MU 2 Presentation 2014v2 final - TSI...
Transcript of MU 2 Presentation 2014v2 final - TSI...
7/17/2015
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Meaningful Use Stage 2
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Agenda
o Introduction to Meaningful Use (approx 30min) o Incentive Payments
o Requirements
o Changes from Stage 1
o Registration, Reporting, & Payments
o Tips for Success
o Reporting Requirements (approx 2 hours; 5min break) o Core Measures
o Menu Measures
o Clinical Quality Measures
o Questions (approx 10 min)
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Goals
o General Understanding of the Stage 2
Meaningful Use program
o Understand the changes from Stage 1 to
Stage 2
o Understand Meaningful Use workflow
changes in NextGen 5.8 & KBM 8.3
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INTRODUCTION
The Long Road to Incentives
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Introduction
o What is the EHR Incentive Program?
o Medicare or Medicaid bonuses for certain providers using
EHR technology
o Signed into law as part of the American Recovery and
Reinvestment Act of 2009
o Rules established by the Centers for Medicare and
Medicaid Services (CMS)
o Payment adjustments on Medicare Part B FFS will begin in
2015 for providers that have not successfully participated
in the program
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Introduction
o Is this the only CMS Quality Improvement Program?o There are other programs:
o Physician Quality Reporting System (PQRS)
o E-Prescribing (eRX) Incentive Program
o Each program has it’s own requirements, timelines, bonuses, and payment
adjustments
o Questions regarding PQRS and eRx incentives/penalties will not be answered
today. Feel free to contact [email protected] for additional
assistance.
**TODAY’S PRESENTATION: EHR Incentives Program**
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Introduction
STAGE 1:
Data Capturing & Sharing
2 Years*
STAGE 2:
Patient Engagement and
Electronic Exchange of Info
2 years
STAGE 3:
Improved Outcomes
*Due to the postponement of Stage 2 MU, providers
that began MU in 2011 may have been in stage 1 for 3
years compared to 2 years
o How does the program work?o Consists of 3 stages w/ increased requirements
o 5 reporting periods, spread over 5 years (depending on initial reporting year)
o 1st reporting period: any 90 days in your first calendar year
o Providers attempting Meaningful Use for the first time in 2015 should attest by October 1st, 2015
o 2nd-5th reporting periods: Full Calendar Yearo Exception: in 2014 all providers reported on a 90 day quarter regardless of stage
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What’s My Status?o Remember: MU is a provider program. Some practices may have
providers in multiple stages. It’s important to determine each providers
status prior to beginning the reporting quarter.
My First MU Year: 2012
During 2015:
•You are on Stage 2
•You must report data
for the full year
•You may qualify for $4k
incentive
•You must attest this
year to avoid
2017penalties
My First MU Year: 2013
During 2015:
•You are on Stage 2
•There are NEW Stage 2
measures that you
didn’t have to do in
Stage 1.
•You must report data
for the full year
•You may qualify for $8k
incentive
•You must attest this
year to avoid 2017
penalties
My First MU Year: 2014
During 2015:
•You are on Stage 1, year
2
•You must report data
for a full calendar year
•You must attest by the
beginning of 2016
•You may qualify for the
$8k incentive
•You must attest this
year to avoid 2017
penalties
My First MU Year: 2015
During 2015:
•You are on Stage 1
•You must report data
for any 90 day period
(does not have to be on
calendar quarter)
•You must ATTEST no
later than Oct 1st of this
year to avoid payment
adjustments in 2016.
•You do not qualify for
any incentive payment
•You must attest this
year to avoid 2017
penalties
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INCENTIVE PAYMENTS
Options To Earn Your Share
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Incentive AmountsMedicare Payment Breakdown
o Eligibilityo Non-hospital based providers, and must see 50% of patients at a practice or
practice(s) with an EHR systemo MD, DO, DDS, DPM, OD, DC
o Amount Stipulationso Bonus amount is based on year Meaningful Use is achieved using certified EHR
o Incentive payment is 75% of your Medicare allowed charges, up to a maximum capo For example, providers that started MU in 2012 must have billed more than $10,666 to
earn the full $8,000K in 2014
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Incentive AmountsSequestration and the EHR Incentive Programs
o Incentive payments made through the Medicare Electronic Health Records (EHR) Incentive Program are subject to the mandatory reductions in federal spending known as sequestration, required by the Budget Control Act of 2011. Under these mandatory reductions, Medicare EHR incentive payments made to eligible professionals and eligible hospitals will be reduced by 2%. This 2% reduction will be applied to any Medicare EHR incentive payment for a reporting period that ends on or after April 1, 2013. If the final day of the reporting period occurs before April 1, 2013, those incentive payments will not be subject to the reduction.
