IPA and HITECH Act Sajid Ahmed MPD/ PDM 1

IPA and HITECH Act Sajid Ahmed MPD/ PDM 1

"Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives." President Barack Obama;Address to Joint Session of Congress; February 24th, 2009 MPD/ PDM 2

Important Definition Important Definition Electronic Health Record (EHR) is an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization. [1] [1] Defining Key Health Information Technology Terms, released May 2008, report funded by the Office of the National Coordinator on Health information Technology (ONC), www.nahit.org MPD/ PDM 3

Health IT Funding Summary On February 17th, 2009, President Obama signed the 2009 American Recovery and Reinvestment Act, (ARRA) allocating over $45 billion for health information technology (HIT). The Health Information Technology for Economic and Clinical Health Act (HITECH), a provision of the ARRA legislation will be distributed as follows: $43 billion incentive payments for EHR use. $2 billion is available for grants and loans for health information technology advancement. MPD/ PDM 4

Medicare Incentives Medicare will provide up to $44,000 per provider, broken down in yearly payments as shown below. MPD/ PDM 5

Medicaid (Medi-Cal) Incentives Medicaid may provide up to $65,000 per provider, also broken down in yearly payments as shown below. To receive funding, providers must qualify by 2016. MPD/ PDM 6

Hospital Incentives Each eligible hospital will receive an amount equal to at least $2 million MPD/ PDM 7

Where Do We Stand? "There may not have been an experience that demonstrates, for me or the country, more powerfully the need for electronic health records... than Katrina" Mike Leavitt, U.S. Department of Health and Human Services Secretary; MPD/ PDM 8

A Plan MPD/ PDM 9 9

Purpose To dramatically improve safe and secure patient and provider access to personal health information and decision-making processes, benefiting the health and wellbeing, safety, efficiency, and quality of care for all residents of Los Angeles County. MPD/ PDM 10 10

The Role of Health IT & Exchange While EHRs offer much promise, Health IT is not a panacea; its use alone will not transform the health care delivery system, improve efficiency and quality, or reduce costs Health IT is a collection of tools like any other; their value is determined by their effective or meaningful use Health IT is instrumental in supporting the transformation of our healthcare delivery system by improving patient and provider access to information and improving decision making processes -California Health IT & Exchange Strategic Plan MPD/ PDM 11 11

Regional Center (REC) Cooperative Agreement Program 70 (or more) RECs across the U.S. will be supported to Serve a defined geographic area that does not overlap any other REC s services area Support at least 100,000 primary care providers in achieving meaningful use of EHRs and enabling nationwide HIE $640 million in federal funding $30 million maximum per REC Health IT RECs Funding-Partnership Summary Year Federal Amount of Costs Recipient Amount of Costs 1 90 percent 10 percent 2 90 percent 10 percent 3 10 percent 90 percent 4 10 percent 90 percent MPD/ PDM 12 12

REC Critical Components Centralized oversight with decentralized services Centralized Services Group Purchasing of 2-5 EHR Products List of vetted/approved products and consultants, standardized EHR contracts, hardware group purchasing, etc. Online support, educational materials, and learning collaboratives Evaluation of services and Federal reporting Coordination with EHR Loan Fund Coordination and management of HIT consultant certification and Internships Development of standardized processes used by RECs Local Services On-site and off-site services tailored to individual providers HIE Support Identification of potential candidates for funding support Documentation and dissemination of training materials and best practice data Coordination with workforce and training programs MPD/ PDM 13 13

We would argue that it is more cost effective and efficient to wire up thousands of doctors through provider groups that can afford to acquire, deploy, train and maintain these systems than it is for tens of thousands of individual doctors to try to find the time to select, purchase, learn and use a plethora of HIT products. In other words, by wiring up 150 groups across California that include 59,000 doctors, it will be far easier to create interconnectivity than it would be individually wiring up each doctor one at a time. -Bill Barcellona V.P. Government Affairs California Association of Physician Groups MPD/ PDM 14

Medical groups rank cost of running a practice as No. 1 worry August 12, 2009 Bernie Monegain, Contributing Editor ENGLEWOOD, CO The 2009 Medical Group Management Association survey reveals the three top challenges of running a group practice remain the same as in 2008, with money worries at the top. According to "Medical practice today: What members have to say," the top three concerns are: 1. Dealing with operating costs that are rising more rapidly than revenues; 2. Maintaining physician compensation levels in an environment of declining reimbursement; and 3. Selecting and implementing a new electronic health record. http://www.healthcarefinancenews.com/news/medical-groups-rankcost-running-practice-no-1-worry MPD/ PDM 15

"There are three ways to handle change. You can fight it and die; accept it and survive; or, lead it and prosper." MPD/ PDM 16

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Payment Schedule Up front allowable costs for EHR purchase Up to 5% to facilitate purchase per provider # Medi-Cal Providers IPA?PPG funding opportunity $ 25,000 0.85 $ 21,250 $ 29,750 $ 1,487.50 1,000 $1,487,500 $ 10,000 $ 8,500 $ 10,000 $ 8,500 $ 10,000 $ 8,500 $ 10,000 $ 8,500 $ 10,000 $ 8,500 Total $ 63,750 MPD/ PDM 18

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Thank you Sajid Ahmed Director, Health Information Technology L.A. Care sahmed@lacare.org HealthIT@lacare.org Sign-up for regular updates from CHHS, get involved: HIT&E@chhs.ca.gov Up-to-date information on State and Federal activities: www.hie.ca.gov MPD/ PDM 21 21