Wisconsin Medicaid Electronic Health Record (EHR) Incentive Program Overview

1. Wisconsin Medicaid Electronic Health Record (EHR) Incentive ProgramOverview Denise B. Webb State Health IT Coordinator May 9, 2013

2. Agenda Protecting and promoting the health and safety of the people of Wisconsin

3. Background Information Regulation • 2009 American Recovery and Reinvestment Act (ARRA) • HITECH Act • $25.9Bappropriated for health IT Protecting and promoting the health and safety of the people of Wisconsin

4. Background Information Medicaid EHR Incentive Program • . • Launched in 2011 and runs through 2021 • Is NOT a mandatory program for Medicaid providers • Provides payment to providers as they Adopt, Implement, or Upgrade (AIU) or Meaningfully Use Certified EHR Technology (CEHRT) Protecting and promoting the health and safety of the people of Wisconsin

5. Program Requirements Protecting and promoting the health and safety of the people of Wisconsin

6. Program Requirements Eligibility • Medicaid Provider Types: Physician, Dentist, Certified Nurse Midwife, Advanced Practice Nurse Prescriber, Nurse Practitioner, and certain Physician Assistants • Not hospital based • Meet patient volume thresholds • 30%, except pediatricians (20%)

7. Program Requirements Calculating Patient Volume • In order to be eligible to receive payments, Eligible Professionals must meet patient volume requirements. Eligible Professionals can meet the requirement through three different calculation options. • Needy Individual Patient Volume • Medicaid Patient Volume • Group/Clinic Patient Volume A standard deduction will be applied to Patient Volumes using Medicaid Encounters Protecting and promoting the health and safety of the people of Wisconsin

8. Program Requirements Certified EHR Technology – Adopt, Implement, or Upgrade 1st Payment Year Eligible Professional 2nd – 6th Payment Year • Adopt, Implement, or Upgrade Certified EHR Technology or demonstrate meaningful use of certified EHR technology • Demonstrate Meaningful Use of certified EHR technology • EHR Reporting Period • 90 consecutive days within the Program Year for 1st year of demonstrating MU • 1 year for subsequent years of demonstrating MU • In 2014 – 90 consecutive days within the Program Year for all EPs • Adopt • Acquired or installed • Implement • Commenced use • Upgrade • Expansion of the functionality Protecting and promoting the health and safety of the people of Wisconsin

9. Program Requirements Certified EHR Technology – Meaningful Use (MU) 1st Payment Year Eligible Professional 2nd – 6th Payment Year • Demonstrate Meaningful Use of certified EHR technology • EHR Reporting Period • 90 consecutive days within the Program Year for 1st year of demonstrating MU • 1 year for subsequent years of demonstrating MU • In 2014 – 90 consecutive days within the Program Year for all EPs • Adopt, Implement, or Upgrade certified EHR technology or demonstrate meaningful use of certified EHR technology Three Stages of Meaningful Use: A Graduated Approach • Stage 1 – Capture and share data • Stage 2 – Advanced Clinical Processes • Stage 3 – Improved Outcomes Protecting and promoting the health and safety of the people of Wisconsin

10. Value of Certified EHR Technology Protecting and promoting the health and safety of the people of Wisconsin

11. Value of Certified EHR Technology Benefits for Medical Practices and Patients An EHR in your county department may enable providers to… Increase Healthcare Quality Improve Operational Efficiency Reduce Healthcare Costs • Enhance care coordination • Help reduce duplicate testing and delays • Reduce health disparities among different populations • Increase access to affordable care • Enhance patient safety by reducing errors • Access accurate and complete information about patient’s health • Diagnose medical health problems sooner • Better informed clinical decisions • Prescribe more safely and reliably • Measure quality of care and population health through reports and graphs • Reduce paperwork and paperwork storage costs • Eliminate the cost of chart supplies • Increase interoperability with others in- and out-of-state • Reduce or eliminate transcription costs • Lower chronic disease management costs • Lower wellness program costs • Lower medication costs • Increase charge capture with more complete documentation of the care provided • Improve clarity of data entered • Share data with other healthcare providers using state HIEs and the Nationwide Health Information Network, i.e. eHealth Exchange • Reduce missing medical charts • Remotely access electronic medical records • Allow simultaneous access to patient charts by multiple users • Interface with labs, registries, other EHRs, and Health Information Exchanges (HIEs) Protecting and promoting the health and safety of the people of Wisconsin

12. Strategies for Adopting Certified EHR Technology Protecting and promoting the health and safety of the people of Wisconsin

13. Strategies to Consider Before Implementation: Deciding to Participate Vendor Analysis • Interface capabilities of the software • Functions of the software • E-Prescribing • Remote/Mobile Needs • Security • Data exchange and interoperability • Computerized physician order entry (CPOE) • Price 2) Budget/Financial Considerations 3) Penalty Assessment 4) Organizational readiness/provider buy-in • Direct Secure Messaging/HIE • Patient Portal/Personal Health Records • Quality reporting • Coding standards Protecting and promoting the health and safety of the people of Wisconsin

14. Strategies to Consider Purchasing and Financing Options • . County co-op or local health system partnership/sponsorship Group purchases Hospital donations Bank loans and lines of credit Credit Cards 6) Vendor financing options 7) Grants 8) Lab Companies 9) Malpractice Insurance Company Incentives Protecting and promoting the health and safety of the people of Wisconsin

15. Next Steps & Resources Protecting and promoting the health and safety of the people of Wisconsin

16. Path to Payment Steps to begin participating in the Wisconsin Medicaid EHR Incentive Program Protecting and promoting the health and safety of the people of Wisconsin

17. Program Year 2013 Important Dates for Eligible Professionals • Upcoming Key Dates for the Current Program Year • Program Year 2013 ends on December 31, 2013 • The last day for Eligible Professionals to submit an application for Program Year 2013 is March 31, 2014 • Adopt, Implement, Upgrade: Eligible Professionals must demonstrate they Adopted, Implemented, or Upgraded their Certified EHR Technology (CEHRT) prior to December 31, 2013 • Meaningful Use: For those attesting to Meaningful Use, the EHR Reporting Period must be between January 1, 2013 and December 31, 2013 • If this is the Eligible Professional’s first year attesting to Meaningful Use, the professional meets the requirements through the use of a consecutive 90-day EHR Reporting Period • The last day to start the 90-day EHR Reporting Period is October 2, 2013 Protecting and promoting the health and safety of the people of Wisconsin

18. EHR Incentive Program Information CMS Medicare and Medicaid EHR Incentive Program Information https://www.cms.gov/EHRIncentivePrograms/ Certified Health Information Technology List website http://onc-chpl.force.com/ehrcert Wisconsin Medicaid EHR Incentive Program Information http://www.dhs.wisconsin.gov/ehrincentive/ dhsehrincentiveprogram@wi.gov Provider Services (HP) 800-947-9627, ext. 6 Technical Assistance Wisconsin HIT Regional Extension Center (WHITEC) http://whitec.org/ Statewide Health Information Exchange Wisconsin Statewide Health Information Network (WISHIN), Inc. http://www.wishin.org Resources Protecting and promoting the health and safety of the people of Wisconsin

19. Protecting and promoting the health and safety of the people of Wisconsin