Dentists & Meaningful Use: Stage 1Adele Allison,National Director of Government Affairs, SuccessEHS

The Opportunity

•Dentists are eligibleunder both Medicare and Medicaid Incentive Programs

However…

•Medicare does notcover General Dentistry; No Medicare, No Incentive

And…

• No oral health measures in Meaningful Use Stage 1

–No Standards for EDR Certification

–All applicable measures must be performed using EHR Functionality

•253 dentists were paid during Year One of the Incentive Program

YTD earnings = $5,376,250

•Same Stage 1 Criteria applies

•Consider 13 exclusion clauses

Medicaid EHR Incentives: Highlights

• Types of (Medicaid) Providers – §495.100–Physicians, Dentists, Certified

Nurse Midwives, Nurse Practitioners, Physician Assistants (In FQHC/RHC led by PA)

• Year 1: Adopt, Implement, Upgrade – §495.100

–Acquire, purchase or secureaccess to certified EHR technology

–Install/use certified EHR technology capable of MU

Or…

−Expand functionality of certified EHR solution at the practice with:−Staffing−Maintenance−Training−Upgrading from existing EHR to

certified EHR technology.

• Year 2: Meaningful Use for 90 continuous days.

• Years 3 – 6: Meaningful Use for a full year.

• Must meet the individual state requirements for volume threshold–20% for Pediatricians–30% for FQHCs and RHCs–30% for all others

• Defined in the State’s SMHP – Method’s available–By Encounter–By Panel–By Group–Other

•“Needy Individual” is a patient who… §495.302 (FQHC/RHC)−Receives Medicaid or CHIP assistance−Receives uncompensated care by the provider

•“Needy Individual” is a patient who… §495.302 (FQHC/RHC)−Services provided at no cost or reduced cost based on sliding scale and ability to pay

Dentists & MU: Metrics

•67% of U.S. dentists are in a solo practice

•65% of U.S. dentists are “General”

•70% of Americans see the dentist one time a year

•2% of dentists work full-time in safety net

•4.6 million children receive no dental care due to cost

•33.3 million live in Dental Health Professional Shortage Areas

•6.7% of general dentists’ patients are publicly insured

•18.9% of pediatric dentists’ patients are publicly insured

Dentists & MU: Barriers

•Few dentists meet the 30% volume threshold requirement for MU

•20% volume threshold does not apply to pediatric dentists

•Dentists are not on REC “hit list,” including safety net dentists

•Dentistry uses “procedure codes.” This does not include Diagnostic Codes (ICD-9)

•Dentists must continue CMS communication

•Most patients see the dentist when “Well.” This is a missed opportunity for point-of-care alerting

•The IT infrastructure that is common to physicians and hospitals is virtually non-existent in dentistry

•U.S. dentists use the current dental terminology

•There is a lack of EHR and EDR standards-based interoperability in marketplace

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