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AHCCCS EHR Incentive Program Update AHCCCS Managed Care Organization Update September 19, 2012

AHCCCS EHR Incentive Program Update AHCCCS Managed Care Organization Update September 19, 2012. Overall CMS EHR Incentive Program Participation. More than $3.2 billion in Medicare EHR Incentive Program payments have been made between May 2011 and July 31, 2012.

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AHCCCS EHR Incentive Program Update AHCCCS Managed Care Organization Update September 19, 2012

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  1. AHCCCS EHR Incentive Program Update AHCCCS Managed Care Organization UpdateSeptember 19, 2012 Our first care is your health care Arizona Health Care Cost Containment System

  2. Overall CMS EHR Incentive Program Participation • More than $3.2 billion in Medicare EHR Incentive Program payments have been made between May 2011 and July 31, 2012. • More than $3.1 billion in Medicaid EHR Incentive Program payments have been made between January 2011 (when the first set of states launched their programs) and July 31, 2012 • More than 110,000 eligible professionals and over 2,400 eligible hospitals have been paid by the Medicare and Medicaid EHR Incentive Programs. • Approximately 48 percent of all eligible hospitals and critical access hospitals in the U.S. have received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR. • One out of every 5 Medicare and Medicaid eligible professionals in the U.S. has received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR. • CMS Electronic Health Record Website: • https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/DataAndReports.html Our first care is your health care Arizona Health Care Cost Containment System

  3. Medicare and Medicaid Paymentsby State and Provider (July 31,2012) • Medicare Eligible Professionals (1,149) $19,833,425 • Medicaid Eligible Professionals (988) $20,817,925 • Total EP Payments = (2,137) $40,651,350 • Medicare Eligible Hospitals $0 • Medicaid Eligible Hospital (1) $1,879,947 • Total Dually Eligible Hospitals (63) $84,994,984 • Total Paid Amount $127,526,281 Our first care is your health care Arizona Health Care Cost Containment System

  4. AHCCCS Overall EHR Incentive ProgramAugust 2012 Eligible Hospitals • Total Hospitals Paid = 52 • Total Amount $63,277,383.36 Eligible Professionals • Total Paid = 1,135 • Total Amount= $23,941,675. Our first care is your health care Arizona Health Care Cost Containment System

  5. AHCCCS EHR Incentive Program Eligible Hospitals (EH) As of August 2012 • 69 Registered with CMS • 67 Registered with e-PIP • 62 EHs Attested • 53 EHs Validated • 9 hospitals unpaid; data validation, charity care definitions, Medicare Cost Reporting Our first care is your health care Arizona Health Care Cost Containment System

  6. Summary of Payment by EH Provider Type • Total 52 EHS Paid • Acute Care = 50 • Children’s Hospitals = 2 Our first care is your health care Arizona Health Care Cost Containment System

  7. Link to AHCCCS Website • List of Hospitals that have been paid to date: • http://www.azahcccs.gov/commercial/Downloads/HospitalSupplements/EHRPayments2011_2012.pdf Our first care is your health care Arizona Health Care Cost Containment System

  8. AHCCCS EHR Incentive Program Eligible Professionals (EPs) As of August 2012 • 3,062 Registered with CMS • 2,753 Registered with ePIP • 1,683 Attested • 1,188 validated (gap 495) • 1,135 Paid • Monthly payment processed = 149 • Monthly payment total = $3,166,250. Our first care is your health care Arizona Health Care Cost Containment System

  9. Summary of Payment by EP Provider Type • 45 Certified Nurse Midwives • 40 Dentists • 146 Nurse Practitioners • 0 Physician Assistants so led in FQHC/RHC • 602 Physicians (Non-Pediatricians) • 302 Physicians (Pediatricians) • 1,135 EPS Paid Total Our first care is your health care Arizona Health Care Cost Containment System

  10. Regional Extension Center EHR Incentive Program Analysis

  11. REC Membership Analysis EP Attestations (1,683) Membership Percentage Membership by Provider Type Provider Type Percentage REC Percentage Non-REC Percentage

  12. EP Payments (1,135)REC Membership Analysis

  13. Barriers To Payment EHR Incentive Program

  14. REC - EP Rejections (25) • Root Causes • Failed Patient Volume Criteria (16) • Failed Hospital-Based Criteria (3) • Failed Provider Type (5) • Fraud Detected(1)

  15. Next Steps: Meaningful Use • AHCCCS Opening Soon for MU for Eligible Hospitals and Eligible Professionals • http://www.azahcccs.gov/EHR/MeaningfulUse.aspx • For questions regarding the Arizona Electronic Provider Incentive Payment System, please contact the AHCCCS EHR Incentive Program Staff at: Email: EHRIncentivePayments@azahcccs.gov • Contact Information: Lorie.Mayer@azahcccs.gov • Failed Hospital-Based Criteria (3) • Failed Provider Type (5) • Fraud Detected(1)

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