Michigan Medicaid EHR Incentive Program Update November 28, Jason Werner, MDCH
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1 Michigan Medicaid EHR Incentive Program Update November 28, 2012 Jason Werner, MDCH
2 Program Summary This ARRA funded program provides financial incentives (100% Federal) to eligible Medicaid professionals and hospitals to meaningfully use (MU) a certified EHR technology. Program administration (90% Federal) is the responsibility of DCH.
3 Program Registration Process
4 Who Is Eligible to Receive the Medicaid Incentive Payments? Eligible Professionals: (Non-hospital based with at least 30% Medicaid volume) Physicians/Pediatricians (20%) Optometrists Dentists Certified Nurse Mid-wives Nurse Practitioners Physician Assistants (PA) practicing in a PA-led FQHC or Rural Health Clinic Eligible Hospitals: Acute care -- at least 10% Medicaid volume Children s hospitals Critical access hospitals
5 Certified EHR Technology Certified = Capable of meeting Meaningful Use (MU). Office of National Coordinator (ONC) maintains the list of complete EHRs and EHR modules that have been tested and certified. There are now 6 certifying bodies and nearly 2,900 certified products.
6 Registration Year 1 In year one of the program, Medicaid providers and hospitals must attest to Adopting, Implementing or Upgrading to a certified EHR system No measures need to be submitted
7 Registration Year 2 In year 2 of the program, Medicaid professionals and hospitals must meet a set of predetermined measures for a 90 day period during the current year. EPs 15 Core Measures, 5 of 10 Menu Measures, 6 Clinical Quality Measures EHs- 14 Core Measures, 5 of 10 Menu Measures, 15 Clinical Quality Measures
8 EP Core Measures
9 EP Menu Measures
10 EP Clinical Quality Core Set
11 EP Clinical Quality Menu Set
12 Stage II of MU Set to launch on January 1, 2014 for EP s Measures are further enhanced from Stage I More Measures Higher Thresholds Public health measures moving towards production More of an emphasis on electronic information exchange
13 Where is Michigan in all of this? January 3, 2011 Providers could begin registering for Medicaid EHR incentive program at CMS. January 21, Michigan s on-line registration and attestation system went live within CHAMPS. April 20, 2012 Michigan went live with collection of MU attestations (Year 2).
14 Registrations/Payments As of 11/27/12 Registered Paid Dollars Paid (In Millions) EP 3,178 1,671 $34.8 EH $68.9 Totals 3,286 1,753 $103.7
15 Medicare? CMS is running a similar program for Medicare providers. Professionals can only claim one incentive program (either Medicaid or Medicare). Very similar eligibility criteria. 9,119 Medicare providers have registered with 2,608 having received a payment.
16 Closing Remarks Very interested in Non-Medicaid providers as well. Working very closely with MiHIN and MDCH Data Hub. Certified EHR technology is the foundation for Health Information Exchange.
17 Questions?
18 MICHIGAN HEALTH INFORMATION NETWORK SOM Presentation
19 Unraveling the Current Information Tangle Patients & Families Physicians Public Health Lab tests & XRAYs Specialty Providers Hospitals & Clinics Medications Insurance Companies Copyright MiHIN
20 Desired Solution Patients & Families Physicians Public Health Lab tests & XRAYs Specialty Providers Hospitals & Clinics Medications Insurance Companies Copyright MiHIN
21 MiHIN Relationship with the State of Michigan State of Michigan Internal MDCH Data Hub CORE SHARED SERVICES MiHIN & the Qualified Data Sharing Organizations Transparency via HIT Commission Monitoring External Shared Governance via MiHIN BOD Copyright MiHIN
22 Medicaid s Examples of Core Shared Services Security services Health Provider Directory (Master Clinicians Index) Message routing Identity management Transaction logging & Universal Audit Repository Consent management Terminology services Transformation services Master Person Index Record Locator Service & Patient Directory Services NwHIN gateway Sub-scribe to Alerts & Notifications DIRECT HISP Copyright MiHIN
23 Public Act Created HIT Commission Michigan s Statewide Governance Model HIT Commission Collaboration MiHIN PRIVATE & PUBLIC REPRESENTATION Copyright MiHIN
24 LEGAL INFRASTRUCTURE FOR DATA SHARING QUALIFIED DATA SHARING ORGANIZATION AGREEMENT (QDSOA) Definitions Basic Connection Terms Basic BAA Terms Minimal Operational SLA Contracting & Payment Cyber Liability Insurance Termination Use Case #1 MiHIN Data Sharing Agreement Use Case #2 Use Case #3 AN UMBRELLA MASTER AGREEMENT Copyright MiHIN
25 Overlapping Phases Knowledge & Discovery Consumer Empowerment Closing the Gaps Who, What, Where, & How Public Health as a Focal Point for Integration EVOLUTIONAL PHASES OF THE MICHIGAN MODEL Copyright MiHIN
26 MiHIN Early Use Cases PUBLIC HEALTH HEALTH PROVIDER DIRECTORY ALERTS & NOTIFICATION (e.g. ADT & MTM) CCD Push Gateway (e.g. Care Summary & Referrals) SERVICE ORIENTED ARCHITECHTURE Copyright MiHIN
27 Three Types of Data Sharing Possible Level One DIRECT Secure Messaging provider to provider or end system communication Level Two Clinical Messaging & results delivery via sub-state HIEs & qualified organizations Level Three Cross document sharing ( Query for Care Summaries) MICHIGAN MODEL DATA SHARING LEVELS Copyright MiHIN
