Electronic Medical Records (EMRs) & The Stimulus Plan

Topics: I. Government Stimulus Act for Electronic Medical Records (EMRs) Medicare Incentives Medicaid (Medical) Incentives II. How to Qualify for Government Incentive Payments? What You Need to Participate in an EHR Program Specifics of Stage 1 Meaningful Use Beyond Stage 1 Meaningful Use III. Why SuiteMed IMS? Certification IMS Meaningful Use Dashboard

I. American Recovery and Reinvestment Act Health Information Technology for Economic & Clinical Health (HITECH) Act

Stimulus Act In February 2009, President Obama signed into law the American Recovery & Reinvestment Act, authorizing $27 billion to: Transform the healthcare system and improve the quality safety and efficiency of care Confidential information provided by AC Group, Inc. 4

What Does This Mean to You as a Provider? Eligible Providers (EP) to receive from $44,000 to $63,750 in incentives from Medicare, or Medicaid over the next 5 years: As they adopt, implement & demonstrate meaningful use of certified EHR technology Incentives available under only one of the programs for office-based providers

Medicare/ Medicaid Summary Table * Physicians (defined in Section1861 Social Security Act) include: doctors of medicine, osteopathy, dental surgery, dental medicine, podiatry, and optometry

I.A. Medicare Incentives Start 2011 2012 2013 2014 2015 2016 Total 18,000 12,000 8,000 4,000 2,000 $44,000 15,000 $39,000 $24,000 7

I.A. Medicare Incentive Eligible professionals (EP) who are meaningful EHR users can receive up to $44,000 over 5 years The incentive payment is equal to 75% of Medicare allowable charges for covered services furnished by the physician in a year, subject to a maximum payment (not to exceed this table). A hospital-based EP who furnishes 90% or more of their services in the hospital setting is not qualified as an EP to receive meaningful use incentives. Physicians operating in a "provider shortage area" will be eligible for an incremental increase of 10%. For the 1st year for which an EP applies for and receives an incentive payment (2011), the EHR Reporting Period is 90 days. After 2011, the EHR reporting period is the entire year. Physicians who do not adopt and use an EHR by 2015 will be penalized by reduced Medicare payments (to a potential maximum of 5%):

I.B. Medicaid Incentives Start 2011 2012 2013 2014 2015 2016 2017 2018 Total 21,250 8,500 $63,750 $55,250 $46,750 $38,250 The Medicaid incentive payment program will begin January 1, 2011 for eligible professionals. An eligible professional can receive Medicaid incentive payments over a 6-year period with a first-year payment of up to $21,250 and five subsequent annual payments of up to $8,500. The eligible professional must demonstrate meaningful use of a certified EHR by the second payment year. 9

I.B. Medicaid (Medical) Incentives Available to non-hospital based physicians, dentists, certified nurse midwives, and physician assistants – only if they lead providers in rural health clinics or FQHCs Incentive payments will go to Eligible Providers (EPs) as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their 1st year and for up to 5 remaining participation years. Upfront Funding: Start up incentives up to $21,250 for the purchase, implementation and upgrade of a certified EHR technology. After receiving start up funds, EPs who can prove “Meaningful Use” can receive up to $8,500 incentive payments for the next 5 years. To be eligible, more than 30% of patient volume must be attributable to Medicaid and/or Badger Care Plus (20% attributable to pediatrics). No penalties for lack of adoption (yet). Confidential information provided by AC Group, Inc. 10

II. How to Qualify for Incentive Payments?

What You Need to Participate in an EHR Program: 1. Certified EHR Technology: All eligible professionals (EP) need to have certified EHR technology. Standards are now available in government sites, which establishes the required capabilities of that technology to support the achievement of meaningful use. 2. NPI, NPPES Use Account and PECOS Enrollment: All Medicare eligible professionals must have a National Provider Identifier (NPI) & be enrolled in the CMS Provider Enrollment, Chain and Ownership System (PECOS) to participate in the EHR incentive program. Most will also need an active user account in the National Plan and Provider Enumeration System (NPPES). CMS will use these systems' records to register for the program and verify Medicare enrollment prior to making Medicare EHR incentive program payments. If you are a Medicare EP that does not have an NPI and/or an NPPES web user account., use the following website to apply for an NPI and/or create a NPPES user account: https://nppes.cms.hhs.gov/NPPES/welcome.do

