NPAIHB REC

1. NPAIHB REC NPAIHB Regional Extension Center Update Katie Johnson, Pharm D EHR Integrated Care Coordinator, REC Manager June 2012

2. Services Planning Resource Guidance on navigating MU registration/attestation Individual planning for participation in Incentive Programs MU Performance Measure Resource Guidance on how to actually meet MU! Assist where possible (Ex: Security Risk Analysis) • Information resource • Office Hours • Website • Tip sheets • Interface with other organizations • Technical resource • Consultants • Lab, Pharmacy, IT • EHR Troubleshooting • WorfkflowAnaylsis

3. More Services • REC is here to meet your needs • It is still a new and developing program • If you identify a need for meeting MU… • Just ask and we’ll see what we can do!

4. Grant Structure • Grant Credits • Milestone 1 • Milestone 2 • Milestone 3 • Earn as you go • 127 Providers from 27 sites • 3 more sites pending

5. MU (Briefly) • Medicaid • Must meet a 30% patient volume requirement • Tribal sites can use “needy patients”, Federal sites can not • More potential money - $63,750 per provider over the life of the program • May start as late as 2016 • First year is simply Adopt, Implement, or Upgrade (this is the easy part!) • Must qualify each year

6. MU (Briefly) • Medicare • No patient volume requirement, but you must be billing on the Medicare Part B Physician Fee Schedule • If the provider is billing less that $25,000/yr Medicare Part B, then their incentive payment will be less • Less potential money – max $44,000 per provider over the life of the program • Last year to start = 2014 (2012 for max payments) • First year is actually meeting MU for 90 days! • Penalty phase – starting in 2015

7. MU (Briefly) • When would you choose Medicare Program? • Provider does not meet 30% patient volume requirement for Medicaid • Provider is a podiatrist, optomitrist, or chiropractor • Switching Programs • Can do this one time • Ex – qualify first year for Medicaid, but can’t qualify the next year….ok to switch to Medicare

8. $ Money $ • ~ $800,000 paid to sites in Portland Area • 41 providers from 10 sites • Several more providers from 5 more sites pending payments • Largely from Medicaid program • Potential for many more providers to get payments – still plenty of time to start!

9. Moving forward • If you haven’t started yet – • Still plenty of time • Focus on qualifying for Medicaid • Registration • This is real money… • Let’s get that first year Medicaid payment!

10. Moving Forward Timeline for those that have already participated

11. Timeline • First Year Medicaid 2011 • Meet MU for 90 days in 2012 • Last day to start Oct 3, 2012 • First Year Medicaid 2012 • Meet MU for 90 days in 2013 • Last day to start Oct 3, 2013

12. Timeline • First Year Medicare 2011 • You already met MU for 90 days in 2011 • You are in a 365 day reporting period for 2012 • First Year Medicare 2012 • You must meet MU for 90 days in 2012 • Start by Oct 3, 2012

13. REC Timeline • M3 Acceleration from ONC • Reasons • What it means • How it will help

14. Barriers • E-prescribing • Required to meet MU • Inhouse RPMS Pharmacy • Tribally owned COTS Pharmacy • No Pharmacy • 14 sites signed up with the REC that will need e-Prescribing for MU

15. RPMS E-Prescribing • Released March 2012 • Controlled Release • Many requirements to complete before going live • Drug File Optimization • 3 signed Agreements • BAA, DEA, EUA

16. E-Prescribing 7 sites with drug files ready to go 2 sites scheduled 1 ready to be scheduled Washington State Board of Pharmacy

17. E-Prescribing • Interface with COTS Pharmacy • Requirements are written from RPMS side • May take to your COTS vendor and ask if they will program a way to interface with RPMS • Will still want Drug File optimized, as interface would use the same functionality as e-Prescribing

18. MU Stage 2 • Final Rule due out this summer • Parts may go into effect immediately • Patient Volume calculations? • Others would take effect in 2014 most likely

19. Stage 2 Comments • Public Comments were written and submitted on behalf of NPAIHB • Also commenting: • USET • NIHB • CRIHB • IHS

20. Stage 2 Highlights Patient Volume Calculations • Expanded definition of Medicaid patient encounter • Hopefully helps Service Units use the Group Volume calculation • Flexible look-back period • Previous 12 months vs prior calendar year

21. Stage 2 Highlights • Performance Measures • Increasing target percentages • Moving menu set to core set • “Test” transmissions changed to “successful and ongoing”

22. Stage 2 Highlights • Measures relying on patient action • Provide online access to health information for more than 50% of patients with more than 10% actually accessing • View/download/transmit health information • More than 10% of patients send secure messages to their providers

23. Stage 2 Comments • General – provider based program now relying on patient action for incentives and to avoid payment penalties? • Internet Access Issue • Broadband Exclusion • Poorly outlined, difficult to interpret

24. Stage 2 Comments Many other, much more detailed comments Will analyze further when Final Rule comes out

25. Questions?

26. Contact Information • NPAIHB Regional Extension Center Contact • Katie Johnson , Pharm D • 503-416-3272 kjohnson@npaihb.org • rec@npaihb.org • http://www.npaihb.org/programs/ehr/ • IHS Meaningful Use Contacts • Angela Boechler, BBA Meaningful Use Consultant 503-414-5579 Angela.Boechler@ihs.gov • Capt. Leslie Dye Meaningful Use Coordinator 503-414-5599 Leslie.Dye@ihs.gov