28 LEVEL ONE: DIRECT SECURE MESSAGING DIRECT HISP Security Copyright MiHIN
29 LEVEL TWO: CLINICAL MESSAGING SUB-STATE HIEs Doctors & Community Providers Data Warehouse MSSS MDCH Data Hub Medicaid State LABS INTEGRATINO N WITH THE STATE OF MICHIGAN Copyright MiHIN
30 LEVEL THREE: DOCUMENT SHARING ACROSS REPOSITORIES HIE HIE HIE HIE XCA, XDS, PIX, PDQ,, etc. Patient History Lookup Copyright MiHIN
31 Michigan s Health Information Services Cloud (HISC) State of Michigan MDCH Data Hub Payers HISC PARTICIPANTS Copyright MiHIN
32 Michigan s Health Information Services Cloud (HISC) State of Michigan Initiate MCIR MDSS BoL MSSS MPI HPD Proxy MDCH Data Hub Force HPD Direct MiHIN Enterprise Architecture Security Interface Monitoring Help Desk Audit Trail Data Enrichment Alerts & Notifications Directory Services Error Checking CLOUD SERVICES Routing Identity Standards Gateway SOM Care Bridge w/ Repository QOs w/ Repositories Beacon w/ Repository Behavioral Health Unified Repository 32
33 Public Health Use Case-Vaccinations State of Michigan MDCH Data Hub VACCINATIONS SERVICE ORIENTED ARCHITECHTURE Copyright MiHIN
34 Public Health Use Case-Vaccinations Using DIRECT Standards Gateway State of Michigan MDCH Data Hub VACCINATIONS SERVICE ORIENTED ARCHITECHTURE No Change Required! Copyright MiHIN
35 Health Provider Directory (HPD) Serve as the source of trusted provider information for secure routing and HIE Sets the stage for provider relationship management Technology & vendor agnostic to future proof HIE evolution Copyright MiHIN
36 Complete Example MiHIN Service Evolution HL7 ADT Sub- State Health Plans MTM High Utilization Alert Patient Data HPD Care Team SERVICE EVOLUTION Patient To Provider Attribution Model Provider Data from message and Attribution Routing Copyright MiHIN
37 THANK YOU! See: MORE INFORMATION ABOUT MIHIN Copyright MiHIN
38 Michigan HIE The MDCH Data Hub Presenters: Tina R. Scott, MDCH Cynthia Green-Edwards, MDCH
39 Michigan HIE MSSS SUB-STATE HIEs Data Warehouse MDCH Data Hub Medicaid State LABS Doctors & Community Providers 39
40 MDCH Data Hub Goals *Support the EHR Incentive Programs and meaningful use objectives *Enhance interoperability of the Medicaid Enterprise * Uniquely identify Michigan s citizens across multiple programs to improve health outcomes * Uniquely identify providers across multiple programs to improve coordination of care * Leverage infrastructure for new initiatives *Reduce fraud by increasing connectivity/communication among MDCH systems *Streamline data flow among MDCH systems and external partners *Enhance security 40
41 MDCH Data Hub MSSS MiHIN MDCH Data Hub connection * Use Cases Submit to MCIR Submit to MDSS * Submit to MSSS * MCIR from other states * MCIR forecast/history * State Labs Send Lab Results * PD Provider Directory * Medical * Non-Medical * Organizations State Labs StarLIMS * MPI Master Person Index Batch - Data Warehouse * Real-time - underway * Households 41 Medicaid DW
42 MDCH Data Hub Data Warehouse MiHIN (Michigan Health Information Network) Meaningful Use, Analytics Michigan Disease Surveillance System Security Services MCIR (Immunization Registry) Web Services Data Audit & Logging Meaningful Use Tracking Labs Michigan Syndromic Surveillance System MPI Integration Engine MDCH Data Hub Provider Directory CHAMPS (MMIS) Cancer Registry Chronic Disease Registry (to be developed) Vital Records (Birth / Death) Registry MDCH Systems 42
43 MDCH Data Hub Data Warehouse Meaningful Use, Analytics LABS MCIR Security Services Data Audit & Logging Meaningful Use Tracking MDSS MSSS MPI Integration Engine MDCH Data Hub Provider Directory CHAMPS Cancer Registry Chronic Disease Registry (to be developed) Vital Records (Birth / Death) Registry MDCH Systems 43
44 Future Outlook of State of Michigan Information Exchange Federal Government MiHIN Security MDCH Data Hub Data Audit & Logging Meaningful Use Tracking Sub- State HIEs MPI Integration Engine Provider Directory 44 State Courts
45 Master Person Index (MPI) What is MPI? Matches and links person-level records across data sets This matching and linking is required in order to integrate data from multiple sources Data integration enables a 360-degree view of a person MPI/Data Integration Value Enables assessment of longitudinal data from birth to end of life Provides ability to analyze results, influence outcomes, reduce costs Identifies duplicates within same source/system Current/future plans Current - matching/linking 17 data sets in Michigan s Enterprise Data Warehouse (EDW) Next expand to include real-time source system data Future continue adding data sources (MDCH and other) Future identify members of a household Future add Provider Index (matching/linking/identification of Provider-level records) 45
46 Provider Index (PI) *Collaboration with MiHIN for development of Health Provider Directory *Leverage development to expand to Provider Index *Include provider/organizations beyond HIE 46
47 MDCH Data Hub * ScottT1@Michigan.gov 47
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