NPAIHB REC NPAIHB Regional Extension Center Update Katie Johnson, Pharm D EHR Integrated Care Coordinator, REC Manager June 2012

Services Information resource – Office Hours – Website – Tip sheets – Interface with other organizations Technical resource – Consultants Lab, Pharmacy, IT – EHR Troubleshooting Worfkflow Anaylsis Planning Resource – Guidance on navigating MU registration/attestation – Individual planning for participation in Incentive Programs MU Performance Measure Resource – Guidance on how to actually meet MU! – Assist where possible (Ex: Security Risk Analysis)

More Services REC is here to meet your needs It is still a new and developing program If you identify a need for meeting MU… –Just ask and we’ll see what we can do!

Grant Structure Grant Credits Milestone 1 Milestone 2 Milestone 3 Earn as you go 127 Providers from 27 sites –3 more sites pending

MU (Briefly) Medicaid –Must meet a 30% patient volume requirement Tribal sites can use “needy patients”, Federal sites can not –More potential money - $63,750 per provider over the life of the program –May start as late as 2016 –First year is simply Adopt, Implement, or Upgrade (this is the easy part!) –Must qualify each year

MU (Briefly) Medicare –No patient volume requirement, but you must be billing on the Medicare Part B Physician Fee Schedule If the provider is billing less that $25,000/yr Medicare Part B, then their incentive payment will be less –Less potential money – max $44,000 per provider over the life of the program –Last year to start = 2014 (2012 for max payments) –First year is actually meeting MU for 90 days! –Penalty phase – starting in 2015

MU (Briefly) When would you choose Medicare Program? –Provider does not meet 30% patient volume requirement for Medicaid –Provider is a podiatrist, optomitrist, or chiropractor Switching Programs –Can do this one time Ex – qualify first year for Medicaid, but can’t qualify the next year….ok to switch to Medicare

$ Money $ ~ $800,000 paid to sites in Portland Area –41 providers from 10 sites –Several more providers from 5 more sites pending payments Largely from Medicaid program Potential for many more providers to get payments – still plenty of time to start!

Moving forward If you haven’t started yet – –Still plenty of time –Focus on qualifying for Medicaid –Registration –This is real money… –Let’s get that first year Medicaid payment!

Moving Forward Timeline for those that have already participated

Timeline First Year Medicaid 2011 –Meet MU for 90 days in 2012 Last day to start Oct 3, 2012 First Year Medicaid 2012 –Meet MU for 90 days in 2013 Last day to start Oct 3, 2013

Timeline First Year Medicare 2011 –You already met MU for 90 days in 2011 –You are in a 365 day reporting period for 2012 First Year Medicare 2012 –You must meet MU for 90 days in 2012 Start by Oct 3, 2012

REC Timeline M3 Acceleration from ONC –Reasons –What it means –How it will help

Barriers E-prescribing –Required to meet MU –Inhouse RPMS Pharmacy –Tribally owned COTS Pharmacy –No Pharmacy 14 sites signed up with the REC that will need e-Prescribing for MU

RPMS E-Prescribing Released March 2012 –Controlled Release –Many requirements to complete before going live Drug File Optimization 3 signed Agreements –BAA, DEA, EUA

E-Prescribing 7 sites with drug files ready to go 2 sites scheduled 1 ready to be scheduled Washington State Board of Pharmacy

E-Prescribing Interface with COTS Pharmacy –Requirements are written from RPMS side –May take to your COTS vendor and ask if they will program a way to interface with RPMS –Will still want Drug File optimized, as interface would use the same functionality as e- Prescribing

MU Stage 2 Final Rule due out this summer –Parts may go into effect immediately Patient Volume calculations? –Others would take effect in 2014 most likely

Stage 2 Comments Public Comments were written and submitted on behalf of NPAIHB –Also commenting: USET NIHB CRIHB IHS

Stage 2 Highlights Patient Volume Calculations Expanded definition of Medicaid patient encounter –Hopefully helps Service Units use the Group Volume calculation Flexible look-back period –Previous 12 months vs prior calendar year

Stage 2 Highlights Performance Measures –Increasing target percentages –Moving menu set to core set –“Test” transmissions changed to “successful and ongoing”

Stage 2 Highlights Measures relying on patient action –Provide online access to health information for more than 50% of patients with more than 10% actually accessing –View/download/transmit health information –More than 10% of patients send secure messages to their providers

Stage 2 Comments General – provider based program now relying on patient action for incentives and to avoid payment penalties? Internet Access Issue –B–Broadband Exclusion Poorly outlined, difficult to interpret

Many other, much more detailed comments Will analyze further when Final Rule comes out

Questions?

Contact Information NPAIHB Regional Extension Center Contact –Katie Johnson, Pharm D – /programs/ehr/ /programs/ehr/ IHS Meaningful Use Contacts – Angela Boechler, BBA Meaningful Use Consultant – Capt. Leslie Dye Meaningful Use Coordinator