Robert H. Roswell, M.D. Oklahoma Hospital Association September 1, 2009

Health Information Technology  $17.2 B for Medicare and Medicaid incentives for physician and hospital adoption of electronic health records (EHRs)  $2B for grants from the Secretary of HHS and the Office of the National Coordinator for Health Information Technology (ONCHIT)

Incentive payments for eligible professionals  2011 $18,000  2012$12,000  2013$8,000  2014$4,000  2015$2,000  Total $44,000 (plus an additional $4,400 if in a designated health professional shortage area) Penalties begin in 2015 if EHR has not been adopted

Failure to adopt EHRs  Physician Medicare penalties start in 2015  % reduction in Medicare fees  2016 – 2% reduction in Medicare fees  2017 – 3% reduction in Medicare fees  HHS may increase penalties after 2017 if EMR adoption level is unsatisfactory

Medicaid Incentives  Up to $21,250 for adoption of certified EHR technology  Up to $8,500 a year for 5 years for operation and maintenance  Total funding cap of $63,750 per eligible physician (Medicaid patients comprise 30% of practice; 20% for pediatricians)

Incentive payments for eligible hospitals  Base amount ($2M) plus a a discharge-related payment, adjusted for Medicare share up to $11M  Year 1 100%  Year 275%  Year 3 50%  Year 425%  Beginning in FY 2011 (October 1 st, 2010) Penalties begin in 2015 for hospitals not adopting EMRs.

“Meaningful Use”: Certified  New HIT Policy Committee must define initial certification criteria by December 31 st, 2009  Second draft matrix released July 16th

Meaningful use of certified EHR technology  Using a certified EHR technology including the use of electronic prescribing  Connected in a manner that provides for electronic exchange of health information  Submits information on clinical quality measures

2011 Hospital Meaningful Use Matrix  10% of all orders through CPOE  Implement drug/allergy software  Problem, medication, and allergy lists  Demographics, advance directives, vital signs  Structured lab data, quality measures  Electronic billing  Exchange key clinical information among providers

And we have 13 months to get it done!

HHS Grant Program: $2 Billion  Section 3012  Health information technology implementation assistance  HIT Research Center and Regional Extension Centers

Regional HIT Extension Centers  FOA released August 20 th  $598M in 3 phases  Letter of intent due September 8 th  Full application due November 3 rd  Oklahoma effort led by OPCA coalition  OFMQ will be the lead agency

HIT Regional Extension Centers Initial CycleApprox Funding Preliminary Application Preliminary Approval Full Application s Awardee Selection 1$189,000,00 0 September 8, 2009 September 29, 2009 November 3, 2009 December 11, $225,000,00 0 December 22, 2009 January 19, 2010 March 2, 2010 April 27, $184,000,00 0 June 1, 2010 June 22, 2010 August 3, 2010 September 28, 2010

HHS Grant Program: $2 Billion  Section 3013  $300M to States or State-designated entities  Planning and implementation of HIE efforts

State HIE Cooperative Agreement Program  FOA released August 20 th  $564 million in funding  Secretary Terri White designated state lead  Public forum held August 14 th  OHCA coordinating application with broad stakeholder input

State HIE Grant Program Item to SubmitDate Letter of IntentSeptember 11, 2009, by 5:00pm EST ApplicationOctober 16, 2009 by 5:00pm EST Award AnnouncementsDecember 15, 2009 Anticipated Project Start DateBeginning January 15, 2010

State HIE Grant Program  Estimated Oklahoma funds $6-10M  Planning phase cannot exceed 6 months