meaningful use elizabeth w. woodcock, mba, facmpe, cpc update: 2015 sponsored by
TRANSCRIPT
Meaningful Use
Elizabeth W. Woodcock, MBA, FACMPE, CPC
Update: 2015
Sponsored bySponsored by
©
2015
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©2015
Elizabeth W. Woodcock, MBA, FACMPE, CPCSpeaker, Author, Trainerwww.elizabethwoodcock.com
MBA, Wharton School of Business, University of Pennsylvania
BA, Duke University Fellow, American College of Medical Practice
Executives Certified Professional Coder Author, 12 textbooks and more than 500 Articles Founder and Principal, Woodcock & Associates Former Consultant, Medical Group Management
Association; Group Practice Services Administrator, University of Virginia Health Services Foundation; Former Senior Associate, Health Care Advisory Board
Your Speaker
©2015
Agenda
Background News! Proposed Stage Two Proposed Stage One Proposal Penalties Q&A Session
To all participants: Please note that this
presentation is focused on eligible
professionals, not eligible hospitals or
critical access hospitals.
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2015
Background
February 2009American Recovery and
Reinvestment Act
“TITLE XIII—HEALTH INFORMATION TECHNOLOGY”
HITECH Act“Eligible professionals” will be paid for
“demonstrating use of a qualified electronic health record in a meaningful manner.”
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2015
Background
1st Year
Meaningful Use Annual Incentive Payments
2011 2012 2013 2014 2015 2016 [….] TOTAL2011 MCR $18,000 $12,000 $8,000 $4,000 $2,000 $0 $0 $44,000
MCD $21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $0 $63,750 2012 MCR $18,000 $12,000 $8,000 $4,000 $2,000 $0 $44,000
MCD $21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750 2013 MCR $15,000 $12,000 $8,000 $4,000 $0 $39,000
MCD $21,250 $8,500 $8,500 $8,500 $17,000 $63,750 2014 MCR $12,000 $8,000 $4,000 $0 $24,000
MCD $21,250 $8,500 $8,500 $25,500 $63,750 2015 MCR $0 $0 $0 $0
MCD $21,250 $8,500 $34,000 $63,750 2016 MCR $0 $0 $0
MCD $21,250 $ 42,500 $63,750 MCR = Medicare; MCD = Medicaid. MCD participants must begin
participation by 2016.
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Background
•Transmitted via email•Review the audit request – complete? limited (to one measure)?•Retain documentation for 6 years•CMS – and (2015) OIG
http://go.cms.gov/1J6buIshttp://bit.ly/1dB9eg3
Audit InformationGovernment Sample
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2015
News!
“Shorten the EHR reporting period in 2015 to 90 days…”
-Patrick Conway, MD
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2015
News!
April 15, 2015
Medicare and Medicaid
Programs; Electronic
Health Record Incentive Program—
Modifications to Meaningful Use
in 2015 Through 2017; Proposed Rule
March 30, 2015
Medicare and Medicaid
Programs; Electronic
Health Record Incentive
Program-Stage 3; Proposed
Rule
CMS Proposals
Final Rules Expected
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2015
News!
When the Final Rule is released, the Meaningful Use criteria for Stage One and Stage Two will change.
