, Evaluation, and Modeling 6

7 Percent of Physicians e-prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, Created by HHS Office of the National Coordinator for, Office of Economic Analysis, Evaluation, and Modeling 7

8 Percent of Physicians e-prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, Created by HHS Office of the National Coordinator for, Office of Economic Analysis, Evaluation, and Modeling 8

9 Percent of Physicians e-prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, Created by HHS Office of the National Coordinator for, Office of Economic Analysis, Evaluation, and Modeling 9

10 Percent of Physicians e-prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, Created by HHS Office of the National Coordinator for, Office of Economic Analysis, Evaluation, and Modeling 10

11 Eligible Professionals and Hospitals Paid under the Medicare or Medicaid Electronic Health Record (EHR) Incentive Program Number of Unique Providers Paid Monthly (thousands) Note: Payments for May 2012 and June 2013 include payments to Medicare Advantage providers Jan ,673 unique eligible professionals and hospitals (7 out of 10 of all eligible providers) have received a payment under the Medicare or Medicaid EHR Incentive Program Cumulative Providers Paid ,673 Feb-11 Mar-11 Monthly Total Cumulative Total Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan Feb Mar-13 Apr May Jun Jul Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb Mar , , , , , , ,000 50,000 0 Cumulative Unique Providers Paid Source: CMS EHR Incentive Program Health Information Technology Data as of 03/31/

12 Payments under the Medicare or Medicaid EHR Incentive Program Eligible Professionals and Hospitals $1,800 The Medicare and Medicaid EHR Incentive Programs have cumulatively paid $22.9 billion in incentive payments as of March 2014 Cumulative Total $22,904 $25,000 $1,600 Amount Paid per Month (Millions) $1,400 $1,200 $1,000 $800 $600 $400 Monthly Total Cumulative Total Note: Payments for May 2012 and June 2013 include payments to Medicare Advantage providers. $1,254.5 $20,000 $15,000 $10,000 $5,000 Cumulative Amount Paid (Millions) $200 $0 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 $0 Source: CMS EHR Incentive Program Data as of 03/31/2014 Health Information Technology 12

13 Progress with Adoption of and ehealth HOW ARE WE DOING IN RURAL? 13

14 How Are We Doing in Rural Areas? 60% 50% 40% Basic EHR adoption among office-based physicians in rural areas and small practices Total: 48% Rural: 46% Small: 41% 30% 20% Rural: 38% Small primary care practices: 35% Total: 34% 10% 0% Note: From 2009 to 2011, the adoption rate for rural providers *more than doubled* and the percentage of rural physicians that have adopted EHRs slightly higher than for physicians overall All Physicians Rural Physicians Small Practice Primary Care Physicians Rural refers to physicians in a county outside of a Metropolitan Statistical Area. Small practice primary care physicians refer to primary care physicians in practices with 10 or fewer physicians. Data source: National Ambulatory Medical Care Survey (NAMCS) Electronic Health Record Supplement mail surveys,

15 How Are We Doing in Rural Areas? 100% Percent of pharmacies in urban and rural counties actively prescribing medication electronically 90% 80% 95 % of urban pharmacies enabled on the surescripts network 93% of rural pharmacies enabled on the surescripts network 70% 60% December 2008: Urban 73%, Rural 59% April 2014: Urban 93%, Rural 93% From 2008 to 2014, rural pharmacies actively prescribing medication electronically *increased by more than 50%* 50% Percent Enabled (Urban) Percent Enabled (Rural) 15

16 Payment Rates of Rural and Overall for Hospitals and Professionals December 2014 Hospitals 94% 95% 57% Professionals 64% Rural professionals are participating in the EHR Incentive Programs at a higher rate than the national trend. Rural hospitals are participating at the same rate as all hospitals. Overall Rural Overall Rural

17 Location of Small Rural Hospitals (SRH) and Critical Access Hospitals (CAH) by Attestation Status 89 Percent of CAHs/SRHs Attested to MU Stage 1 December 2014 Map identifies SRHs and CAHs (n=1,541) from the CMS Provider of Services (POS) File and determines attestation status based on CMS EHR Incentive Program. Attested Not Attested from the HHS

