Presentation Transcript

1. Stage 2 Meaningful UsePresented by Becky Kane

2. Stage 2 Topics Overview 2014 Reporting Changes Medicaid Provider Eligibility Core Objectives Comparison Menu Objectives Comparison Clinical Quality Measures
3. High Level Overview (1 of 2) Does everyone move to Stage 2 in 2014? No, everyone must do TWO years of Stage 1 before they move to Stage 2 (unless they skipped a year because they did not meet MU) If you have not completed a second year of attesting for Stage 1, you do not need to worry about most of these changes until you complete the second year of stage 2 Which Meaningful Use stage do providers need to demonstrate in 2014? If you demonstrated MU Stage 1 for the first time in 2011 or 2012, then you must demonstrate Stage 2 in 2014 If you demonstrated MU Stage 1 for the first time in 2013 (or have never demonstrated MU) , then you must demonstrate Stage 1 in 2014
4. High Level Overview (2 of 2) How long is the attestation period in 2014? All providers, regardless of their stage of MU, are only required to demonstrate MU for a three-month EHR reporting period in 2014: Medicare Providers - three-month reporting period is fixed to the quarter of calendar year for EPs Medicaid Providers - three-month reporting period is not fixed Which Certified EHR Technology Do I Need to Use in 2014? Regardless of the Meaningful Use Stage, if you are demonstrating in 2014 you must use 2014 Certified EHR Technology All 2011 certifications “expire” on 12/31/13
5. Stages of Meaningful Use
6. Triple Aim for Meeting Meaningful Use
7. Stage 2 Topics Overview 2014 Reporting Changes Medicaid Provider Eligibility Core Objectives Comparison Menu Objectives Comparison Clinical Quality Measures
8. 2014 Reporting Changes Reporting Period Reduced to Three Months Allows providers time to adopt 2014 certified EHR technology and prepare for Stage 2 All participants will have a three-month reporting period in 2014 Stage 2 rule allows for batch reporting Starting in 2014, groups will be allowed to submit attestation information for all of their individual EPs in one file for upload to the Attestation System, rather than having each EP individually enter data
9. All EPs, EHs, and CAHs: Upgrade to2014 Edition certified EHR Starting with the 2014 meaningful use reporting period all EPs, EHs, and CAHs need to upgrade to 2014 Edition EHR technology only – regardless of the meaningful use stage they need to meet The 2014 Edition EHR certification criteria support both revised MU Stage 1 and new Stage 2 requirements 2011 Edition will no longer be acceptable for the purposes of meeting the “Certified EHR Technology” definition and from a regulatory perspective 2011 Edition certifications will “expire” come the 2014 MU reporting period
10. 2014 has a Special MU Reporting Period Length Medicare Medicaid All Medicaid EPs, EHs, and CAHs (as determined by their state) will have an “any continuous 90-day” or 3-month reporting period during 2014 For non-first time Medicare EPs, EHs, and CAHs One calendar quarter during the reporting year (e.g., April 1, 2014 through June 30, 2014 would be a Medicare EP’s 2nd quarter and an EH/CAH’s 3rd quarter) All new EPs, EHs, and CAHs continue to have an “any continuous 90-day” reporting period
