ARRA HITECH Programs and Goals
Where is Nevada?
1eebngggeee $7,151,783 awarded, 50% to NV or $3,575,892
Feb. 2010 – Feb. 2014
Approx. 700 NV providers enrolled out of 3,000 eligible providers.
Regional Extension Center
HealthInsight – NV and UTEstimated 2,500-3,000 IT professionals needed in NV over next 3-5 yrs.
College of Southern Nevada (CSN) awarded $717,430 for new program, 300 graduates required by Dec. 2012.
14 Graduates to date, 102 currently enrolled.
Workforce Training
Adoption of EHRs
Medicare & Medicaid Incentives
Approx. $500K initial incentives disbursed to30 NV Medicare eligible providers. Anticipated $80M in NV Medicaid Incentives
to be paid 2012-2021.
State HIE Cooperative Agreement
$36B appropriated nationally, NV awarded $6,133,426 Funds 4 state level positions, including required State HITCoordinator, through grant period, 2/8/10–2/7/14. Approximated $635K required match (not General Funds).
Potential new small business opportunities for HIT services.
Beacon Communities
Meaningful Use
of EHRs
Exchange of Health
Information
NV Senate Bill 43 (2011)• Improved
individual and
population health
outcomes
• Increased
transparency and
efficiency
• Improved ability to
study and improve
care delivery
17 Awards Nationwide, $265M Total Renown unsuccessful after applying during both
submission opportunities
Research to enhance HIT Adoption
Collaborative efforts by the Univ. of IL at Urbana-Champaign, the Univ. of TX at Houston, Harvard, and the Mayo
Clinic of Medicine, $60M Total Security & Privacy framework Standards & Interoperability Framework
HITECH CMS EHR Incentives for Eligible Providers and Hospitals
The Medicare EHR Incentive Program
The Medicare EHR Incentive Program provides incentive payments to eligible professionals, eligible hospitals, and CAHs that demonstrate meaningful use of certified EHR technology.
Participation can begin as early as 2011.
Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There's an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HPSA).
To get the maximum incentive payment, Medicare eligible professionals must begin
participation by 2012.
Incentive payments for eligible hospitals and CAHs may begin as early as 2011 and are based on a number of factors, beginning with a $2 million base payment.
For 2015 and later, Medicare eligible professionals, eligible hospitals, and CAHs
that do not successfully demonstrate meaningful use will have a decreased payment adjustment in their Medicare reimbursement.
The Medicaid EHR Incentive Program
The Medicaid EHR Incentive Program provides incentive payments to eligible professionals, eligible hospitals, and CAHs as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their first year of participation and demonstrate meaningful use for up to five remaining participation years.
The Medicaid EHR Incentive Program is voluntarily offered by individual states and territories and may begin as early as 2011, depending on the state.
Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program.
Eligible hospital incentive payments may begin as early as 2011, depending on when the state begins its program. The last year a Medicaid eligible hospital may begin the
program is 2016. Hospital payments are based on a number of factors, beginning with a
$2 million base payment.
This material was prepared by HealthInsight as part of our work as the Regional Extension Center for Nevada and Utah, under grant #90RC0033/01 from the Office of the National Coordinator, Department of Health and Human Services.
Page 1: Payment Incentives, Medicare Penalties , Other Incentives
Page 2: Eligibility, Definitions
PAYMENT INCENTIVES
Physicians must choose between Medicare and Medicaid incentives
Medicare
Beginning with professional services provided in 2011, physicians who adopt and use electronic health records (EHRs) to improve care may receive to up to $44,000 over five years if they have at least
$24,000 in Medicare allowed charges per year.
Incentive payments would be equal to 75% of the allowed charges for all covered professional services furnished each year up to a maximum payment as shown in the following table:
Year of Services
MAXIMUM MEDICARE INCENTIVE First Year of Meaningful Use of EHR
2011 2012 2013 2014 2015* 2011 $18,000 --- --- --- --- 2012 $12,000 $18,000 --- --- --- 2013 $8,000 $12,000 $15,000 --- --- 2014 $4,000 $8,000 $12,000 $12,000 --- 2015 $2,000 $4,000 $8,000 $8,000 $0 2016 --- $2,000 $4,000 $4,000 $0 Total Max $44,000 $44,000 $39,000 $24,000 $0 *There will be no incentive payments for those who reach meaningful use after 2014 and penalties will begin in 2015
Eligible professionals predominantly furnishing services in a health professional shortage area will be eligible for an additional 10% maximum incentive payment each year.
