Meaningful Use 2.0
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Funding Background
• On February 17, 2009, the President signed the American Recovery and
Reinvestment Act of 2009 (ARRA). Title XIII of Division A and Title IV of Division B of ARRA, together cited as the Health Information Technology for Economic and Clinical Health Act (HITECH Act).
• The HITECH Act authorizes incentive payments to eligible Medicare and Medicaid providers for meaningful use of certified electronic health record (EHR) technology.
• 2011-California funded four Regional Extension Centers to support over 10,000 Primary Care providers to select and implement and EHR through Stage 1
Meaningful Use. RECs were not funded to assist specialists or groups with more than 10 providers.
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What is New ?
$37,500,000 over three years has been awarded to continue to address
Medi-Cal
provider challenges to meaningfully use EHR technology, now:• include specialists (Board Certified MDs, NPs and PAs) and providers practicing in large size practice settings
• provides funding for EHR, MU support Any Stage
• includes support for HIE
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Awardees
Object Health is one of four awardees under the Medi-Cal Technical
Assistance funding to support providers in Meaningful Use. Awardees are:
• CalHIPSO – 3200 EPs • Cal Optima- 800 EPs
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Medi-Cal Program Overview
•
Program runs from 2011 through 2021.
•
2016 is the LAST Year to start the program!
•
Maximum incentive amount is $63,750 (across 6 years of program
participation).
•
No Medicaid payment reductions if you choose not to participate (for
now).
•
In the first year, providers can receive an incentive payment for adopting,
implementing, or upgrading a certified EHR (AIU) = $21,500
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Medi-Cal Meaningful Use Program Definitions
TODAY
CMS Modifications to Meaningful Use in 2015-2017 Proposed Rule May 7, 2015.
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Eligible Professional includes physicians*, nurse practitioners,
dentists, certified nurse midwives, optometrists, and physician
assistants who, individually or with a group, meet the 30% Medicaid encounter volume (20% for pediatricians) requirement for the Medi-Cal (EHR) Incentive Program.
*board certified by a specialty board which is a member of the American Board of Medical Specialties (except family practice, obstetrics and gynecology, pediatrics, and general internal
medicine)
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Eligible Provider Special Considerations
• Pediatricians
− Incentive payments for pediatricians who meet 20% Medicaid patient volume but fall short of 30% Medicaid patient volume are reduced to two-thirds of the incentive payment. These
pediatricians would receive $14,167 in the first year and $5,667 in subsequent years.
Pediatricians who do qualify with at least 30% Medi-Cal patient volume should not designate themselves as pediatricians and should not upload documentation of board eligibility or board certification. These physicians will receive the full incentive payments.
• Hospital-Based Disqualification
− Providers cannot be “hospital based.” This is defined as furnishing 90% or more of professional services in an inpatient hospital setting or emergency room connected to a hospital in the
calendar year preceding the payment year.
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Eligible Provider 30% Medi-Cal Encounter Documentation
• Encounter is One Provider/One Day
− Multiple encounters with the same provider on the same day can only be counted as one encounter.
• Definition of Medi-Cal Encounter
− Effective Jan 1, 2013, providers may count “billable” services provided to Medi-Cal enrolled patients as Medi-Cal encounters regardless of whether Medi-Cal paid for any part of the services.
To be considered “billable,” services must be covered by Medi-Cal.
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Year 4 Year 3
Year 2
Year 1 Year 5 Year 6
AIU $21,250 Last year Is 2016 First MU $8,500 90 days MU $8,500 Full year MU $8,500 Full year MU $8,500 Full year MU $8,500 Full year
Performance & Payment
possible in same year
Performance of one full calendar year, Attestation and Payment the following year
Medi-Cal Incentive Program – Timing is Everything
Incentive Program Payments to Providers
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• Work with our health plan, medical association, community association, professional society, and other partners to provide relevant and effective outreach and education to support program enrollment and achievement of meaningful use by eligible professionals in our Target Group – 2016 IS THE LAST YEAR TO START THE MU PROCESS FOR MEDI-CAL.
• Support Eligible Professionals in successfully attesting to meaningful use by staying informed of federal rulings and updates and changes to the State Level Registry (SLR) – THE SLR WILL CLOSE AS SOON AS THE NEXT WEEK TO
ATTESTATIONS FOR 2015 AND WILL NOT OPEN UNTIL THE MIDDLE OF 2016!
• Deploy proven techniques for successful EHR Implementation and Project Management to ready practices for Meaningful Use- MEANINGFUL USE
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• Provide industry standard Workflow Redesign for optimized use of EHR to achieve Meaningful Use
• Assist Eligible Professionals in connecting to a clinically appropriate and qualified HIE infrastructure
• Provide EP's with customized, effective and efficient assistance that is tailored to their unique needs in attaining and advancing in the stages and years of Meaningful Use
• Support and actively manage the attestation process in the SLR with the eligible providers
• Assist specialists and solo practitioners with cost effective EHR solutions.
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Team
Object Health is partnering in each Target Group for enrollment and technical assistance.
Partner Enrolling HIE Onsite MU Tech Assist CDCB-Funded LHDs Intrepid Ascent ✔ ✔ ✔ San Joaquin and Stanislaus Intrepid Ascent ✔ ✔ ✔ Imperial County ICMS ✔ Riverside and
San Bernardino IEEHRC ✔ ✔
Orange County E2o
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• Intrepid Ascent is currently working with 10 Local Health Departments (LHD) through the Lifetime of Wellness and Prevention First programs
• CDC funding through the Chronic Disease Control Branch (CDCB) of CDPH
• Assisting LHDs in promoting the monitoring of clinical quality
measures for diabetes and hypertension that are also part of the MU program
• Approved by DHCS to support these county LHDs with MU through the EHR TA program, including behavioral health:
• Alameda, Fresno, Madera, Merced, Sacramento, San Joaquin, Shasta • Potentially BHS only in Solano, Monterey, and Tulare
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PAYOFF 2014 2015 2016 2017
New AIU MU-90 MU
Scheduled for Stage 1 Year 1 MU 1 -90 MU MU Year 2 MU 1 -90 MU MU Scheduled for Stage 2 Year 3 MU 90 MU MU Year 4 MU 90 MU MU
• Providers scheduled for Stage 1 in 2015 can do MU with Exclusions.
• Providers scheduled for Stage 2 in 2015 must do MU (new definition).
• Everyone does only 90 continuous days of reporting for 2015 ONLY.
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Contact Us
If you have questions or would like more information please contact us at: Lori L. Hack, Object Health
415-260-6277
Lori.hack@objecthealth.com www.objecthealth.com
Mark Elson, Intrepid Ascent 415-533-8831