o This reduction does not apply to Medicaid EHR incentive payments
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Incentive AmountsMedicaid Payment Breakdown
o Eligibility
o Minimum 30% Medicaid Patient Population (defined by each state)
o Physicians, Certified Nurse Midwives, Nurse Practitioners, and Physician Assistants
o PAs must be employed by a FQHC or RHC run by a PA
o Amount Stipulations
o Year 1- Must show providers have “Adopted, Implemented, or Updated” (AIU) a certified EHR
o Year 2 & Up- Must meet Meaningful Use Objectives
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Incentive AmountsMedicare Penalties
o Failure to Participate
o If you don’t meet MU for the first time by October 1st, 2015, your Medicare reimbursements will be penalized in 2016
o If you don’t meet MU in consecutive years you will also be penalized.
o Penalties will increase 1% until schedule is reduced by 5%
o 2015: 1% reduction in Medicare fee schedule
o 2016: 2% reduction in Medicare fee schedule
o 2017: 3% reduction in Medicare fee schedule
o And so forth…
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INCENTIVE REQUIREMENTS
Certified EHR, Meaningful Use Objectives & Clinical Quality Measures
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Incentives RequirementsCertified EHR
o EHRs must be certified to earn incentives
o NextGen™ EHR v5.8 KBM 8.3
Ambulatory EHRNextGen EHR v5.8+Behavioral Health
+Cardiovascular with Advanced Reporting
+Child Health
+Dermatology
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Incentives RequirementsCertified EHR
o What does this mean for your practice?
o Must upgrade to version 5.8 and KBM 8.3 prior to
beginning your Meaningful use reporting period
o Two Separate Upgrades:
o NextGen 5.8 – Application Version (EHR & EPM)
o KBM 8.3 – Clinical Templates (EHR Only)
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Incentives RequirementsMeaningful Use
o What is Meaningful Use?
o Comprised of three measures groups:
o Core & Menu Objectives/Measures
o Focus on utilization of EHR, patient engagement, and
electronic exchange of health info
o Clinical Quality Measures
o Focus on Provider’s Clinical Performance
Meaningful Use
17 + 3 + 9 = MUCore
Measures
Menu
MeasuresCQMs
Meaningful
Use
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Incentives RequirementsCore & Menu Objectives
o Objective Setso 17 Core Objectives
o Required for all providerso Some core objectives have
exclusions
o 6 Menu Objectiveso Must choose 3 out of 6o Providers can choose objectives
based on existing workflowo Exclusions no longer count as
satisfying the measure unlessthere are no other measures that would apply
3 Core CQMs & 3 Menu
CQMs
Total 6 of 44 CQMs
3 Core CQMs & 3 Menu
CQMs
Total 6 of 44 CQMs
9CQMs
Covering 3 Strategy
Domains
Total 9 of 64 CQMs
9CQMs
Covering 3 Strategy
Domains
Total 9 of 64 CQMs
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Incentives RequirementsMeaningful Use
o In addition to the Core & Menu Objectives, professionals must report on Clinical Quality Measures.o Clinical Quality Measures are different from the Core and
Menu Objectives
o There are no thresholds to meet, simply report data exactly as reported by your EHR
Meaningful Use
17 + 3 + 9 = MUCore
Measures
Menu
Measures
CQMs Meaningful
Use
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Incentives RequirementsClinical Quality Measures
o Things to remember:
o Must report on 9 out of the 64 possible CQMS
o 3 different National Quality Strategy Domain
o Our team will assist you in selecting measures & running
reports.
o There are no minimum values to achieve- You only have to
report on them.
o IMPORTANT NOTE: CQM’s will eventually become public data. This
means that patients will have the ability to view how the EPs are
providing additional clinical quality care to their patients.