How to Qualify for EHR Incentives? To qualify for incentive payments in 2011 and 2012, EP must achieve: Specifics of Stage 1 meaningful use and clinical quality measure (CQM) reporting The Recovery Act specifies 3 main components of Meaningful Use. The use of a certified EHR: In a meaningful manner (e.g., e-Prescribing); For electronic exchange of health information to improve quality of health care; To submit clinical quality and other measures.

Specifics of Stage 1 Meaningful Use (2011 & 2012) For Stage 1, which begins in 2011, the criteria for meaningful use is based on a series of specific objectives that allows EPs to demonstrate meaningful users of certified EHR technology. For EPs, there are total of 25 meaningful use (MU) objectives: 15 Core Set Objectives (mandatory), 5 Menu Set Objectives (optional, out of 10) For details see: http://suitemed.com/MU_measures.pdf In 2011, EPs seeking to demonstrate Meaningful Use are required to submit aggregate clinical quality measures (CQM) and MU numerator, denominator, and exclusion data to CMS (or the States) by attestation. In 2012, seeking to demonstrate meaningful use must electronically submit clinical quality measures selected by CMS directly to CMS (or the States) through certified EHR technology. By using certified EHR technology to report information on clinical quality measures electronically to a health information network, a State, CMS, or a registry, the burden on providers that are gathering the data and transmitting them will be greatly reduced.

Beyond the Stage 1 Criteria for Meaningful Use CMS intends to propose through future rulemaking two additional stages of the criteria for meaningful use. Stage 2 would expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies. These changes will be reflected by a larger number of core objective requirements for Stage 2. Stage 3 would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.

III. Why SuiteMed Intelligent Medical Software (IMS)?

III.2. Meaningful Use Made Easy with SuiteMed IMS Meaningful Dashboard You can gather real-time indications of your current Meaningful Use levels. Monitoring of countless CMS-required data elements. Quick exporting of the data for delivery to Regional Health Information Exchanges

Guide to Meaningful Use: Core Set (Mandatory) Objectives

Guide to Meaningful Use: Menu Set (Optional) Objectives

Source: CMS

III. Why SuiteMed IMS? III.3. EMR Systems, Authorized Partner of SuiteMed IMS You Will Experience Peace of Mind Exceptional long-term support (customized CPSP forms) Local experts, sales and support Maximize the effectiveness to you Seamless implementation Hands-on consultative approach to training Saas & Client-Server Models III.4. Proven Positive Return on Investment (ROI)* Cost savings Revenue enhancements Data accuracy, patient security and safety * ROI – for details, see Appendix (1) 21

Appendix (1): Proven Return on Investment Data Accuracy & Patient Safety Reduced risk of transcription errors Reduced risk of missing critical information Regulatory compliance & reduced professional liability rate Cost Savings Eliminates soaring dictation & transcription costs Minimizes paper costs (storage rooms, copying, printing, staff time) Eliminates out sourcing billing costs Substantial cost savings through qualifying for the Gov’t Financial Stimulus Revenue Enhancements Accuracy of coding Built-in protocols & reminders including health maintenance Improved quality of charting & documentation Ease of integration with specialists, labs, pharmacies, insurance companies, etc. Increasing number of patient visits per day

Appendix (2): About SuiteMed LLC Financially secure company Founded 1998 – privately held and self funded Headquartered in Oakland, CA with offices nationwide Integrated PM / EMR/ Patient Portal & more Over 26 different medical specialties Local technology experts, sales, service & support Multiple sister companies, community health, plastic surgery, pharmacy automation, allergy, pain management and more Over 3000 physician users nationwide