18 2013 CAH Survey Data What we ve learned See: 18

19 CAH Progress with Advanced Capabilities As of percent of CAHs had an EHR in place; 62% with an EHR had a fully electronic system, 27% with an EHR had a system that was part electronic and part paper. Most CAHs adopted or planned to adopt (by the end of 2014) telehealth, teleradiology, and capabilities associated with care coordination and health information exchange with other providers and patients. CAHs reported the highest rates of adoption for teleradiology (70%) and telehealth (59%) capabilities. 15% of CAHs reported patient engagement capabilities. 19

20 CAH Challenges and Factors Associated with Advanced Capabilities Financing and workforce related challenges were most commonly reported. CAHs that pooled resources with other hospitals were more likely to have EHR and capabilities related to health information exchange and care coordination CAHs with faster internet upload speeds were more likely to have the capability to provide patients with the option to view, download, and transmit their health information. 20

21 Links to Data on CAH Progress and Challenges ONC Blog Posting: ONC Data Brief: Health Affairs paper on CAH progress and challenges: 21

22 WHAT ARE WE DOING TO HELP? 22

23 Collaborate with and Leverage Federal and private sector partners White House Rural Council Streamline programs serving rural America 1. Technical assistance 2. Funding, Broadband & Workforce 3. Veterans Care Coordination and Quality 23

24 Expand Funding for Rural In late 2011, the President announced an initiative, led by HHS and USDA, to help link rural providers to financing assistance. Financing is cited as the top challenge for rural doctors and hospitals serving remote and poor communities. State-specific workshops: By the end of 2014, we convened workshops to reach doctors, clinics and hospitals in each of 13 states: Iowa, Kansas, Illinois, Texas, Mississippi, Georgia, Michigan, Minnesota, Tennessee, Missouri, Montana, Wyoming and Kentucky. Today, Pennsylvania joins this list of states and bringing this initiative to 14 states! Target populations: We reached rural areas that are poor, frontier, Appalachian and in the Delta, as well as Indian and tribal communities.

25 Current Project Locations Collaborative Rural Health Financing Initiative 25

26 ONC/VA Leveraging to Improve Care Coordination and Quality for Rural Veterans The Veteran Initiated Electronic Care Coordination HHS and VA signed an MOU and launched initiatives to use patient engagement and health information exchange to improve care quality and care coordination for rural veterans that wish to seek care both within the VHA system as well as at their local rural clinic or hospital. These efforts were to address the concern that while nearly 70% of Veterans get health care services at both VA and non-va clinics and hospitals, there is no systematic and streamlined way for VA and non-va providers to exchange the patients health information to coordinate and co-manage care. See our White House blog posting

27 Current Project Locations Veteran Initiated Care Coordination (VIECC) Project 27

28 LINKS AND RESOURCES 28

29 Get involved Contact: Leila Samy, Rural Share: Tools, resources and best practices For more information: Overview of collaborative rural health IT efforts : HHS/USDA collaborative rural health IT funding workshops: HHS/VA projects to improve care coordination and quality for rural veterans.: CAH Survey Data ONC blog posting summarizing results: ONC Data Brief: Health Affairs paper on CAH progress and challenges:

30 Tools and resources for critical access and rural hospitals adopting 30

31 Federal Funding Programs Visit Healthit.gov/RuralHealth Then, click Funding Opportunities Tab for information about USDA Rural Development, Rural Utilities Service and Federal Communications Commission assistance programs. USDA Rural Development,, and Telehealth Program Funding Overview See link to webinar that provides overview of all USDA Rural Development loan and grant programs that fund health IT infrastructure, telehealth equipment, hardware and software and network infrastructure. Access to capital: Insights from a commercial bank This webinar explains the evaluation process commercial banks use to make a decision on a loan. Prepares Rural and Critical Access Hospitals for questions and requests when applying for a loan with a commercial bank, and work to make their loan applications more appealing to lenders. All these resources are available from main landing page: Healthit.gov/RuralHealth 31

32 Opportunity for Public Comment to Proposed HHS Rule Concerning EHR Certification ONC published the 2015 Edition Proposed Rule in the Federal Register on March 30, The comment period is open until May 29, Please consider using the comment template ONC has provided. Read the proposed rule: (public inspection version) Other resources: Press release: op_final_formatted.docx Fact sheet: Program-2015-Edition_FactSheet.pdf ONC regulations: Contact: 32

33 Thank you!