Meaningful Use and the
EHR Incentive Program
NIHB Annual Consumer Conference
EHR Incentive Program
• The Medicare and Medicaid EHR Incentive
Programs will provide incentive payments to
eligible professionals (EPs), eligible hospitals
(EHs) and critical access hospitals (CAHs) as
they adopt, implement, upgrade or
demonstrate meaningful use of
certified EHR technology.
Meaningful Use
• Eligibility
• Certified EHR
• Meaningful Use Measures
• Clinical Quality Measures
Provider Eligibility
Meaningful Use
• Eligibility
• Certified EHR
• Meaningful Use Measures
• Clinical Quality Measures
Certified RPMS EHR Requirements
Name Space
Version
Patch
Release Date
Patient Registration
7.1
9
12/3/10
APCL
Export
3.0
27
11/10/10
APSP
BGP
BJMD
BJPC
BMC
BQI
BRN
Pharmacy MOD-ePrescribing (eRx)
Clinical Reporting System (CRS)
C32
PCC Mgmt Reporting
Referred Care Information System (RCIS)
iCare
Release of Information (ROI)
7.0
11.0
1.0
2.0
4.0
2.1
2.0
1010
3
1
6
7
4/29/11
6/22/11
6/24/11
6/2/11
5/12/11
3/11/11
4/13/11
BYIM
BGO
LR
PXRM
BPHR
Immunization Exchange Message
Electronic Health Record (EHR)
Lab
EHR Reminders
Personal Health Record (PHR)
Central Ensemble
GuardianEdge/ Symantec
2.0
1.1
5.2
1.5
1.0
2009.1.6
8.0
01
8
1027 or 372 or 334
1007
AG
Package or Application
IPSEC (Windows)
VanDyke (AIX)
WinHasher
Universal Client -Continuity of Care Record (CCR)*
1.6
1.0
3
921.0.10414
2/24/11
6/10/11
12/07/10
4/13/10
6/22/11
2011
3/31/11
2010
2010
2011
4/27/11
Meaningful Use
• Eligibility
• Certified EHR
• Meaningful Use Measures
• Clinical Quality Measures
Meaningful Use Measures
• Yes/No Measures
– Implement drug-drug and drug-allergy checks
– Generate at least one report listing patients with a
specific condition
• Measures with Targets
– Record smoking status for more than 50% of
patients
– Provide patient-specific education resources for
more than 10% of patients
Meaningful Use Measures
EP Core Set Measures (15)
EH Core Set Measures (14)
Use CPOE for medication orders
Implement drug-drug and drug-allergy checks
Record demographics
ePrescribing
Maintain up-to-date problem list, medication list, medication allergy list
Record and chart changes in vital signs
Record smoking status
Implement one clinical decision support rule
Report clinical quality measures
Provide patients an electronic copy of health info upon request
Provide clinical summaries for
office visits
Provide electronic copy of discharge
instructions upon request
Capability to electronically exchange key clinical information (perform test)
Protect electronic health information (security risk analysis)
Meaningful Use Measures
EP Menu Set Measures (10)
EH Menu Set Measures (10)
Implement drug formulary checks
Incorporate clinical lab test results into certified EHR
Generate lists of patients by specific conditions
Record advance directives
Send reminders to patients
Provide patients with timely electronic
access to their health information
Use certified EHR to identify and provide patient-specific education resources
Perform medication reconciliation for patients referred to the EP/EH
Provide summary of care records for patients referred to other providers/facilities
Submit electronic data to immunization registries
Submit electronic syndromic surveillance data to public health agencies
Submit electronic data on reportable lab
results to public health agencies
Meaningful Use
• Eligibility
• Certified EHR
• Meaningful Use Measures
• Clinical Quality Measures
Clinical Quality Measures: EPs
• Core/Alternate Core Set (6)
– Hypertension
– Tobacco Use Assessment/Cessation Intervention
– Adult Weight Screening/Follow-up
– Weight Assessment/Counseling for Children
– Adult Influenza Immunization
– Childhood Immunization
• Additional Measures (38)
– Breast Cancer Screening; Cervical Cancer
Screening; Colorectal Cancer Screening
Clinical Quality Measures: EHs
• Emergency Department (2)
– Median time from ED arrival to ED departure for
admitted patients; median time from admit
decision time to ED departure time for admitted
patients
• Stroke (7)
– Anticoagulation for A-fib/flutter, discharge on
statins, stroke education, etc.