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Incentives RequirementsRecap of MU Stage 2 Changes
o Must be on 2014 Certified EHR Versiono Requires system upgrades
o New Objectives/Measures
o Exclusions for Menu Objectiveso No longer count towards your 3 items
o Updated clinical quality measures
o No Longer Utilize MU Crystal Reporto The summary report will be located in the HQM Module
o MU Check and CQM Check Templates
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REGISTRATION, ATTESTATION, &
PAYMENT
How Will CMS Know I’ve Achieved the Measures?
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Registrationo Each provider must be registered. If you have any new providers you
must re-register the provider with your practice.o https://ehrincentives.cms.gov
o If you have not registered:o Email [email protected] and request to schedule a shadow session
o Items neededo National Provider Identifier (NPI)
o National Plan & Provider Enumeration System (NPPES) User ID and Password.o (Some practices call this the NPI log-in and password)
o Payee Tax Identification Numbero Last 4 SS #
o Group Tax ID
o Group NPI
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Attestation (Reporting) Process
o Each provider’s data must be submitted individually.
o To avoid Medicare Part B payment reductions in 2015 providers must have
reported by Oct 1st 2014 if it is their 1st year reporting, and meet Meaningful Use
for each consecutive year
o Providers that are not in their first reporting year have until the end of February
of the following year to submit data
o TSI Healthcare is happy to shadow your attestation. TSI Healthcare will not
shadow an attestation without first completing the pre-attestation call.
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Payment Timing
o Incentives for each provider will be paid in a single,
consolidated, annual incentive payment.
o Payments will be made on a rolling basis, typically 4 to 12
weeks after attestation.
o ***Must meet Medicare Allowable minimums prior to receiving check
o Payments ARE taxable income.
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TIPS FOR SUCCESS
What We’ve Learned
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Tips for SuccessEstablish a MU Team & Delegate Responsibilities
o Create a Team & Meet Often
o Create a Meaningful Use team comprised of a practice administrator and a clinical manager at a minimum.
o Meet weekly to review HQM Module reports and identify areas of improvement.
o Share with Your Entire Team
o Keep EVERYONE in the loop. Many of the objectives are workflow items for administrative staff, nurses, and medical assistants. Sharing everyone’s progress with the entire group encourages individual improvement.
o Save your documentation
o CMS can audit your practice up to 6 years after participation.
o It’s important for practices to retain supporting documentation that all measure requirements were satisfied. The practice is responsible for this not TSI Healthcare.
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Tips for SuccessPlan Aheado Establish a Time Line
o Setting an end-goal will help define how your team progresses through the process.
o Communicate with TSI Healthcare often and with advanced notice. We’re here to help.
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Tips for Success
o Plan Ahead - Don’t Procrastinate
o There WILL be changes to your workflow with the new Stage 2
measures. Account for these changes when you plan your timeline.
o Contact TSI Healthcare as often as necessary
o Our Meaningful Use team is here to help with questions on reports,
reviewing progress, registration, and attestation.
o To ensure your team moves forward successfully, feel free to reach
out regularly. The resources are available… requesting assistance
ensures our team is aware of your plans and progress.
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What the lawyers make us say…o Eligibility for incentives is tied to adoption and “meaningful” use of certified EHR technology, which is
defined by the various agencies and offices of the US Federal Government. Incentive programs are part
of the American Recovery Act of 2009 and the HITECH Act of 2009 and are administered by such agencies
outlined therein and are subject to change. All questions as to the interpretation of ARRA, The HITECH
Act, other relevant rules, regulation, incentives programs, and/or their application to a specific practice,
provider or organization should be directed at the appropriate government agency. TSI Healthcare (TSI)
will attempt but does not guarantee to provide the necessary tools to achieve these requirements;
furthermore, the responsibility remains on the provider to successfully achieve and report on each
incentive payment. TSI does not administer incentive payments, guarantee eligibility, or guarantee the
accuracy or analysis of any statements of or about the program. TSI and its representatives have
provided guidance on current policy and does not present these findings as expert advice regarding
federal policies or their requirements. The opinions of this presenter are not necessarily the opinions of
TSI Healthcare.
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