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Performance Progress CoP

Medicaid EHR Incentive Program June 9, 2015

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This is an advanced copy of the Performance

Progress presentation for your review only. This

presentation is subject to change and should not

be reproduced. The final version of the presentation

will be posted to the Medicaid HITECH TA Web site

at a later date.

Agenda

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Snapshot of the Medicaid EHR Incentive Program

• Sam Schaffzin, CMS/CMCHO

Medicaid EHR Incentive Program Analytics

State Spotlight: Wisconsin

• Denise Webb, Director and State Health IT Coordinator

Implementation Advance Planning Document (IAPD) Submission:

Process, Tips and Q&A

• Robert McCarthy, CMS/CMCHO

Wrap Up and Next Steps

• Melissa Corrado, MeT

Snapshot of the Medicaid EHR

Incentive Program:

June 2015

Sam Schaffzin, CMS/CMCHO

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By the Numbers

• Total Medicaid EHR incentive payments through June 3,

2015: 250,295 payments to providers totaling

$9,752,734,790.

• 155,882 unique participating providers.

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Disbursed Payment

Adopt,

Implement,

Upgrade

(AIU)

50 States plus Puerto Rico, D.C., and N.M.I.

Meaningful

Use (MU) 50 States plus D.C. & Puerto Rico

Eligible professional (EP) AIU to MU Return

Percentages Nationally (June 2015)

EP Year 2 to Year 3 Return Percentage

(June 2015)

EP Year 3 to Year 4 Return Percentage

(June 2015)

Dentists-Only Year 2 to Year 3 Nationally

(June 2015)

Eligible hospital (EH) Return Percentage for

Payment Year 1 to Year 2 (June 2015)

Wisconsin Medicaid EHR Incentive

Program

Health Information Technology

Landscape Assessment

Denise Webb, Wisconsin eHealth Program

Director and State Heath IT Coordinator

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Wisconsin HIT Landscape Assessment Topics

Process

Data Sources Wisconsin Medicaid data warehouse

Attestation system (Medical Assistance Provider Incentive Repository - MAPIR)

CMS EHR Incentive Program Public Use Files

Tools Business Objects

Microsoft Excel

Tableau

Report highlights

Eligible Hospitals summary

Eligible Professionals summary

What’s next and Q&A

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ELIGIBLE HOSPITALS SUMMARY

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Location of Eligible Hospitals Highest Stage of Certified

EHR Technology (CEHRT) Adoption

Figure based on Medicare & Medicaid EHR Incentive Program Data

115 Wisconsin Eligible

Hospitals are Stage 1

Meaningful Users

10 Wisconsin Eligible

Hospitals Adopted,

Implemented or

Upgraded CEHRT

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Eligible Hospital Meaningful Use Core Measures Analysis

Title Measure Threshold Wisconsin Average Percentage

Core Measure 1: Computerized

Physician Order Entry (CPOE)

for Medication Orders

More than 30 percent 90.30%

Core Measure 3: Maintain

Problem List

More than 80 percent 96.13%

Core Measure 4: Active

Medication List

More than 80 percent 98.65%

Core Measure 5: Medication

Allergy List

More than 80 percent 98.88%

Core Measure 6: Record

Demographics

More than 50 percent 97.34%

Core Measure 7: Record Vital

Signs

More than 50 percent 94.03%

Core Measure 8: Record

Smoking Status

More than 50 percent 96.40%

Core Measure 11: Electronic

Copy of Health Information

More than 50 percent 95.71%

Core Measure 12: Electronic

Copy of Discharge Instructions

More than 50 percent 95.30%

Figure based on Medicare & Medicaid EHR Incentive Program Data

*Measures with Numerator and Denominator only

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Eligible Hospital Meaningful Use Menu Measures Analysis

Title Measure Threshold Wisconsin Average

Percentage Menu Measure 2: Advance

Directives

More than 50 percent 93.93%

Menu Measure 3: Incorporate

Clinical Lab Test Results

More than 40 percent 96.56%

Menu Measure 5: Patient-

Specific Education Resources

More than 10 percent 85.94%

Menu Measure 6: Medication

Reconciliation

More than 50 percent 89.58%

Menu Measure 7: Transition of

Care Summary

More than 50 percent 78.95%

Figure based on Medicare & Medicaid EHR Incentive Program Data

*Measures with Numerator and Denominator only

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Eligible Hospital CEHRT Vendors

