Meaningful Use 2016What You Need To Know

We will be covering the following information today …

2016 Programs and how they will impact 2018 payments• Medicare EHR Incentive Program: Meaningful Use• PQRS (Physician Quality Reporting System)• VBM (Physician Value-based Payment Modifier)

Key Points for 2016 MU Reporting • Reporting Periods – Returning Participants / New Participants• 2016 MU Objective Measures• 2016 Clinical Quality Measures• Attestation Timeframe to Avoid 2018 Penalty

What you should be doing now to prepare for a successful attestation

What’s next?

Penalties

• 2016 Reporting affects your 2018 Medicare FFS payments.

• The last year to begin participation and receive an incentive payment for MU was 2014. For the Medicaid program, 2016 is the last year to begin and receive incentive payments.

• Negative payment adjustments for those who do not demonstrate MU of EHR began in 2015, unless a

hardship exemption was filed and accepted.

Potential 2018 Penalties

Meaningful Use: - The 1st negative payment adjustment began in

2015 by 1% and has increased each year by 1%.• If you never participated in MU you are

looking at a -4% payment adjustment in 2018.

Physician Quality Reporting System: 2%

Value-based Program Modifier Program: Depending on practice size, 2% - 4%

Potential Total Penalty: 10%

Reporting Periods

• The EHR reporting period for all providers is based on a calendar year.

• In 2016, the reporting period is as follows: - Returning participants: full calendar year - First-time participants: minimum of 90 continuous days

While CMS has proposed offering additional flexibility for all EP, not just those reporting for first time, this ruling has not yet been approved. It is recommended that EPs not in their first reporting year be prepared to provide the full year of reporting.

MU 2016 – 10 Objectives

1. Protect Patient Health Information – Yes / No

2. Clinical Decision Support – Yes / No / Exclusion• Measure 1: Implement 5 CDSR related to 4 or more CQM. • Measure 2: Enable and implement functionality for drug-drug and drug-

allergy interaction checks.

3. Computerized Provider Order Entry (CPOE) – Numerator / Denominator• Measure 1: More than 60% of medication orders created by the EP

during the reporting period are recorded using computerized provider entry.

• Measure 2: More than 30% of laboratory orders created by the EP during the reporting period are recorded using computerized provider entry. • Measure 3: More that 30% of radiology orders created by the EP during the reporting period are recorded using computerized provider entry.

4. Electronic Prescribing (eRX) – Numerator / Denominator / ExclusionMore than 50% of all permissible prescriptions written by the EP are queried for a drug formulary and transmitted electronically.

5. Health Information Exchange - Numerator / Denominator / ExclusionThe EP that transitions or refers their patient to another setting of care or provider o care must create a SOC record and transmit the summary to a receiving provider electronically for more than 10% of transitions of care and referrals.

6. Patient Specific Education – Numerator/Denominator/ExclusionPatient Specific education is provided to more than 10% of all patients seen during the reporting period.

MU 2016 – 10 Objectives (cont.)

7. Medication Reconciliation - Numerator / Denominator • Medication reconciliation for more than 50% of transitions of care in

which the patient is transitioned into the care of the EP

8. Patient Electronic Access (VDT) - Numerator / Denominator / Exclusion• Measure 1: More than 50% of all unique patients seen during the

reporting period are provided timely access to view online, download, and transmit to third party their health information.

• Measure 2: At least 1 patient views, downloads or transmits their health information.

9. Secure Messaging – Yes / No / Exclusion• At least 1 patient sends or responds to a secure message electronically via a patient portal.

10. Public Health Reporting – Yes / No / Exclusion • Measure 1: Immunization Registry Reporting• Measure 2: Syndromic Surveillance Reporting• Measure 3: Specialized Registry Reporting

MU 2016 – 10 Objectives (cont.)

MU 2016 – Clinical Quality Measures

You must select 9 measures that cover at least 3 of the 6 domains Patient and Family Engagement Patient Safety Population / Public Health Efficient Use of Healthcare Resources Clinical Process / Effectiveness Care Coordination

There are no thresholds for CQMs, so you can report “0” on these measures

Attestation Deadline

Returning and New Participants who successfully demonstrate Meaningful Use for this CY 2016 and satisfy all other program requirements will avoid the payment adjustment in CY 2018 if the EP successfully attests by February 28, 2017.

Don’t wait until the last minute to prepare

What you do now can prepare you for a successful attestation. 1. Confirm your provider’s stage: Returning participant or First time participant2. Check your provider’s registration status

• NPPES login information• Verify email address• Verify payment information is correct• Identity and Access management• Does each provider have a surrogate user and is the login information up

to date?3. Verify your EHR vendor is certified and your software meets the certification

requirements for 2016.4. Verify Reporting tools are in place and working properly.

• If you have not already done so, get benchmark reporting as soon as possible.

5. Complete your Meaningful use audit binder to ensure your data and screenshots reflect your reporting period.

What’s Next???

Meaningful Use is NOT dead!MIPS: Merit-Based Incentive Payment System

MACRA: Medicare Access and CHIP Reauthorization ActBeginning in 2017 providers will be annually measured in 4 performance categories:• Meaningful Use (proposed rename: “Advancing Care

Information”)• Value Based Modifier for Cost• PQRS and Value Base Modifier for Quality• Clinical Practice Improvement

These programs make up 85% of the MIPS score.

Improve on these programs NOW

IS YOUR PRACTICE HEADING IN THE

RIGHT DIRECTION?????

In order to potentially increase your net revenue now and help prepare yourself and your practice to become “MIPS/MACRA ready”, you should:

• Report data on quality measures through the Physician Quality Reporting System.

• Know your Quality and Resource Use Report• Use your electronic health record (EHR) and attest to Meaningful use• If your practice doesn’t provide chronic care management (CCM) services,

consider starting now.

The Future of MU

• Meaningful Use IS expected to change again under MACRA/MIPS, but it is not going away.

• The pending changes will affect the Medicare MU program but not necessarily the Medicaid MU program currently scheduled to end in 2021.

State of the Practice Review

• Complimentary• 30 Minutes to Run• Available for any EHR/PM System

State of the Practice Report

• Top 20 Payers• Denial Rate• A/R Aging• Bill Lag Time• Charge Entry Lag Time• Unapplied Credits• Active Contracts• BBP Jobs List• Average Appointment per Day

by Provider

The State of the Practice Report captures information in these areas

• First Third Appointment by Resource• Meaningful Use Attestation• CQM/PQRS by Provider• CCM Coding• Users with Old/Unresolved Tasks• All Templates by Usage• All KBM Templates in Use During the

Last 2 Months• Open Referrals• MIPS Bonus/Penalty• Unspecified ICD-10 Codes in Use

Q&A