CRISPMaryland’s Regional Extension Center

MSO Program Overview

June 2 and June 9, 2010

REC, As Defined By The ONCThe purpose of the Regional Centers is to furnish

assistance, defined as education, outreach, and technical assistance, to help providers in their geographic service areas select, successfully implement, and meaningfully use certified EHR technology to improve the quality and value of health care. Regional Centers will also help providers achieve, through appropriate available infrastructures, exchange of health information in compliance with applicable statutory and regulatory requirements, and patient preferences. The support for health information exchange that is provided by Regional Centers will also be consistent with any applicable State Plan(s) for HIE developed and HHS-approved via the cooperative agreements issued by ONC pursuant to PHSA Section 3013, as added by ARRA.

2Cited from Health Information Technology Extension Program: Regional Extension Centers Cooperative Agreement Program, Funding Opportunity Announcement and Grant Application Instructions

CRISP Mission Statement

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To advance the health and wellness of Marylanders by deploying health information technology solutions adopted through cooperation and collaboration. We will enable the Maryland health care community to appropriately and securely share data, facilitate and integrate care, create efficiencies, and improve outcomes.

Mission And Vision

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Mission Statement:The Mission of the REC is to advance the health and wellness of

Marylanders by assisting 1,000 priority primary care providers successfully achieve Meaningful Use by 2012.

Vision Statement:The REC will facilitate a minimum of 1,000 priority primary care

providers throughout the state to successfully implement, and meaningfully use certified electronic health record technology to improve the quality and value of health care. The REC will utilize Management Services Organizations (MSOs), designated by the state, as the mechanism for achieving widespread adoption and Meaningful Use.

CRISP/REC Background• April 6, 2010 - CRISP receives notice of grant award

from ONC to becomes Maryland’s REC– CRISP is awarded $5,535,423 (original request for $12,196,128)

• CRISP REC Model - MSOs will be sub-recipients of CRISP to provide direct assistance to 1,000 providers in Maryland

• Direct Assistance Funding - Based on milestone payments: provider signature, Go-Live, Meaningful Use

• Education and Outreach - CRISP, in partnership with MedChi, will provide best practice guidelines and educational material to providers

Maryland’s Unique REC Program• On May 19, 2009, Governor Martin O’Malley signed into law House

Bill 706, Electronic Health Records- Regulation and Reimbursement– Law requires the MHCC to designate one or more State Designated MSOs that

offer EHRs throughout the state by October 12, 2012

• MSOs will be capable of supporting multiple EHR products at reduced cost through economies of scale and bulk pricing

• REC is expected to be the driver for new MSO entrants into the market and as such will support the state’s vision to offer education, outreach, and technical assistance to physician practices largely through designated MSOs

• Meant to spark the adoption of EHRs throughout the state by allowing regionally managed MSOs to assist providers in their geographic area

PresidentDavid Horrocks

REC Program Director

Daniel Wilt

Clinical Improvement Coordinator

Deborah Kephart

MSO CoordinatorRobert Horst

Outreach CoordinatorCheryl Jones

MSOs MSOs MSOsMSOs

CRISP REC Program

CRISP Contact Information

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Regional Extension Center Team

Member Name Title OrganizationDavid Horrocks President CRISPDaniel Wilt REC Program Director CRISPCheryl Jones Director of Outreach CRISPRob Horst MSO Coordinator Audacious InquiryDeb Kephart Clinical Coordinator Audacious Inquiry

Email REC@crisphealth.org with questions

Eligible Providers

• As outlined by the ONC, a priority primary care provider (PPCP) is a licensed clinician with prescriptive privileges (MD, DO, NP, PA) that works in the following practice care settings:

1. Private physician practice of 10 or less

2. Non-profit primary care clinics including community health centers and rural health clinics

3. The ambulatory care clinics associated with public, rural, and critical access hospitals.

Milestone Definitions

1. Milestone One - Signed provider agreement between a healthcare practice and MSO

2. Milestone Two – EHR “Go Live” (“Go Live” must include e-Prescribing and quality reporting measures)

3. Milestone Three - Practice and its associated providers have met Meaningful Use. ONC will verify meaningful use based on the CMS standard

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NGA Funding Breakdown

Provider Value Proposition

Measurement Value PropositionKnowledgeable resources to assist in EHR acquisition Through supplemental funding through the REC program,

MSOs will be capable of providing additional resources to assist PPCPs in identifying suitable EHR solutions.