Figure based on Medicare & Medicaid EHR Incentive Program Data

* The following vendors were used in one attestation: Allscripts,

ExitCare, IHM Services, Interface People, RWHC QI Program and

SCC Soft Computer

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Location of Eligible Hospitals Top 5 CEHRT Vendors

Figure based on Medicare & Medicaid EHR Incentive Program Data

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Regional Summary of Top 5 CEHRT Vendors with Medicaid

Population

Figure based on Medicare & Medicaid EHR Incentive Program Data

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Location of Eligible Hospitals Non-Top 5 CEHRT Vendors

Figure based on Medicare & Medicaid EHR Incentive Program Data

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ELIGIBLE PROFESSIONALS

SUMMARY

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Location of Eligible Professionals Highest Stage of CEHRT

Adoption

Figure based on Medicare & Medicaid EHR Incentive Program Data

7,925 Wisconsin Eligible

Professionals are Stage 1

Meaningful Users

1,500 Wisconsin Eligible

Professionals Adopted,

Implemented or Upgraded

CEHRT

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Location of Dentists Highest Stage of CEHRT Adoption

Figure based on Medicare & Medicaid EHR Incentive Program Data

60 Wisconsin Dentists are

Meaningful Users

162 Wisconsin Dentists

Adopted, Implemented or

Upgraded CEHRT

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Location of Nurse Practitioner & Nurse Services Highest

Stage of CEHRT

Figure based on Medicaid EHR Incentive Program Data OnlyEentive

285 Wisconsin Nurse

Practitioner and Nurse

Services Providers are

Meaningful Users

442 Wisconsin Nurse

Practitioner and Nurse

Services providers

Adopted, Implemented or

Upgraded CEHRT

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Location of Physicians Highest Stage of CEHRT Adoption

Figure based on Medicare & Medicaid EHR Incentive Program Data

7,567 Wisconsin Physicians

are Meaningful Users

886 Wisconsin Physicians

Adopted, Implemented or

Upgraded CEHRT

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Location of Physician Assistant Highest Stage of CEHRT

Adoption

Figure based on Medicaid EHR Incentive Program Data Only

13 Wisconsin Physician

Assistants are Meaningful

Users

10 Wisconsin Physician

Assistants Adopted,

Implemented or Upgraded

CEHRT

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Eligible Professional Meaningful Use Core Measures

Analysis

Title Measure Wisconsin Average Percentage

Core Measure 1: CPOE for

Medication Orders

More than 30 percent 92.67%

Core Measure 3: Maintain

Problem List

More than 80 percent 97.43%

Core Measure 4: e-

Prescribing

More than 40 percent 90.12%

Core Measure 5: Active

Medication List

More than 80 percent 98.78%

Core Measure 6: Medication

Allergy List

More than 80 percent 98.97%

Core Measure 7: Record

Demographics

More than 50 percent 97.43%

Core Measure 8: Record Vital

Signs

More than 50 percent 92.19%

Core Measure 9: Record

Smoking Status

More than 50 percent 95.60%

Core Measure 12: Electronic

Copy of Health Information

More than 50 percent 93.65%

Core Measure 13: Clinical

Summaries

More than 50 percent 84.89%

Figure based on Medicaid EHR Incentive Program Data Only

*Measures with Numerator and Denominator only

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Eligible Professional Meaningful Use Menu Measures

Analysis

Figure based on Medicaid EHR Incentive Program Data Only

*Measures with Numerator and Denominator only

Title Measure Wisconsin Average Percentage

Menu Measure 2: Clinical

Lab Test Results

More than 40 percent 95.79%

Menu Measure 4: Patient

Reminders

More than 20 percent 68.64%

Menu Measure 5: Patient

Electronic Access

At least 10 percent 74.33%

Menu Measure 6: Patient-

Specific Education

Resources

More than 10 percent 70.24%

Menu Measure 7:

Medication

Reconciliation

More than 50 percent 91.38%

Menu Measure 8:

Transition of Care

Summary

More than 50 percent 91.21%

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Eligible Professional CEHRT Vendor Landscape

Figure based on Medicare & Medicaid EHR Incentive Program Data

* The following vendors were used in 50-100 attestations: eClinicalWorks, IOD Inc., LSS Data Systems, McKesson, SRSsoft

** The following vendors were used in 10-49 attestations: AmazingCharts, Aprima, Athenahealth, Business Computer Applications,

CPSI, Data Strategies, DR Systems, Elekta, e-MDs, Greenway , Healthland, Henry Schein , ImagingElements, Indian Health