• Venous Thromboembolism (6)
– Anticoagulation overlap therapy, discharge
instructions, etc.
Medicare Incentive Program
Requirements and Amounts for EPs who begin
in 2011 or 2012
Year
Requirement
Incentive
1
Demonstrate MU for 90-day period
$18,000
2
Demonstrate MU for full calendar year
$12,000
3
Demonstrate MU for full calendar year
$8,000
4
Demonstrate MU for full calendar year
$4,000
5
Demonstrate MU for full calendar year
$2,000
Medicare Incentive Payments
Payment
Year
First Year EP Demonstrates MU
2011
2012
2013
2014
2015
CY 2011 $18,000
CY 2012 $12,000 $18,000
CY 2013
$8,000
$12,000 $15,000
CY 2014
$4,000
$8,000
$12,000 $12,000
CY 2015
$2,000
$4,000
$8,000
$8,000
$0
$2,000
$4,000
$4,000
$0
$44,000 $44,000 $39,000 $24,000
$0
CY 2016
Total
Medicaid Incentive Payments
Requirements and Amounts for EPs
Year
Requirement
Incentive
1
Adopt/Implement/Upgrade to certified
EHR technology
$21,250
2
Demonstrate MU for 90-day period
$8,500
3
Demonstrate MU for full calendar year
$8,500
4
Demonstrate MU for full calendar year
$8,500
5
Demonstrate MU for full calendar year
$8,500
6
Demonstrate MU for full calendar year
$8,500
EHR Incentive Program Registration
www.cms.gov/ehrincentiveprograms/
EHR Incentive Program Registration
EHR Incentive Program Registration
• Medicare EPs:
– Register with CMS
• Medicaid EPs:
– Register with CMS
– Register with state Medicaid program
• Hospitals:
– Register as dual-eligible
• With CMS for Medicare
• With state Medicaid program for Medicaid
Certified EHR is not required for registration!
Regional Extension Center
The RECs will support and serve health care
providers to help them quickly become adept
and meaningful users of EHRs. RECs are
designed to make sure that primary care
clinicians get the help they need to use EHRs.
• Provide training and support services to
assist providers in adopting EHRs
• Offer information and guidance to help with
EHR implementation
• Provide technical assistance
REC vs Incentive Program
Regional Extension Center
EHR Incentive Program
EHR certification rule
Meaningful use rule
Support providers
and hospitals in
achieving MU
Reward providers
and hospitals for
achieving MU
Provider Responsibilities
Regional Extension Center
EHR Incentive Program
• Sign up with REC
• Register with CMS/State
• Go live with certified EHR
• Achieve MU
• Achieve MU
• Attest/submit each year
Completing Milestone =
REC Funding
Demonstrating MU =
Incentive Payment
Regional Extension Center
EHR Incentive Program
ONC
$
NIHB AI/AN REC
1.
2.
3.
CMS
$
IHS
EPs/EHs
Provider signs up with NIHB AI/AN REC
Provider “goes live” with certified EHR
Provider achieves meaningful use
NIHB REC M1: Sign Up
http://nihb.org/rec/rec.php
NIHB REC M2: Go Live
NIHB REC M3: Achieve MU
• Medicare EPs
– Provide CMS Attestation ID
• Medicaid EPs and others
– Provide attestation data from RPMS-EHR reports
Things to Do Now
• Sign up with the NIHB REC
• Designate a Meaningful Use Coordinator
• Install RPMS EHR patches and other required
software applications for certification
• Review MU Measures and redesign workflows
• Register for EHR Incentive Program (pending
launch of State program for Medicaid
EPs/EHs)
2011 Timeline
• Hospitals
– Medicare: Last 90-day period within FY 2011 to
demonstrate MU is July 1 – Sept 30, 2011
– Medicaid: Check with state about deadlines
• Providers
– Medicare: Last 90-day period within CY 2011 to
demonstrate MU is Oct 1 – Dec 31, 2011
– Medicaid: Check with state about deadlines
Resources
• www.usetinc.net/ehr
– Resources
– Frequently Asked Questions
• www.cms.gov/ehrincentiveprograms/
– EHR Incentive Program Eligibility, Registration
– Status of State Medicaid Programs
– Frequently Asked Questions
• www.ihs.gov/meaningfuluse/
– Resources
– MU Listserv
– RPMS-EHR Certification Info
Contact
Vicki French
United South and Eastern Tribes
615-467-1578
vfrench@usetinc.org
Vicki.French@ihs.gov