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Medicare & Medicaid EHR Incentive Programs

This resource provides information on the eligibility criteria, requirements, and stages of meaningful use for the Medicare and Medicaid EHR Incentive Programs. It also includes details on the core and menu objectives for each stage, as well as the reporting of clinical quality measures.

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Medicare & Medicaid EHR Incentive Programs

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  1. Medicare & Medicaid EHR Incentive Programs Robert Anthony Deputy Director, Health IT Initiatives Group Office of E-Health Standards and Services Centers for Medicare and Medicaid Services

  2. Eligibility

  3. Who is Eligible to Participate? • Eligibility was defined in statute • Hospital-based EPs are NOT eligible for incentives • DEFINITION: 90% or more of their covered professional services in either an inpatient (POS 21) or emergency room (POS 23) of a hospital • Incentives are based on the individual, not the practice

  4. Medicare-only Eligible Professionals Medicaid-only Eligible Professionals Could be eligible for both Medicare & Medicaid incentives

  5. Meaningful Use

  6. Conceptual Approach to Meaningful Use Stage 3 Stage 2 Stage 1

  7. What are the Requirements of Stage 1 Meaningful Use? 2 Years 2 Years And so on . . . Stage 3 – 1 Year Stage 3 – 1 Year Stage 2 – 1 Year Stage 2 – 1 Year Stage 1 – 1 Year Stage 1 – 90 Days

  8. What are the Requirements of Stage 1? Stage 1

  9. Stage 1 EP Core Objectives • 15 Core Objectives • Computerized physician order entry (CPOE) • E-Prescribing (eRx) • Report ambulatory clinical quality measures to CMS/States • Implement one clinical decision support rule • Provide patients with an electronic copy of their health information, upon request • Provide clinical summaries for patients for each office visit • Drug-drug and drug-allergy interaction checks • Record demographics • Maintain an up-to-date problem list of current and active diagnoses • Maintain active medication list • Maintain active medication allergy list • Record and chart changes in vital signs • Record smoking status for patients 13 years or older • Capability to exchange key clinical information among providers of care and patient-authorized entities electronically • Protect electronic health information

  10. Stage 1 EP Menu Objectives • 5 of 10 Menu Objectives • Drug-formulary checks • Incorporate clinical lab test results as structured data • Generate lists of patients by specific conditions • Send reminders to patients per patient preference for preventive/follow up care • Provide patients with timely electronic access to their health information • Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate • Medication reconciliation • Summary of care record for each transition of care/referrals • Capability to submit electronic data to immunization registries/systems* • Capability to provide electronic syndromic surveillance data to public health agencies* * At least 1 public health menu objective + 4 others

  11. Stages of Meaningful Use Stage 3 Stage 2 Stage 1

  12. What are the Requirements of Stage 2 Meaningful Use? Stage 1 Stage 2

  13. Stage 1 Menu  Stage 2Core

  14. New for Stage 2

  15. Closer Look at Stage 2: Patient Engagement • Patient engagement – engagement is an important focus of Stage 2. • EXCLUSIONS–CMS is introducing exclusions based on broadband availability in the provider’s county. • Requirements for Patient Action: • More than 5% of patients must send secure messages to their EP • More than 5% of patients must access their health information online

  16. Closer Look at Stage 2: Electronic Exchange • Stage 2 focuses on actual use cases of electronic information exchange: • Stage 2 requires that a provider send a summary of care record for more than 50% of transitions of care and referrals. • The rule also requires that a provider electronically transmit a summary of care for more than 10% of transitions of care and referrals. • At least one summary of care document sent electronically to recipient with different EHR vendor or to CMS test EHR.

  17. Clinical QualityMeasures

  18. CQM Reporting in 2013 and 2014 • Reporting in 2014 and Beyond Reporting in 2013

  19. CQM Selection and HHS Priorities • All providers must select CQMs from at least 3 of the 6 HHS National Quality Strategy domains: • Patient and Family Engagement • Patient Safety • Care Coordination • Population and Public Health • Efficient Use of Healthcare Resources • Clinical Processes/Effectiveness

  20. http://www.cms.gov/EHRIncentivePrograms/For questions, please contact:Robert AnthonyOffice of E-Health Standards and ServicesCenters for Medicare & Medicaid Servicesrobert.anthony@cms.hhs.gov Stage 1 and Stage 2 Resources

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