1. Meaningful Use and the EHR Incentive Program Tribal Self-Governance Conference

2. Why Is MU Important?  Do you have full-time medical providers (physicians, dentists, etc.)?  Do you currently have an EHR or do you plan to implement an EHR?  Do you bill Medicare and/or Medicaid?  Are you interested in improving the quality of patient care, increasing efficiency, and limiting risk?  Are you interested in financial incentives?

3. EHR Incentive Program  The Medicare and Medicaid EHR Incentive Programs will provide incentive payments to eligible professionals, eligible hospitals and critical access hospitals (CAHs) as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.

4. Meaningful Use  Eligibility  Certified EHR  Meaningful Use Measures  Implement drug-drug and drug-allergy checks  Generate at least one report listing patients with a specific condition  Record smoking status for more than 50% of patients  Provide patient-specific education resources for more than 10% of patients  Clinical Quality Measures  Hypertension: Blood Pressure Management  Tobacco Use Assessment and Cessation Intervention  Influenza Immunization for Adults

5. Provider Eligibility

6. Regional Extension Center The RECs will support and serve health care providers to help them quickly become adept and meaningful users of EHRs. RECs are designed to make sure that primary care clinicians get the help they need to use EHRs.  Provide training and support services to assist providers in adopting EHRs  Offer information and guidance to help with EHR implementation  Provide technical assistance

7. REC vs Incentive Program Support providers and hospitals in achieving MU Reward providers and hospitals for achieving MU Regional Extension CenterEHR Incentive Program Program administered by the Office of the National Coordinator for Health Information Technology (ONC) Program administered by the Centers for Medicare and Medicaid Services (CMS) EHR certification ruleMeaningful use rule

8. Eligible Providers Physicians (MDs and DOs) Family Practice General Practice Internal Medicine Obstetrics and Gynecology Pediatrics Adolescent Medicine Geriatrics Physician Assistants Nurse Practitioners Certified Nurse Midwives Alaska CHA/Ps Regional Extension CenterEHR Incentive Program Medicare EPs Physicians (MDs and DOs) Dentists Podiatrists Optometrists Chiropractors Physician Assistants Medicaid EPs Physicians (MDs and DOs) Dentists Certified Nurse Midwives Nurse Practitioners Physician Assistants*

9. Provider Responsibilities Funding for the REC is dependent upon each provider achieving each milestone Incentive payments to EPs/EHs are dependent upon the EP/EH demonstrating MU Register with CMS/State Achieve MU Attest/submit each year Sign up with REC Go live with certified EHR Achieve MU Regional Extension CenterEHR Incentive Program

10. Regional Extension CenterEHR Incentive Program ONCCMS NIHB AI/AN RECEPs/EHs 1. Provider signs up with NIHB AI/AN REC 2. Provider “goes live” with certified EHR 3. Provider achieves meaningful use IHS $$$$$$$$

11.  Maximize Medicare and Medicaid billing  30% Medicaid patient volume for Medicaid eligibility.  Medicare incentives based on Medicare billing.  Capture required data in the EHR  Record smoking status for more than 50% of all unique patients 13 years old or older.  Record demographics for more than 50% of all unique patients (demographics: preferred language, gender, race, ethnicity, and date of birth).  Record vital signs for more than 50% of all unique patients (vital signs: height, weight, and blood pressure). Preparing for MU

12.  Avoid paper charts and forms  Document patient encounters in the EHR  Problem list, medication list, medication allergy list measures: More than 80% of all unique patients seen by the EP have at least one entry or an indication that no [problems/medications/medication allergies] are known/prescribed.  At least 80% of patient records must be in the EHR.  Track actions that take place outside the EHR  ePrescribing measure: More than 40% of all permissible medication orders are transmitted electronically using the EHR.  To determine percentage, must know # of orders not transmitted electronically using the EHR. Preparing for MU

13. Sign Up with NIHB REC  http://nihb.org/rec/rec.php

14. EHR Incentive Program Registration

16.  Medicare EPs:  Register with CMS  Medicaid EPs:  Register with CMS  Register with state Medicaid program  Hospitals:  Register as dual-eligible  With CMS for Medicare  With state Medicaid program for Medicaid Certified EHR is not required for registration!

17. Timeline  Now – Sign up with the NIHB REC!  Now – Designate a Meaningful Use Coordinator  Anytime – Register for EHR Incentive Program (pending launch of State Medicaid program for Medicaid EPs)  May/June – Install RPMS EHR patches to bring your local EHR up to the certified version.  July 1 – September 30, 2011 – Last 90-day period within FY 2011 for hospitals to demonstrate MU for FY 2011.  October 1 – December 31, 2011 – Last 90-day period within CY 2011 for providers to demonstrate MU for CY 2011.

18. Contact Vicki French United South and Eastern Tribes 615-467-1578 vfrench@usetinc.org Vicki.French@ihs.gov