EHR Training and Go-Live support resources MSOs provide PPCPs with more regionally qualified and consistent training and go-live support resources for proven EHR systems.

Resources to assist in reaching Meaningful Use MSOs have the knowledge and support structure necessary to assist PPCPs in reaching Meaningful Use.

Providers receive incentives through utilization of a State Designated MSO

“Provider incentives in the regulations will be broad and may result in increased reimbursement for specific services; lump sum payments; gain-sharing arrangements; rewards for quality and efficiency; in-kind payments; and other items or services to which a specific monetary value can be assigned. “ (cited from http://mhcc.maryland.gov )

Connectivity with CRISP Health Information Exchange (HIE)

PPCPs that receive direct assistance from MSOs will have access to resources that are familiar with the process of getting connected to the CRISP HIE.

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MSO Value Proposition

Measurement Value PropositionCost of implementing and supporting EHRs for employed and/or community providers

Through participation with the REC, MSOs will can offset costs by participating in the REC program.

Provide support for PPCPs already using an EHR to achieve Meaningful Use

MSOs can offset the cost of assisting PPCPs already using an EHR to meet Meaningful Use criteria.

As part of the mission of certain organizations, demonstrate value to community providers

Becoming an MSO and providing REC services to community providers demonstrates an organization’s commitment to providing quality services that foster an interactive community of quality patient care.

Operational support for the MSO to provide direct assistance to PPCPs

ONC and the Health Information Technology Research Center (HITRC) will provide materials such as sample contracts, workflow templates, marketing materials, privacy/security guidelines and quality improvement curriculum.

Connectivity with CRISP Health Information Exchange Connectivity with, or knowledge of connectivity requirements with the CRISP HIE will allow MSOs to provide additional value-added services to PPCPs.

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Parallel Tracks

MSO applicants should pursue both at the same time:

1.Apply to become a State Designated MSO

2.Submit CRISP Sub-recipient application (not yet available)

Timelines are tight—we encourage you to move quickly.

Becoming State Designated

1. Visit the MHCC’s website for MSOs

2. Read the Program Overview and the MSO State Designation Criteria document

3. Complete the MSO State Designation Application and return to the MHCC

NOTE: If you have concerns about this process, or your organization’s ability to comply, please contact CRISP

CRISP Application Process1.Thoroughly review the REC Funding

Opportunity Announcement (FOA) that is located on the ONC website

2.Register as a government contractor at www.CCR.gov to receive DUNS #

3.Complete the CRISP Sub-recipient application (details will be posted on www.crisphealth.org)

4.Sign agreement with CRISP upon application review

Contents Of Sub-Recipient ApplicationApplicants will be asked to provide details about the following:

1. Organizational characteristics (background, mission, org chart, etc.)

2. Ability to provide REC core services

3. HIE Connectivity Plan for MSO and/or PPCPs

4. Provider geographic coverage area

5. Provider enrollment timeline

6. MSO service delivery plan

7. Financial information (ONC budget, etc.)

Key Dates For MSOs

• May 17, 2010 – MHCC began accepting State Designation Applications

• REC Program: All milestones must be met by April 6, 2012, or while funding is available

Next Steps for CRISP

• Continued outreach to prospective MSOs• Review sub-recipient applications and sign

contracts with MSOs• Awareness building amongst providers about the

REC program in Maryland• Begin tracking milestones for MSOs in ONC-

provided CRM tool• Modifications to www.crisphealth.org • Take comments and questions from this session

and publish an updated FAQ

FAQs

• The FAQs previously in this presentation have moved to http://crisphealth.org/REC/RECFAQ/tabid/133/Default.aspx

Questions?