1. History Reasons Certified EMR’s Penalties Attestation Incentives Measures & Stages Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

2. American Recovery and Reinvestment Act of 2009 (ARRA – the “Stimulus”) Signed Feb. 17, 2009 Infrastructure… Education… Healthcare… Health Information Technology – $25.8 billion $787 billion Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

3. Improve Quality, Safety, Efficiency Engage Patients & Families Improve Care Coordination Improve Public and Population Health Ensure Privacy and Security for Personal Health Information Each Meaningful Use objective/measure is designed to meet one of these criteria Meaningful Use Criteria Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

4. Eligible Professionals (“EP”) EP’s under the Medicare EHR Incentive Program include: Doctor of Medicine or Osteopathy Doctor of Dental Surgery or Dental Medicine Doctor of Podiatry Doctor of Optometry Chiropractor Hospital-based eligible professionals are not eligible for incentive payments. An eligible professional is considered hospital-based if 90% or more of his or her services are performed in a hospital inpatient (Place Of Service code 21) or emergency room (Place Of Service code 23) setting. If you are eligible for incentive payments, YOU ARE ALSO ELIGIBLE FOR THE PENALTY PHASE! EP’s must select whether to qualify for Medicare or Medicaid incentive. Medicare incentive payments are larger and there are no penalties. Most EP’s cannot qualify for Medicaid incentive program. More EP’s eligible for Medicaid incentive (NP’s, some PA’s, etc.) Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

6. Meaningful Use is forever… Stage 1 – Starting 2011 15/15 “Core Set” Objectives/Measures 5/10 “Menu Set” Objectives/Measures Stage 2 – Starting 2014 17/17“Core Set” Objectives/Measures 3/6 “Menu Set” Objectives/Measures Stage 3 – Starting 2016? ?/?“Core Set” Objectives/Measures ?/?“Menu Set” Objectives/Measures Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

7. CY 2011CY 2012CY 2013CY 2014 CY 2015 and later CY 2011$18,000 CY 2012$12,000$18,000 CY 2013$8,000$12,000$15,000 CY 2014$4,000$8,000$12,000 CY 2015$2,000$4,000$8,000 $0 CY 2016$2,000$4,000 $0 TOTAL$44,000 $39, 000$24,000$0 These amounts are “per physician”. The last year to start receiving incentives is 2014. Starting MU in 2015 will result in NO incentive payments. Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

8. What if you fail to meet MU? 2015:1% 2016:2% 2017:3% 2018: 4%* 2019:5%* * At the discretion of the Secretary of HHS Penalties (“adjustments”) will be applied as a percent of Medicare Part B Professional Fee Schedule Charges. They are scheduled to begin in 2015, and continue as follows: You are at risk for adjustments WHETHER OR NOT you received incentive payments Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

9. To attest for Meaningful Use, you MUST use a certified EMR/EHR! In the Radiation Oncology sphere, you have 3 choices: ONCOCHART Aria Mosai q Aria Mosaiq You do not have to use a RadOnc-oriented EMR. Make sure the non-RadOnc-oriented EMR does not introduce compliance issues. Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

10. Things to watch for when selecting an EMR: Does the EMR make it easier or harder to achieve MU? Does the EMR cause a negative impact on your workflow? Is Support really responsive? Are CQM’s easily captured? PQRS? Does the EMR/MU tool really work and is it helpful? Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

11. Does the EMR cause a negative impact on your workflow? Vitals collection is part of normal workflow – not added on as an extra task Are extra steps needed for MU? Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

12. Does the EMR make it easier or harder to achieve MU? All elements of MU should be part of normal workflow MU should not add to your workflow – EVER! Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

13. Are CQM & PQRS easily captured and reported? Describe each measure Calculate Results Show Deficiencies Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

14. Does the EMR/MU tool really work and is it helpful? Describe each measure Calculate Results Show Deficiencies Break down By Patient Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

15. Is Support really responsive? MU experts always available – not “we’ll get back to you later” Live answers, not recordings MU support included at no extra cost Help with attestation at no extra cost Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege

16. You MUST prepare for Meaningful Use…now Is the EMR you are considering over-priced? How many “extras” do you have to buy? Take advantage of incentive payments by complying early Use an EMR that compliments workflow – not impedes it Your EMR must provide supportive support Privileged and Confidential Work Product – Subject to the Attorney – Client Privilege