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Performance Progress CoP Medicaid EHR Incentive Program June 9, 2015
1 Agenda
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 2 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. Disbursed Payment Adopt, Implement, 50 States plus Puerto Rico, D.C., and N.M.I. Upgrade (AIU)
Meaningful 50 States plus D.C. & Puerto Rico Use (MU)
4 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 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
11 ELIGIBLE HOSPITALS SUMMARY
12 Location of Eligible Hospitals Highest Stage of Certified EHR Technology (CEHRT) Adoption
115 Wisconsin Eligible Hospitals are Stage 1 Meaningful Users 10 Wisconsin Eligible Hospitals Adopted, Implemented or Upgraded CEHRT
Figure based on Medicare & Medicaid EHR Incentive Program Data 13 Eligible Hospital Meaningful Use Core Measures Analysis
Title Measure Threshold Wisconsin Average Percentage
Core Measure 1: Computerized More than 30 percent 90.30% Physician Order Entry (CPOE) for Medication Orders Core Measure 3: Maintain More than 80 percent 96.13% Problem List Core Measure 4: Active More than 80 percent 98.65% Medication List Core Measure 5: Medication More than 80 percent 98.88% Allergy List Core Measure 6: Record More than 50 percent 97.34% Demographics Core Measure 7: Record Vital More than 50 percent 94.03% Signs Core Measure 8: Record More than 50 percent 96.40% Smoking Status Core Measure 11: Electronic More than 50 percent 95.71% Copy of Health Information Core Measure 12: Electronic More than 50 percent 95.30% Copy of Discharge Instructions Figure based on Medicare & Medicaid EHR Incentive Program Data 14 *Measures with Numerator and Denominator only Eligible Hospital Meaningful Use Menu Measures Analysis
Title Measure Threshold Wisconsin Average Percentage Menu Measure 2: Advance More than 50 percent 93.93% Directives Menu Measure 3: Incorporate More than 40 percent 96.56% Clinical Lab Test Results Menu Measure 5: Patient- More than 10 percent 85.94% Specific Education Resources Menu Measure 6: Medication More than 50 percent 89.58% Reconciliation Menu Measure 7: Transition of More than 50 percent 78.95% Care Summary
Figure based on Medicare & Medicaid EHR Incentive Program Data *Measures with Numerator and Denominator only
15 Eligible Hospital CEHRT Vendors
Figure based on Medicare & Medicaid EHR Incentive Program Data * The following vendors were used in one attestation: Allscripts, 16 ExitCare, IHM Services, Interface People, RWHC QI Program and SCC Soft Computer Location of Eligible Hospitals Top 5 CEHRT Vendors
Figure based on Medicare & Medicaid EHR Incentive Program Data
17 Regional Summary of Top 5 CEHRT Vendors with Medicaid Population
Figure based on Medicare & Medicaid EHR Incentive Program Data 18
Location of Eligible Hospitals Non-Top 5 CEHRT Vendors
Figure based on Medicare & Medicaid EHR Incentive Program Data 19 ELIGIBLE PROFESSIONALS SUMMARY
20 Location of Eligible Professionals Highest Stage of CEHRT Adoption
7,925 Wisconsin Eligible Professionals are Stage 1 Meaningful Users 1,500 Wisconsin Eligible Professionals Adopted, Implemented or Upgraded CEHRT
Figure based on Medicare & Medicaid EHR Incentive Program Data 21 Location of Dentists Highest Stage of CEHRT Adoption
60 Wisconsin Dentists are Meaningful Users 162 Wisconsin Dentists Adopted, Implemented or Upgraded CEHRT
Figure based on Medicare & Medicaid EHR Incentive Program Data 22 Location of Nurse Practitioner & Nurse Services Highest Stage of CEHRT
285 Wisconsin Nurse Practitioner and Nurse Services Providers are Meaningful Users 442 Wisconsin Nurse Practitioner and Nurse Services providers Adopted, Implemented or Upgraded CEHRT
Figure based on Medicaid EHR Incentive Program Data OnlyEentive
23 Location of Physicians Highest Stage of CEHRT Adoption
