Nursing Management Congress 2013 Advanced Track ... · 1 Nursing Management Congress 2013 Advanced...

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1 Nursing Management Congress 2013 Advanced Track: Informatics and Meaningful Use Maureen Bueno, PhD, RN VP, Clinical Integration Objectives Describe the purpose of the electronic health record (EHR) incentive/meaningful use (MU) program that is available to providers through the Centers for Medicare and Medicaid Services (CMS) List at least six core objectives for eligible professionals and for eligible hospitals List at least six menu objectives for eligible professionals and for eligible hospitals Describe at least two clinical conditions in the outpatient environment and hospital setting that are the focus of improvement and identify related quality metrics Describe the current state of adoption of EHRs nationwide Determine ways to support EHR adoption Identify at least three resources to learn more about EHR incentives Meaningful Use Use of a certified EHR system in a hospital or provider practice, in a secure manner, to: – Improve quality, safety, efficiency, and reduce health disparities – Engage patients and families in their health care – Improve care coordination – Improve population and public health Aligned with the CMS Triple Aim: 1) improve care for individuals, 2) improve health of populations, and 3) reduce growth in health care expenditures

Transcript of Nursing Management Congress 2013 Advanced Track ... · 1 Nursing Management Congress 2013 Advanced...

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Nursing Management Congress 2013

Advanced Track:Informatics and Meaningful Use

Maureen Bueno, PhD, RNVP, Clinical Integration

Objectives• Describe the purpose of the electronic health record (EHR)

incentive/meaningful use (MU) program that is available to providers through the Centers for Medicare and Medicaid Services (CMS)

• List at least six core objectives for eligible professionals and for eligible hospitals

• List at least six menu objectives for eligible professionals and for eligible hospitals

• Describe at least two clinical conditions in the outpatient environment and hospital setting that are the focus of improvement and identify related quality metrics

• Describe the current state of adoption of EHRs nationwide• Determine ways to support EHR adoption• Identify at least three resources to learn more about EHR

incentives

Meaningful Use

• Use of a certified EHR system in a hospital or provider practice, in a secure manner, to:– Improve quality, safety, efficiency, and reduce

health disparities– Engage patients and families in their health

care– Improve care coordination– Improve population and public health

• Aligned with the CMS Triple Aim: 1) improve care for individuals, 2) improve health of populations, and 3) reduce growth in health care expenditures

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Meaningful Use – 3 Stages

Source: CMS.gov

Office of the National Coordinator (ONC) of the US Department of Health and Human Services

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Certified EHR (Example)

Based on original start (changes

are made to the program)

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National Quality Forum

National Quality Forum

EHR Incentive Requirements:More Difficult Over Time

• Year 1 = Stage 1 for 90-day period• Year 2 = Stage 1 for full year• Year 3 = Stage 2 for full year• Year 4 = Stage 2 for full year

Stage 3 MU expected to begin in 2016 but rule not yet finalized

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Stage 2 Requirements (Examples)

• Electronic medication administration record• Secure messaging• ePrescribing with drug formulary check• Imaging result incorporated• Family health history• Specialized registry• Structured electronic laboratory data

Providers Eligible for Incentive Payments

Eligible professionals under the Medicare EHR Incentive Program include:

Eligible professionals under the Medicaid EHR Incentive Program include:

Doctor of medicine or osteopathy Physicians (primarily doctors of medicine and doctors of osteopathy)

Doctor of dental surgery or dental medicine

Nurse practitioner

Doctor of podiatry Certified nurse-midwife

Doctor of optometry DentistChiropractor Physician assistant who furnishes

services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant

Source: CMS.gov website

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Incentive PaymentsMedicare EHR Incentive Program Medicaid Incentive Program

Run by CMS Run by the State Medicaid AgencyMaximum incentive amount is $44,000 Maximum incentive amount is $63,750Payment over 5 consecutive years Payments over 6 years, does not have

to be consecutivePayment adjustments will begin in 2015 for providers who are eligible but decide not to participate

No Medicaid payment adjustments

Providers must demonstratemeaningful use every year to receive incentive payments

In the first year providers can receive an incentive payment for adopting, implementing, or upgrading EHR technology. Providers must demonstrate meaningful use in the remaining years to receive incentive payments.

Source: CMS.gov website

Attestation Process

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Eligible Professional Payment (75% of Medicare allowed charges, up to the maximum cap below)

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EHR Incentive Payments(as of May 2013)

Number of Payments

Amount in Millions

Professionals 346,245 $5,841

Hospitals 8,057 $8,960

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Alignment of MU and Patient-Centered Medical Home (PCMH)

NCQA PCMH Recognition

MU Aligned with New NCQA Specialty Practice Recognition

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Internet References• http://www.cms.gov/Regulations-and

Guidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html

• http://www.healthit.gov/• http://www.qualityforum.org/projects/im/meaningful_use/meanin

gful_use.aspx• http://www.ncqa.org/PublicPolicy/HealthITMeaningfulUseNCQA

PCMH.aspx• http://www.advisory.com/About-Us• http://www.ahrq.gov/• https://www.cchit.org/home• http://www.hitechanswers.net/