Meaningful Use and Ohio Medicaid
Mel Borkan
June 18, 2010
Meaningful Use As Opposed To???
• ARRA (American Recovery and
Reinvestment Act) …Stimulus $$, recall?
Provided incentive $ for eligible
professionals and hospitals who
become meaningful users of certified
electronic health record technology.
• Medicare’s got a program
• Medicaid’s got a program. Cleverly named:
the Medicaid Incentive Pmt Pgm: MPIP
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What’s This All About? Free Money?
SHOCKINGLY NO!
Actually the meaningful use of certified EHR
technology is one part of a broader Health
Information Technology infrastructure
needed to improve health care quality,
efficiency and patient safety.
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So, This Goes with a Bigger Plan?
• Of course it does!
• So, Ohio, like every other state, has to come
up with a vision and plan to get there for
Health Information Technology (HIT) and the
meaningful use of Electronic Health Record
Technology
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So, This Goes with a Bigger Plan?
Yep, but only if we want the money…and
we don’t want to break the law…and there
is that improve the quality of health care
aspect….
• As Is (where we are now)
• To Be (vision)
• Road Map for getting there
• SMHP
• I-APD
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So Meaningful Use Goes with the big
HIT/EHR work and I’ve got to do what to get
MPIP $?
Per ARRA (American Recovery and
Reinvestment Act) …You have to be an
eligible professional or a hospital who
is a meaningful user of certified
electronic health record technology.
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MPIP EPs
• Eligible professionals (EPs): physicians,
dentists, certified nurse-midwives, nurse
practitioners, physician assistants who are
practicing in FQHC or RHC led by a physician
assistant
• Meet min M’d patient volume percentages
• Waive rights to M’care EHR incentive pmts
• Can get up to 85% of net average allowable
cost for certified EHR tech, trning
• Up to max level, for no more than 6 yrs
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MPIP Acute Care Hospitals
• Acute Care Hospitals with at least 10%
Medicaid patient volume
• Children’s Hospitals of any Medicaid
patient volume.
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Meaningful Use Means??
• A phased approach with reasonable
criteria for meaningful
use of certified EHR
.
technology based on currently available
technology capabilities and provider
practice experience, and builds up to a
more robust definition of meaningful use,
based on anticipated technology and
capabilities development according to the
proposed rule
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Initial Year Meaningful Use
• The HITECH Act requires that to receive
a Medicaid incentive payment in the
initial year of payment, an EP or eligible
hospital may demonstrate that they have
engaged in efforts to adopt, implement,
or upgrade certified EHR technology
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Meaningful Use Means?
• Stage 1 meaningful use criteria focuses on
electronically capturing health information in a
coded format, using that information to track
key clinical conditions and communicating that
information for care coordination purposes. It
also calls for implementing clinical decision
support tools to facilitate disease and medication
management and reporting clinical quality
measures and public health information.
• For MPIP it means Attestations
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Meaningful Use Means?
• CMS officials are recommending
that Stage 2 criteria be proposed by the
end of 2011 and the Stage 3 definition be
proposed by the end of 2013.
• Yes, requirements to meet Meaningful Use
get more rigorous over time
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What Does Ohio Have To Do To
Participate?
Demonstrate compliance with three criteria:
– Use the funds for the purposes of administering the incentive
payments, including the tracking of meaningful use of certified
EHR technology by Medicaid providers
– Conduct adequate oversight of the incentive program, including
routine tracking of meaningful use attestations and reporting
mechanisms
– Pursue initiatives to encourage the adoption of certified EHR
technology to promote health care quality & the exchange of
health care information under Medicaid, while ensuring privacy &
security of data
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Is My Check in the Mail?
• First, CMS has to approve our plan to
define:
– Today’s As Is about HIT and EHR
– The Vision for Ohio’s To Be (including defined
by not just bureaucrats but Ohioans!)
– The Road Map for Getting to the Vision
*Our SMHP
*Ohio’s I-APD
Plan submitted last Tuesday
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Is My Check in the Mail?
• Then we have to actually do the work
outlined in the plan, including building the
MPIP Infrastructure
• And we have to hook up our infrastructure
with CMS’
• Did I mention there is no final CMS rule
yet, including no rule on what a certified
system is?
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So When Already??
• Confirmation of Federal Approval
• Begin Work on As Is; To Be Vision; Road
Map
• Creation of SMHP and IAPD
• Submit to CMS
• CMS approval
• State Oks EPs and Hospitals to submit
• State Payment
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What Do You Need from Me and How Can I
Keep Track of What You’re Doing?
• We’ll be looking for feedback
– Calculation of Medicaid patient percentages
– What influences choice of M’d or Mcare?
– Attestations
– Monitoring/fraud
• We’ll have website info available
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Keep In Touch
• Mark Vidmar, Project Manager
Mark.Vidmar@jfs.ohio.gov
• Mel Borkan, Chief Strategy Officer
Mel.Borkan@jfs.ohio.gov
• Ohio Department of Job and Family
Services, Ohio Health Plans, 614-752-3086
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