Medicare Penalties
If the eligible professional has not demonstrated “meaningful use” of their EHR by 2015, the fee schedule for furnished services will be reduced by 1% each year beginning in 2015, to a maximum
reduction of 3%. Hardship exceptions may apply.
Medicaid
Beginning in 2011, states will pay eligible Medicaid providers up to $63,750 (reduced by payments from any other sources) for certified EHR technology and support services including maintenance and training necessary for adoption and operation. Incentives may not exceed:
1) Year 1: $ 21,500. per provider
2) Subsequent Years: $8,500 per provider, for up to five years, but no later than 2021.
If a provider has completed adopting, implementing, or upgrading such technology prior to the first year of payment, #1 & #2 above will still apply.
This translates to a maximum payment of:
MAXIMUM MEDICAID INCENTIVE Year 1
2011-2016 Year 2 Year 3 Year 4 Year 5 Year 6 Total
Max $21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
Please ask your HealthInsight representative about your specific incentive amount if you received payments for EHR technology or support services from other sources. Otherwise, the maximum incentives above apply.
There will be no incentive payments after 2021.
OTHER INCENTIVES
1) All Medicare providers who become meaningful users of an EHR will be recognized on the CMS website. 2) Low cost loans and grants may be available for purchase of hardware, software, and implementation.
3) Assistance with selection, adoption, and workflow re-design will be provided by the Health Information Technology Regional Extension Center
For information see www.healthinsight.org, or contact HealthInsight by phone, 1-800-483-0932, fax 877-335-2490 or email [email protected].
Adoption of Health Information Technology
Physician Incentives—
as described in the AmericanThis material was prepared by HealthInsight as part of our work as the Regional Extension Center for Nevada and Utah, under grant #90RC0033/01 from the Office of the National Coordinator, Department of Health and Human Services.
ELIGIBILITY
Medicare
To be eligible for the payment incentives, providers must: 1) Use a certified EHR in a meaningful* manner; 2) Exchange* health information to improve the quality of
care; and
3) Report* on clinical quality measures.
4) Meet these requirements by the 2014 payment year, although those ready by 2011-2012 will earn the most 5) Be a practicing MD, DO, DDS, DMD, DPM, OD, or
Chiropractor
*See definitions below
Medicare Advantage (MA)-Affiliated Physicians: Physicians employed by a MA organization are eligible if the organization attests that they are meaningful EHR users. A contracted physician is eligible if he/she furnishes at least 80% of the entity’s Medicare patient care services; at least 80% of his/her services are provided to the entity’s enrollees; and provides at least 20 hours per week of patient care service.
Medicaid
To be eligible for the payment incentives, providers must: 1) Be an eligible professional* that is not hospital-based
and has at least 30% of patient volume attributable to Medicaid; or
2) Be a pediatrician, who is not hospital-based and at least 20% of the volume is attributable to Medicaid (These physicians will be eligible for two-thirds of the indicated payments); or
3) Practice predominantly in a Federally Qualified Health Center (FQHC) or Rural Health Center (RHC) and have at least 30% of patient volume attributable to
needy individuals*
To receive Medicaid incentives in the initial year, an EP only needs to demonstrate that they have engaged in efforts to “adopt, implement, or upgrade certified EHR technology” but by the second year they need to show meaningful use* of the EHR.
*See definitions below.
DEFINITIONS
Meaningful Use of Certified EHR Technology: The eligible professional demonstrates that he/she is using certified EHR technology in a meaningful manner (see HealthInsight’s What is Meaningful Use document), which includes the use of electronic prescribing. Demonstration of “Meaningful Use”
A professional may satisfy the demonstration requirement through means specified by the Secretary, which may include: 1) An attestation
2) The submission of claims with appropriate coding 3) A survey response
4) Reporting on clinical quality measures using an EHR 5) Other means specified by the Secretary
Note: The Secretary may not require the electronic reporting of information on clinical quality measures unless the Secretary has the capacity to accept the information electronically, which may be on a pilot basis.
