StateNet Community Meeting & Webinar May 30, 2012

1. StateNet Community Meeting & Webinar May 30, 2012

2. Meeting Overview • Welcome • Randy McCleese, StateNet Chair • Neal Ganguly, Vice StateNet Chair • Medicaid HIT • Jessica Kahn, Senior Technical Advisor, Center for Medicaid and CHIP Services • StateNet in 2012 • StateNet Community Updates

3. Medicaid HIT Jessica Kahn • Senior Technical Advisor, Center for Medicaid and CHIP Services

4. Medicaid IT (HIT, HIE, HIX and other acronyms du jour) Presented by Jessica Kahn Senior Technical Advisor Center for Medicaid and CHIP Services CHIME May 30, 2012

5. Overview • Quick Status look • Medicaid HIE Funding and current approaches • Overlaps with Eligibility and Enrollment, MMIS and HIX • Questions to Ponder

6. Medicaid EHR Incentive Program Status • First 11 States launched January 3, 2011 (same date Medicare EHR Incentive Program went live) • 44 States have active incentive programs as of May 7, 2012 • Remaining States to launch during 2012 (Territories will start launching in 2013) • 43 States have paid incentives as of late May 2012

7. Medicaid EHR Incentive Payments • As of April 30, 2012: • 1,894 eligible hospitals have been paid $1.6 billion • 35,040 eligible professionals have been paid $736 million • Total Medicaid Incentives Paid through April 30, 2012: $2.3 billion

8. Medicare Payments • As of April 30, 2012: • 949 eligible hospitals have been paid $1.7 billion • 56,214 eligible professionals have been paid $953 million • Total Medicare Incentives Paid through April 30, 2012: $2.7 billion • Total Medicaid & Medicare EHR Incentives Paid through April 30, 2012: $5 billion!

9. Medicaid HIE Funding • Under HITECH, CMS can provide administrative funding to States for the administration of the Medicaid EHR Incentive Program, including activities that enable EHR adoption and health information exchange • Enables MU measures (public health reporting, transmission of care summaries, etc.) • Potential use for CQM submission (not just HITECH but also CHIPRA, ACA Adult measures, etc)

10. Approved Medicaid HIE Funding • Approved for 90% FFP (Federal Financial Participation) matching funds are: • Massachusetts • Tennessee • Iowa • North Carolina • Arizona • Vermont • Under discussion: RI, NM, TX, AL, IN

11. Medicaid HIE Funding Continued • The parameters for Medicaid funding for States’ HIE activities are outlined in a State Medicaid Directors Letter from May 2011 • Highlights include cost allocation among other payers and providers per OMB A87 • Example projects include provider directories, master patient indexes, interfaces with public health, privacy & security applications, and discounts for HIE participation fees for providers eligible for EHR incentive payments

12. Examples • Vermont- enterprise-wide HIE components such as ID management (eMPI) & provider directory for HIE, HIX and the Medicaid Eligibility and Enrollment System • Massachusetts- reliant upon local/regional HIEs; creating a HISP and a State-hosted virtual gateway

13. Examples Cont’d • Iowa- statewide, enterprise model HIE that captures quality measures and serves as the gateway to public health • North Carolina- federated, statewide HIE; hybrid model to connect existing HIEs and provide HIE services itself. Funding requested for a security service, patient matching, provider directory, NwHIN gateway and secure messaging using DIRECT.

14. Examples • Tennessee- network of networks approach, core HIE services such as Service Access Layer, Trust Broker, RLS, Master Provider/Facilities Index and connection to public health; Medicaid claims CCD

15. Linkages with Other Systems Initiatives • Several of the HIE components can be leveraged for the Health Insurance Exchanges (HIX), for Medicaid eligibility and enrollment systems (E&E) and Medicaid Management and Information Systems (MMIS). • Identity management (ex. Vermont’s enterprise master persons index and State Master Provider Directory) • Data management • Rules engines • Workflow engines • Cost allocation is the name of the game

16. HIE, E&E and HIX Overlap • State CIOs: • Where are the builds happening (Medicaid/CHIP, Human Services, HIX grantee)? • Authorities • Cost Allocation • Funding stream(s) and duration • Enterprise planning possible? • Short-term vs. long-term (uncoupling, recoupling, staying coupled) concepts of operations • Reusability • CMS Standards and Conditions for Medicaid IT

17. Questions to Ponder • What should we invest in (Medicaid)? • What do we need to be a value-based purchaser of health care (ACOs, shared savings reforms, better care coordination for duals, etc)? • Where could HIE be a tool to prevent/identify fraud and abuse? • Where can shared components/services improve the whole enterprise instead of considering each of these IT initiatives in silos.

18. Questions • www.cms.hhs.gov/EHRIncentiveprograms • List-serve • Data and reports • www.medicaid.gov • State Medicaid directors letters • Information on Medicaid IT guidance, eligibility and enrollment and MMIS guidance, etc. • Questions: Jessica.kahn@cms.hhs.gov

19. Questions?

20. StateNet Membership CIO Coordinators are CHIME members who have taken ownership of HIT activities in their state and they are more active in communicating and coordinating with other stakeholders • CHIME Members • may include: • PSC Members • ALT Members • Other CHIME members Other HIT Stakeholders can include public officials, HIE or REC professionals, vendors, doctors, etc.

21. StateNet Community Updates • Workforce Survey • First week of June • Meant to inform stakeholders on the challenges and opportunities in staffing HIT-related positions • Active StateNet Groups • Health Information Exchange group • Looking at top road blocks – governance, sustainability, etc. • Join conversation at: http://ciostatenet.org/group/health-information-exchange • We’re Growing! • Nearly 500 StateNet Community members • Invite others to join at http://ciostatenet.org

22. StateNet Community Updates • State CIO Coordinators • For those who are, or those who are interested, a survey will be coming within the next few days asking for you to “re-up” or suggest candidates to represent CHIME in their state • We’ll be looking to gather information on: • HIT Governance and State Strategy • EHR Adoption and Workforce • HIE Participation More to come soon!

23. Calendar Upcoming Events: • Advocacy Leadership Webinar – June @ 11am ET • StateNet CHIME Members Only Webinar– June @ 2pm ET

24. StateNet Community Updates • Fall Forum (Oct. 16-19) • 3rd Annual StateNet Sunrise Session • Well attended last year – StateNet community was around 50; now we’re at 500! • We’ll be looking to highlight innovative work • For example HIE, workforce, State-led (Medicaid) initiatives, etc. • Contact jsmith@cio-chime.org if you’re interested in presenting or learning more

25. Questions? Go to: http://ciostatenet.org to get started! CHIME StateNet Chair: Randy McCleese, St. Claire Regional CHIME StateNet Vice Chair: Neal Ganguly, CentraState CHIME Staff Sharon Canner, Senior Director of Advocacy Programs scanner@cio-chime.org Jeff Smith, Assistant Director of Advocacy Programs jsmith@cio-chime.org Angela Morris, Advocacy Coordinator amorris@cio-chime.org