Service, Instant Health Care, MEDITECH, MPN Software, Patterson Dental, Practice Fusion, SOAPware

***The following vendors were used in 1-9 attestations: Abraxas, ADP AdvancedMD, Advanced Data, Altapoint Data Systems,

CareCloud, ChartLogic, CompuGroup, Compulink, Connexin, Core Solutions, Crowell Systems, CureMD, Defran Systems,

DrChrono, DrFirst, Emdeon, EyeMD, gloStream, gMed, Health IT Services Group, HealthFusion, Horizon, i2i Systems, Infor-Med,

Integrated Systems Management, Intuitive Medical Software, IO Practiceware, iPatientCare, IRCS, Kareo, KSB, MacPractice,

ManagementPlus, MDIntelleSys, Mdoffice, MedcomSoft, Medflow, MEDHOST, MedInformatix, MedPlus, Medstreaming,

meridianEMR, Modernizing Medicine, NexTech, Nuesoft Technologies, OEMR, Office Ally, Open Dental Software, PatientNOW,

Procentive, Prognosis Health Information Systems, SCC Soft , Shareable Ink, simplifyMD, Soren Technology, Streamline

Healthcare Solutions, SuiteMed, SynaMed, The Echo Group, Tolven, Valant, WEBeDoctor, Xcite Health and Encounterpro

Healthcare Resources

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Location of Eligible Professionals Top 5 CEHRT Vendors

Figure based on Medicare & Medicaid EHR Incentive Program Data

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Regional Summary of Top 5 CEHRT Vendors with Medicaid

Population

Figure based on Medicare & Medicaid EHR Incentive Program Data

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WHAT’S NEXT AND Q&A

IAPD Submission:

Process, Tips, and Q&A

Robert McCarthy, CMS/CMCHO

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IAPD Updates

• IAPDs must be updated at least annually

• IAPD-Update (IAPD-U) are due no later than 60 days

after the occurrence of project changes, such as:

– A projected cost increase of $100,000 or more.

– Schedule extensions of more than 60 days for major milestones.

– Significant changes in planning or implementation approach, or

scope of activities beyond the approved Health Information

Technology (HIT) IAPD.

– Changes in implementation concept or a change to the scope of

the project.

– Changes to the approved cost allocation methodology.

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IAPD Expiration Date Timing Examples

• IAPD Expiration on September 30:

• September: IAPD expires 9/30/15

• August: CMS-37 due 8/15/15 for FFQ1

• Early July: Must submit IAPD-U

• June: Recommend submitting IAPD-U

• IAPD Expiration on June 30:

• June: IAPD expires 6/30/16

• May: CMS-37 due 5/15/16 for FFQ4

• Early April: Must submit IAPD-U

• March: Recommend submitting IAPD-U

Bottom Line:

Submit IAPD to

CMS 3 months

before expiration

date to allow for

enough time for

review and

approval

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• HITECH RO Staff: • http://www.medicaidhitechta.org/ContactUs/CMSStaff.aspx

• IAPD: • Robert McCarthy: 206-615-2505, Robert.McCarthy@cms.hhs.gov

• Financial Coordinator: • Carrie Feher: 410-786-8905, Carrie.feher@cms.hhs.gov

Key CMS Contacts

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IAPD Resources

MedicaidHITECHTA.org website

http://www.medicaidhitechta.org/ResourceLibrary/Pr

ogramImplementationToolkit/Pathway2/4IAPD.aspx

• IAPD Template

• IAPD Companion Guide

• Financial Management Tips and Key Considerations

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Contracts

All HITECH contracts must be approved before

the State executes the contract or contract

amendment, per 42 CFR 492.324.

Many States execute contracts without prior

approval and run the risk of that funding being

recovered by the Federal government at some

point.

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What’s Next

• Next Performance Progress CoP:

Tuesday August 25, 2015 at 3:00 PM ET

• Please contact Melissa Corrado

mcorrado@healthmanagement.com if you are

interested in sharing your state’s experiences,

ideas, plans, concerns, and/or progress on future

CoPs

• Any additional suggestions can be sent to:

CMS.MeT.CoP@briljent.com

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Resources

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Web www.cms.hhs.gov/EHRIncentiveprograms

www.MedicaidHITECHTA.org

Twitter @CMSgov

HITECH

Staff

Sam Schaffzin: Samuel.Schaffzin@cms.hhs.gov

Robert McCarthy: Robert.McCarthy@cms.hhs.gov

Nick Aretakis: Nicolas.Aretakis1@cms.hhs.gov