7,567 Wisconsin Physicians are Meaningful Users 886 Wisconsin Physicians Adopted, Implemented or Upgraded CEHRT
Figure based on Medicare & Medicaid EHR Incentive Program Data
24 Location of Physician Assistant Highest Stage of CEHRT Adoption
13 Wisconsin Physician Assistants are Meaningful Users 10 Wisconsin Physician Assistants Adopted, Implemented or Upgraded CEHRT
Figure based on Medicaid EHR Incentive Program Data Only
25 Eligible Professional Meaningful Use Core Measures Analysis
Title Measure Wisconsin Average Percentage
Core Measure 1: CPOE for More than 30 percent 92.67% Medication Orders Core Measure 3: Maintain More than 80 percent 97.43% Problem List Core Measure 4: e- More than 40 percent 90.12% Prescribing Core Measure 5: Active More than 80 percent 98.78% Medication List Core Measure 6: Medication More than 80 percent 98.97% Allergy List Core Measure 7: Record More than 50 percent 97.43% Demographics Core Measure 8: Record Vital More than 50 percent 92.19% Signs Core Measure 9: Record More than 50 percent 95.60% Smoking Status Core Measure 12: Electronic More than 50 percent 93.65% Copy of Health Information Core Measure 13: Clinical More than 50 percent 84.89% Summaries
Figure based on Medicaid EHR Incentive Program Data Only *Measures with Numerator and Denominator only 26 Eligible Professional Meaningful Use Menu Measures Analysis
Title Measure Wisconsin Average Percentage Menu Measure 2: Clinical More than 40 percent 95.79% Lab Test Results Menu Measure 4: Patient More than 20 percent 68.64% Reminders Menu Measure 5: Patient At least 10 percent 74.33% Electronic Access Menu Measure 6: Patient- More than 10 percent 70.24% Specific Education Resources Menu Measure 7: More than 50 percent 91.38% Medication Reconciliation Menu Measure 8: More than 50 percent 91.21% Transition of Care Summary
Figure based on Medicaid EHR Incentive Program Data Only *Measures with Numerator and Denominator only
27 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 28 Healthcare Solutions, SuiteMed, SynaMed, The Echo Group, Tolven, Valant, WEBeDoctor, Xcite Health and Encounterpro Healthcare Resources Location of Eligible Professionals Top 5 CEHRT Vendors
Figure based on Medicare & Medicaid EHR Incentive Program Data
29 Regional Summary of Top 5 CEHRT Vendors with Medicaid Population
Figure based on Medicare & Medicaid EHR Incentive Program Data
30 WHAT’S NEXT AND Q&A
31 IAPD Submission: Process, Tips, and Q&A
Robert McCarthy, CMS/CMCHO
32 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.
33 IAPD Expiration Date Timing Examples
• IAPD Expiration on September 30: • September: IAPD expires 9/30/15 Bottom Line: • August: CMS-37 due 8/15/15 for FFQ1 Submit IAPD to • Early July: Must submit IAPD-U CMS 3 months • June: Recommend submitting IAPD-U before expiration • IAPD Expiration on June 30: date to allow for • June: IAPD expires 6/30/16 enough time for • May: CMS-37 due 5/15/16 for FFQ4 review and • Early April: Must submit IAPD-U • March: Recommend submitting IAPD-U approval
34 Key CMS Contacts
• HITECH RO Staff: • http://www.medicaidhitechta.org/ContactUs/CMSStaff.aspx • IAPD: • Robert McCarthy: 206-615-2505, [email protected] • Financial Coordinator: • Carrie Feher: 410-786-8905, [email protected]
35 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
36 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.
37 38 What’s Next
• Next Performance Progress CoP: Tuesday August 25, 2015 at 3:00 PM ET • Please contact Melissa Corrado [email protected] 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: [email protected]
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Resources
www.cms.hhs.gov/EHRIncentiveprograms Web www.MedicaidHITECHTA.org
Twitter @CMSgov
Sam Schaffzin: [email protected] HITECH Robert McCarthy: [email protected] Staff Nick Aretakis: [email protected]
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