Meaningful Use

Jacqueline L. CandelariaABQ Area Program Analyst

April 25, 2012

What is Meaningful Use and how does it affect us

• “Meaningful Use” simply put is using “CERTIFIED” EHR technology in a meaningful way to:

Improve quality, safety, efficiency, and reduce health disparities

Engage patients and families in their health careImprove care coordinationAll the while maintaining privacy and security

Meaningful Use

• CMS provides incentive payments to promote adoption and meaningful use of a certified EHR.

• Eligible providers can apply for Medicare OR Medicaid

Eligible ProvidersEligible Providers (based on calendar year, CY)

Medicaid Medicare

Starting Dates Start by CY 2016. End by 2021.

Start by CY 2014. End by 2016.Penalty if not enrolled by 2015.

Requirements for Year 1 Need: Adopt/Implement /Update certified EHR (Stage 1).

Need: Demonstrate MU (15 + 5 objectives, electronic exchange, 6 clinical measures)

Eligible Providers[Choose Medicaid or Medicare] not both

Include: MD, NP/Midwife, DDS, PA in FQHC.Need: >30% Paid Medicaid patients.Pay: up to $63,750/EP over 5 yrs.

Include: MD, DO, DDS/DMD, DPM, OD.

Pay: up to $44,000/EP over 5 yrs.

Timeline for Eligible Professionals to Avoid Payment Adjustment

EP Payment Adjustment (CY)

Establish MU for full CY-2 yrs. prior

or EP Demonstrating MU for 1st time in yr. prior to payment adjustment yr/continuous 90 days reporting period beginning no later than:

Or Apply for an Exception no later than:

2015 CY 2013 (with submission 2 months following reporting period)

July 3, 2014 (with submission no later than October 1, 2014)

July 1, 2014

2016 CY 2014 July 3, 2015 (Oct. 1 2015) July 1, 2015

2017 CY 2015 July 3, 2016 (Oct. 1 2016) July 1, 2016

2018 CY 2018 July 3, 2017 (Oct. 1 2017) July 1, 2017

2019 CY 2019 July 3, 2018 (Oct. 1 2018) July 1, 2018

Certified EHR

• RPMS/EHR is certified• Dentrix 6.0 is not certified however if you

use both the RPMS/EHR and Dentrix you are ELIGIBLE to participate (currently it would be dual entry)

What are the requirements for dentists to participate?

• Must meet same eligibility requirements as other eligible EP’s– 15 Core measures; 5 from menu set of their

choosing– 6 CQM’s; 3 core and 3 from menu set of their

choosing(Several MU objectives have exclusion criteria and will need to evaluate whether they meet the exclusion for each applicable objective as there is no blanket exclusion by type of EP)

How can dental qualify for the EHR Incentive Program

• Enter the problem list, medication list, medication allergy data, etc. directly in the EHR (RPMS) – NOTE: If data is entered in the dental “front end”

package it does not pass through to RPMS and this would not meet the MU criteria.

How can dentists participate

• Capture data such as demographics and vitals; it is interfaced to the RPMS PCC database

• RPMS MU Performance measures reports access this data from the PCC database and not the EDR.

• When this procedure is followed CMS has determined that no independent certification of the IHS/EDR is necessary to achieve MU

Stage 2 CQM New Measure

• Proposed new measure:–Children who have dental decay or

cavities–Assesses if children aged 1-17 years

have had tooth decay or cavities in the past 6 months

Performance Report

• MU is a team effort, patient registration, nursing, pharmacy, laboratory, health information management, IT and providers.

• See attached report on a dental provider– NOTE: Dental Providers within the ABQ Area have

AIU’d for Medicaid and their facility will be receiving a MU incentive payment of $21, 250.00

Take-Aways Medicaid EHR Incentive Program

Voluntary program for states to incentivize eligible providers to meaningfully use CEHRT to improve health, improve care delivery, and reduce per capita costs

Provider eligibility is determined by type of provider, location of service, and patient volume

Providers register with CMS, and then attest through SMAs, which may vary by state

Medicaid provider may AIU in first participation year, but must demonstrate MU thereafter

Providers must report MU (functional) measures and CQMs electronically by 2013