Market View: Total Healthcare Spend
Healthcare presents a sizable growth market offering future opportunities
2007 U.S Total Healthcare Expenditures = $2.1 trillion
(~$7,500 per resident)
2007 Ambulatory spend
$448B on Communication, Technology, Information Systems
~ $3B Software &
Services Spending
Need to size the $3B
plus ARRA $:
• EHR
$448B
Communication, Tech, & IS Spending
•Practice Mgmt
• EMR
• HIE
• CHC
• etc.
The American Medical Association, National Health Insurer Report Card www.ama-assn.org
What is the Impact of ARRA/HITECH Act?
The American Recovery and Reinvestment Act contains bonus payments of $44,000 to $64,000 to physicians who
adopt and use EHRs “in a meaningful way”, beginning in 2011 and continuing through 2015 after which doctors
who do not use EHRs will be penalized.
Prevention
Infrastructure,
HIE, CHC, Indian
Health
& Wellness
Telemedicine
Education
& Training
SCHIP
EHR Incentives
Research
In Billions
HHS - $167 Billion in ARRA Funding
• ONC Funding
–
–
–
–
–
Privacy and Security – $24.3 million
NIST – $20 million
Regional HIT Exchange – $300 million
Unspecified – $1.65 billion
Total, HIT - $2 billion
• HRSA – CHC Funding
• CMS Funding:
– State Medicaid Administration – $1.05 billion
– Medicare Administrative Costs – $745.0
million
– Medicaid Administrative Costs – $300 million
– Medicare Incentives – $23.1 billion (available
starting in FY11)
– Medicaid Incentives – $21.6 billion (available
starting in FY11)
– (Total Mandatory Recovery Act HIT Funds
$46.8 billion)
– Capital Improvement Grants- $850 million
for use on capital improvements,
including EHR adoption (will be spent in
FY09)
– Health Information Technology
Systems/Networks Grants- $125 million
(will be spent in FY09)
– Facility Investment Grants- $512.5 million
(will be spent in FY 2010)
– (Total: $1.5 billion)
HRSA – Workforce Training
– Loan Forgiveness - $300 million
– Workforce Training - $200 million
HHS - $167 Billion in ARRA Funding
• Indian Health Service
(IHS) Funding for IT
Adoption
– Certified Electronic Health Record
Adoption - $61.7 million (34.8 in
FY09 and 26.9 in FY10)
•
•
•
•
•
•
CPOE
Clinical Decision Support
Quality Reporting
Health Information Exchange
Certification
Deployment
– Personal Health Record Adoption $2.5 million ($1.7 million in FY09
and $0.8 million in FY10)
– Telehealth and Network
Infrastructure - $16.7 million ($12.7
million in FY09 and $4.0 million in
FY10)
– Administration Costs- $4.1 million
• HHS, AHRQ, and NIH
Comparative Effectiveness
Research
– HHS Discretionary Funding- $400 million
– AHRQ- $300 million
– NIH- $400 million
• HHS Information Technology
Security
– HHS Information Technology Security-$50
million ($31.9 million in FY09, $18.1 million in
FY10)
Non-HHS Funding of Note:
FCC, USDA and Commerce –
Broadband
– $7.3 billion for broadband
How is Sage preparing?
Staying plugged in
• Actively monitoring legislative and regulatory changes
• Ongoing employee and business partner education
Products & Certification
• Sage Intergy EHR v6 – our “meaningful use version”
• ONC-required Meaningful Use certification
• CCHIT 2011 certification
How is Sage preparing?