11. Penalties Add Up for Medicare Providers!
12. Medicaid Differences Medicaid EHR Incentive Program policy is different in two respects: The Medicaid program does not have payment adjustments, so hardship exceptions are unnecessary Medicaid providers are not required to participate in consecutive years of the Medicaid EHR Incentive Program For example, if a Medicaid EP skips 2014 (which would otherwise be their “Stage 1, Year 2”) and also skips 2015 but comes back to the Medicaid program in 2016, they would be required to demonstrate “Stage 1, Year 2” in 2016 as if they never left the Medicaid program for those two years Which is unlike Medicare which requires that they move to the next Stage if it is in place
13. 2014 is the Last Year Medicare EPs Can Start MU to Get Incentive Payments As stated in the Health Information Technology for Economic and Clinical Health (HITECH) Act, no incentives can be paid to Medicare EPs that begin MU after 2014 EPs that start MU in 2014 could still earn as much as $24,000 in incentives if they demonstrate MU from 2014 through 2016
14. Stage 2 Topics Overview 2014 Reporting Changes Medicaid Provider Eligibility Core Objectives Comparison Menu Objectives Comparison Clinical Quality Measures
15. Medicaid Provider Eligibility Expansion Patient Encounters (for 2014) The definition of what constitutes a Medicaid patient encounter has changed. The rule includes encounters for anyone enrolled in a Medicaid program, including Medicaid expansion encounters (except stand-alone Title 21), and those with zero-pay claims The rule adds flexibility in the look-back period for overall patient volume
16. Medicaid Patient Volume Calculation Medicaid Encounters Previously under Stage 1 Rule prior to 2013 Service rendered on any one day where Medicaid paid for all or part of the service or Medicaid paid the co-pays, cost-sharing, or premiums Changed in Stage 2 Rule (applicable to all stages) Service rendered on any one day to a Medicaid-enrolled individual, regardless of payment liability Includes zero-pay claims and encounters with patients in Title 21-funded Medicaid expansions (but not separate CHIPs) Zero-pay claims include Claim denied - Medicaid beneficiary has maxed out the service limit Claim denied - service wasn’t covered under the State’s Medicaid program Claim paid at $0 - another payer’s payment exceeded the Medicaid payment Claim denied - claim wasn’t submitted timely
17. Medicaid Provider Eligibility Patient Volume Calculation Under Stage 1 rule prior to 2013 Medicaid patient volume for providers calculated across 90-day period in last calendar year Under Stage 2 rule (applicable to all stages) States also have option to allow providers to calculate Medicaid patient volume across 90-day period in last 12 months preceding provider’s attestation Also applies to needy individual patient volume Applies to patient panel methodology, too With at least one Medicaid encounter taking place in the 24 months prior to 90-day period (expanded from 12 months prior)
18. Stage 2 Topics Overview 2014 Reporting Changes Medicaid Provider Eligibility Core Objectives Comparison Menu Objectives Comparison Clinical Quality Measures
19. Core Measures Comparison
20. Core Objective 1 Comparison
21. Core Objective 2 Comparison
22. Core Objective 3 Comparison
23. Core Objective 4 Comparison
24. Core Objective 5 Comparison
25. Core Objective 6 Comparison
26. Core Objective 7 Comparison
27. Core Objective 8 Comparison
28. Core Objective 9 Comparison
29. Core Objective 10 Comparison (1 of 2)
30. Core Objective 10 Comparison (2 of 2)
31. Core Objective 11 Comparison
32. Core Objective 12 Comparison
33. Core Objective 13 Comparison
34. Core Objective 14 Comparison
35. Core Objective 15 Comparison (1 of 2)
36. Core Objective 15 Comparison (2 of 2)
37. Core Objective 16 Comparison
38. Core Objective 17 Comparison
39. Stage 2 Topics Overview 2014 Reporting Changes Medicaid Provider Eligibility Core Objectives Comparison Menu Objectives Comparison Clinical Quality Measures
40. Menu Measures Comparison
41. Menu Objective 1 Comparison
42. Menu Objective 2 Comparison
43. Menu Objective 3 Comparison
44. Menu Objective 4 Comparison
45. Menu Objective 5 Comparison
46. Menu Objective 6 Comparison
47. Stage 2 Topics Overview 2014 Reporting Changes Medicaid Provider Eligibility Core Objectives Comparison Menu Objectives Comparison Clinical Quality Measures
48. Clinical Quality Measures Must be submitted electronically Unless 2014 is Year 1 for you PQRS???? Plan is to have aligned and co-reported with CQM’s
49. Topic 5 - Clinical Quality Measures All providers must select CQMs from at least 3 of the 6 HHS National Quality Strategy (NQS) domains Patient and Family Engagement Patient Safety Care Coordination Population and Public Health Efficient Use of Healthcare Resources Clinical Processes/Effectiveness Medicaid providers will electronically report their CQM data to their state
50. Preparing for Stage 2 (1 of 3) What to do to Prepare for Stage 2 Continue Meaningful Use of your current EHR and upgrade to latest version Exceed the MU Stage 1 requirements (higher thresholds and more measures) and choose CQMs
51. Preparing for Stage 2 (2 of 3) Patient Engagement Stage 2 has greater emphasis on Patient Engagement, which includes objectives such as Patient Electronic Access, Patient Reminder, Patient Education, and Secure Electronic Messaging Provide health information access using a patient portal Help patients manage their health and wellness using a patient portal Send Patient Reminders electronically through a patient portal
52. Preparing for Stage 2 (3 of 3) Interoperability Interoperability is the cornerstone of the Meaningful Use Stage 2. The objectives include Summary of Care Record, Submit Immunization Data, Imaging Results, etc. Join electronic provider to provider exchanges to send peer-to-peer communication and exchange Summary of Care Records Connect with your state Immunization Registry
53. Questions? QUESTIONS?
54. Thank You! THANK YOU, Becky Kane at: rkane1@health.usf.edu (813) 455-8950