Program Registration
To be eligible, all providers must meet the following registration requirements:
• Register via the EHR Incentive Program website (registration will be available early 2011) • Be enrolled in Medicare FFS, MA, or Medicaid (FFS or managed care)
• Have a National Provider Identifier (NPI) • Be enrolled in PECOS (Medicare providers only)
MEDICAID SPECIFIC DEFINITIONS
Eligible Professional: 1) Physician 2) Dentist
3) Certified nurse mid-wife 4) Nurse practitioner
5) Physician assistant practicing in a rural health clinic that is led by a physician assistant, or is practicing in a FQHC
Needy Individual
1) Receives Medicaid
HITECH CMS EHR Incentives for Eligible Providers and Hospitals
The Medicare EHR Incentive Program
The Medicare EHR Incentive Program provides incentive payments to eligible professionals, eligible hospitals, and CAHs that demonstrate meaningful use of certified EHR technology.
Participation can begin as early as 2011.
Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There's an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HPSA).
To get the maximum incentive payment, Medicare eligible professionals must begin
participation by 2012.
Incentive payments for eligible hospitals and CAHs may begin as early as 2011 and are based on a number of factors, beginning with a $2 million base payment.
For 2015 and later, Medicare eligible professionals, eligible hospitals, and CAHs
that do not successfully demonstrate meaningful use will have a decreased payment adjustment in their Medicare reimbursement.
The Medicaid EHR Incentive Program
The Medicaid EHR Incentive Program provides incentive payments to eligible professionals, eligible hospitals, and CAHs as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their first year of participation and demonstrate meaningful use for up to five remaining participation years.
The Medicaid EHR Incentive Program is voluntarily offered by individual states and territories and may begin as early as 2011, depending on the state.
Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program.
Eligible hospital incentive payments may begin as early as 2011, depending on when the state begins its program. The last year a Medicaid eligible hospital may begin the
program is 2016. Hospital payments are based on a number of factors, beginning with a
$2 million base payment.
MEANINGFUL USE (MU) FAST FACTS
Intent: Better health care does not come from the adoption of technology itself. It is
accomplished through the exchange and use of health information for effective clinical decisions at the point of care.
Definition: Providers need to show they are using federally-certified EHR technology in ways
that can be measured significantly in quality and in quantity. The three stages of MU criteria each include both a core set and a menu set of objectives that are specific to eligible professionals or eligible hospitals and CAHs.
MU Stage 1:
Electronically capturing health information in a coded/structured format Using that information to track key clinical conditions
Communicating that information for care coordination purposes First Incentive Payment Year: 2011
Priority Area #1: Improve quality, safety, efficiency, and reduce health disparities Priority Area #2: Engage patients and their families in health care
Priority Area #3: Improve care coordination
Priority Area #4: Improve public health (e.g., coordination with immunization registries)
MU Stage 2:
The use of HIT for continuous quality improvement at the point of care The electronic exchange of information in the most structured format possible
Stage 1 Menu Set objectives/measures will be transitioned into the Stage 2 Core Set, with increased thresholds required
First Incentive Payment Year: 2013
MU Stage 3:
Improving quality, safety, and efficiency by requiring physicians to meet a minimum expected performance level
Decision support for national high priority conditions Patient access to self-management tools
Access to comprehensive patient data Improving population health
Top 12 Products - combined 88% market share
* Allscripts MedServices-Data Net
* Alteer * Micro MD
Amazing Charts EHR * NextGen EHR
eClinicalWorks Practice Fusion
* e-MDs Solution Series EMR * Sage
* Greenway Prime Suite SOAPware
* E-Prescribing module approved by the Nevada State Board of Pharmacy, pursuant to NRS 639.070, NRS 639.0745 and NAC 639.7102. (Effective 2003)
Remaining 20 Products
AltaPoint Insync
Aprima Intergy
Athenahealth InTuun
Chartlogic MedInformatix
Digichart/Advanced MD Medisoft Clinical EMR
EncounterPro Medstreaming
Epic OfficeAlly
HealthProbe PrognoCIS
I Patient Care Quest 360 EHR
InforMed Praxis SB Clinical
BioMedix Vascular Solutions/TRAKnet DPM MedPlus Cardinal Health Nuclear Pharmacy Services MinuteClinic
Catalis Inc. Misys Healthcare Systems
Cleveland Clinic Mountain Medical Technologies, Inc. Desert Orthopaedic Center Netsmart Technology
DrFirst Inc. NewCrop, LLC
GE Healthcare Renown Health
Gmed RxNT
H2H Solutions, Inc. (H@H Disgital Rx) SRSsoft
iKnowmed, US Oncology SuiteMed + Meditab Software
Life-File SureScripts, LLC
meridianEMR, Inc. University Medical Center of S Nevada McKesson
32 Federally-Certified EHR Products Used in Nevada
as of Oct. 4, 2011