Giving you less than 6 weeks to prepare
[Last Day to Start in Order to Get your 90 Days in]
www.asha.org
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2015
• 9 Core Objectives
• 1 Public Health Objective
PROPOSAL
Proposed Stage Two
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2015
Proposed Stage Two
Eliminated!!• Patients who secure electronic message
• Patients who download, online or transmit to a third party their health information electronically
PROPOSAL
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2015
No Longer Required to ReportRecord Demographics
Record Vital Signs
Record Smoking Status
Clinical Summaries
Structured Lab Results
Patient List
Patient Reminders
Summary of Care (1-Any Method; 3-Test)
Electronic Notes
Imaging Results
Family Health History
PROPOSAL
Proposed Stage Two
©2015
Proposed Stage Two
1. Protect Electronic Health Information[Conduct or review a Security Risk Analysis]
2. Clinical Decision Support (CDS)[Implement 5 CDS interventions for 4+ CQMs or high-priority health conditions]
[Enable and implement drug-drug and drug-allergy interaction checks]
PROPOSAL
CQM = Clinical Quality Measures
©2015
Proposed Stage Two
3. Computerized Provider Order Entry (CPOE)
[Use CPOE for 60%+ medication orders, 30%+ lab orders, and 30%+ radiology orders]
4. ePrescribing[50%+ are queried for a drug formulary and transmitted electronically]
PROPOSAL
©2015
Proposed Stage Two
5. Summary of Care[EP who transitions or refers their patient to another setting of care or provider of care that uses CEHRT creates a summary of care record; and electronically transmits such summary to a receiving provider for 10%+ transitions of care and referrals]
6. Patient Specific Education[Patient-specific education resources identified by CEHRT are provided to patients for 10%+ of all unique patients with an office visit seen by the EP]
EP = eligible professional; CEHRT = certified electronic health record technologyPROPOSA
L
©2015
Proposed Stage Two
7. Medication Reconciliation[EP performs medication reconciliation for 50%+ of transitions of care in which the patient is transitioned into the care of the EP]
PROPOSAL
©2015
Proposed Stage Two
8. Patient Electronic Access[50%+ of all unique patients seen by the EP during the reporting period are provided timely – within 4 business days after the information is available to the EP – online access to their health information]
[At least one patient seen by the EP during the reporting period views, downloads, or transmits his or her health information to a third party]
PROPOSAL
©2015
Proposed Stage Two
9. Secure Electronic Messaging[During the reporting period, the capability for patients to send and receive a secure electronic message was fully enabled]
PROPOSAL
©2015
Proposed Stage Two
10. Public Health and Clinical Data Registry (CDR) Reporting
The EP is in “active engagement” with a public health agency (PHA) or CDR
Option 1: the EP completed registration to submit data to a PHA or CDR within 60 days after the start of the reporting period, and is waiting an invitation from the PHA or CDR to begin testing
Option 2: the EP is in the process of testing and validation of the electronic submission of the data
Option 3: the EP is electronically submitting production data to the PHA or CDR
PROPOSAL
©2015
Proposed Stage Two
10. Public Health and Clinical Data Registry (CDR) Reporting
Attest to any 2…
1.Immunization registry reporting (bi-directional)
2.Syndromic surveillance reporting
3.Case reporting
4.Public health registry reporting*
5.Clinical data registry reporting*
*can report – and count – more than one registry
PROPOSAL
http://go.cms.gov/1JfPiPr
List of Qualified CMS Registries
©2015
Proposed Stage One
1. Protect Electronic Health Information
2. CDS – 1 rule relevant to specialty/high clinical priority
3. CPOE – 30% medications only
4. ePrescribing – 40% transmitted electronically
5. Patient electronic access – 50% provided access within 4 business days
6. Public Health/Clinical Data Registry Reporting – same as Modified Stage Two
PROPOSAL
©2015
Proposal
Clinical quality measures 9 measures out of 64, covering
at least three domains
None are “required” but some are recommended
Zero in the denominator is a positive response
Can report through the PQRS Portal
CQM reporting period can be different than the rest of MU
PROPOSAL
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Proposal
24
1st Year
Stages of Meaningful Use [as of April 2015]
2011 2012 2013 2014 2015 2016 20172011 1 1 1 1 or 2 2 2 2 or 32012 1 1 1 or 2 2 2 2 or 32013 1 1 2 2 2 or 32014 1 1 2 22015 1 1 22016 1 12017 1
Appendix
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2015
Payment Adjustments(based on Medicare reimbursement)
Note: Exceptions will be made on a case-by-case basis for significant hardships (e.g., rural practices without sufficient Internet access)
Year Penalty
2015 1%
2016 2%
2017 3%
Beyond 4% to 5%
No Medicaid Adjustments
2018 – Final Year
of Penalties
MACRA of 2015
Penalties
Medicare Access and
CHIP Reauthorization Act of
2015
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2015
Penalties
However, every eligible professional will be assigned a “composite score” based on:1.Quality2.Resource use3.Clinical practice improvement activities…
4. and Meaningful Use
Will replace PQRS, VBPM and MU!
©2015
Questions & Questions & AnswersAnswers
©2015
Elizabeth W. Woodcock, MBA, FACMPE, CPCWoodcock & AssociatesSpeaker, Trainer, Author
Atlanta, Georgia404.373.6195
These handouts may not be reproduced without the written consent of the speaker.
Your Speaker
©2015
Sources
Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Modifications to Meaningful Use in 2015 Through 2017; Proposed Rule http://www.gpo.gov/fdsys/pkg/FR-2015-04-15/pdf/2015-08514.pdf
Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 3; 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications; Proposed Rules
http://www.gpo.gov/fdsys/pkg/FR-2015-03-30/pdf/2015-06685.pdf