Advocacy
• Participation in industry groups shaping the dialog with the federal
government
• Written responses to the proposed rules per public comment provision
Readiness
• Education
–
–
–
–
–
Meaningful Use White Paper
Meaningful Use Summits
Educational webinars
Updated stimulus information on www.SageHealth.com
Articles in Sage CheckUp and Sage e-briefs
• Developing practical tools and resources for customers
• Consultative discussions with Sage customers about reaching meaningful
use
The Coming Months
HIT Policy & Standards
Committees deliver and
approve Meaningful Use
Recommendations
State HIE Procurements from
ONC could be released as
early as mid-August
ONC releases HIE
implementation plans and
Regional Extension Center
definitions and procurement
State funding applications
likely due; ONC to issue
guidance on EHR loan
program; ONC to craft
Meaningful Use definition
July 2009
August
October
December
• ONC to release Meaningful
Use definition and CMS to
issue proposed rule by end of
December 2009
Final Rule issued
on Meaningful Use
• 60 day public comment period
Earliest Medicare
payments will be
made available
• First round of administrative
HIT payments could be
released in Q1 2010
January 2010
April
Oct 2010
Meaningful Use Overview
Policy Vision & Goals*
Vision
Enable significant and measurable improvements in population health through
a transformed health care delivery system.
Goals
• Improve quality, safety, and efficiency
• Engage patients and their families
• Improve care coordination
• Improve population and public health
• Ensure privacy and security protections
*Source: Health IT Policy Committee Meaningful Use Workgroup’s June 23, 2009 presentation
Meaningful Use Overview
Regulatory Definition
To be a “meaningful user,” EPs must use a certified EHR to satisfy all Criteria
and all Measures.
In HITECH, Congress specified three types of requirements for meaningful
use:
1. use of certified EHR technology in a meaningful manner (e.g. Electronic Prescribing);
2. that the certified EHR technology is connected in a manner that provides for the
electronic exchange of health information to improve the quality of care; and
3. that, in using certified EHR technology, the provider submits to the Secretary
information on clinical quality measures and such other measures selected by the
Secretary.
CMS Vision for Stages
Requirements Scaling Up Over Time
Stage 1
Stage 2
1. Capturing health information in a
coded format
1. Disease management, clinical
decision support
2. Medication management
3. Support for patient access to their
health information
4. Transitions in care
5. Quality measurement
6. Research
7. Bi-directional communication with
public health agencies
2. Using the information to track key
clinical conditions
3. Communicating captured
information for care coordination
purposes
4. Reporting of clinical quality
measures and public health
information
Stage 3
1. Achieving improvements in
quality, safety and efficiency
2. Focusing on decision support for
national high priority conditions
3. Patient access to selfmanagement tools
4. Access to comprehensive patient
data
5. Improving population health
outcomes
For Stage 2, CMS may also consider applying the criteria more broadly to both the inpatient and outpatient hospital
settings. CMS expects to propose Stage 2 criteria by the end of 2011.
CMS expects to propose Stage 3 criteria by the end of 2013.
Meaningful Use Measures – Stage 1
Measures are grouped into two categories:
Electronic Health Record Technology Functionality
Measures (8)
Clinical Quality Measures (17)
Each measure is linked to a related Meaningful Use Objective
18
Immediate Action for Practices!
• Decide if you will participate
• Pick your program
• Develop detailed implementation plan
–
–
–
–
Set goals & detailed timelines
Set expectations
Gain “buy in”
Plan for the unexpected
• Make EHR selection
• Keep your end goal in mind
• Process Redesign!
Process Redesign | Bottom Line Results
Automating current
manual processes will
provide simple efficiencies
like finding a patient’s
chart in seconds to
complex situations such as
patient flow monitoring
and clinical treatment plan
effectiveness.
The key is to understand
the process before and
after the introduction of
technology into your
practice.
Our staff collaborates with
your team to assess
workflows and design a
system to streamline the
unique needs of your
practice.
Sage Value in Partnership – our program is
growing and offering multiple opportunities to
partner in select areas and/or segments – Referral,
Reseller and Channel Partner Arrangements
Multi-Year Contracts
No Admin Fee
Channel Partner Portal
Attractive Margins
Custom Training
Brian Muck
Vice President - Indirect Distribution
Sage Healthcare Division
4301 W. Boy Scout Blvd.
Suite 800
Tampa, FL 33607
Mobile: 610-334-6165
Fax: 813-207-9922
brian.muck@sage.com
visit us at: www.sagehealth.com